Socioecological profiles of syndemic vulnerability and mental health outcomes among black sexual minority men living with HIV.

Theoretically, socioecological factors interact with syndemic conditions to amplify health problems for highly marginalized populations. However, variable-centered approaches can obscure population heterogeneity regarding risk and resilience. Person-centered methods can identify distinct configurations of socioecological conditions that reflect differing levels of syndemic burden and illuminate subgroup-specific intervention targets. This study used latent profile analysis to examine socioecological risk and protective patterns among Black sexual minority men living with HIV (n = 999). Data collected between 2023 and 2024 included measures of homophobia, anal sex and HIV-related stigma, discrimination, community connectedness, and resilience. Three profiles were identified: (1) Resilient and Connected (30.60%), with above average resilience and connectedness; (2) Average and Connected (38.20%), with strong connectedness; and (3) High Stigma, Low Resilience (31.20%), with low resilience and connectedness. Profiles were distinguished based on sociodemographic characteristics and mental health outcomes. Findings highlight how person-centered approaches can identify syndemic vulnerability and inform targeted interventions for population subgroups.