Syndemics theory suggests that there are overlapping, synergistic epidemics that contribute to HIV risk in culturally and socioeconomically marginalized communities. As a conceptual framework, syndemics postulates that HIV is only one of many social problems that infringes upon the health of affected communities. The seminal syndemics literature urges researchers and scholars to identify the socio-cultural antecedents of syndemic production and the conditions facilitative of health and well-being; however, much of the syndemics literature has prioritized the identification of syndemics, rather than the causes of syndemics or the factors that preclude syndemic production. The conceptual syndemics literature is evolving to include attention to protective factors that inhibit or mitigate health problems or risk behavior. In this dissertation, I examined relational factors associated with the avoidance of syndemic production among a group disproportionately likely to be affected by HIV: young Black gay and bisexual men. Using analytic induction, I analyzed the relational lives of 23 young Black gay and bisexual who have avoided syndemic production (i.e., the expression of psychosocial health issues associated with heightened risk for HIV) to examine how relationships and relational factors promote young men's healthy development and sexual health. Using theoretical sampling, I also examined the narratives of 23 young men who evinced syndemic production associated with heighted HIV risk as a means of exploring how they differ in their relational characteristics from men who have avoided syndemics. The young men who avoided syndemic production had rich, fulfilling, supportive relational lives that included relationships with empathic others who supported them as young Black gay and bisexual men, helped them develop a strong sense of personal identity, and provided them with opportunities to give back to their communities. They also had diverse relational networks of people -particularly family members, male friends, and men in the gay community- who promoted pro-social norms about health behaviors. In contrast, the young men experiencing syndemics described numerous instances of trauma and oppression that infringed upon their desire or ability to form strong, healthy relational connections. In these men, pervasive experiences of oppression were associated with shame, identity incongruence, social isolation, relational disconnect, mistrust in other men, and expectations of further rejection and marginalization. Participants' different relational experiences were examined through community psychology's conceptualization of sense of community. As an initial glimpse into relational resilience among young Black gay and bisexual men, results of this study provide evidence for a number of strength-based intervention strategies that researchers may utilize not just in HIV prevention programs, but also in addressing antecedent psychosocial health conditions (i.e., syndemics) that increase vulnerability to HIV. As means of attenuating men's socio-structural barriers to health and addressing comorbid psychosocial health issues, interventions must address young men's social isolation, identity-related issues, and sense of community.
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