Structural Competency as a Global Framework for Syndemic HIV Care: A Critical Synthesis

View at publisher
Authors: Katerina Melino, Adam Leonard
Cited by: 2
References: 44

Abstract

ABSTRACT: The co-occurrence of HIV with mental health disorders, substance use, and tuberculosis continues to constitute significant global public health issues. Syndemic theory elucidates how these conditions interact synergistically to exacerbate health outcomes, reduce engagement in care, and hinder adherence to antiretroviral therapy. Structural competency offers a useful framework for conceptualizing and addressing the broader social, economic, and political determinants that influence health outcomes for people living with HIV as well as mental illness, substance use issues, and tuberculosis. We call for a shift toward structural competency, encouraging health care providers to move beyond individual-level interventions and address the root causes of health inequities through holistic, multilevel approaches that improve outcomes for those affected by HIV and its intersecting syndemics.

Fields of Study & Subjects

HIV/AIDS Research and Interventions Adolescent Sexual and Reproductive Health Mental Health and Patient Involvement

Publication details

Journal / source
Journal of the Association of Nurses in AIDS Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Volume
37
Issue
3
Pages
268–277
Publication date
16 January 2026
Language
EN