An adverse condition or a disease can (either directly or indirectly) interact in a synergistic fashion with other adverse conditions or diseases/maladies, and co-cluster together with them: this fundamental observation is at the basis of the term “syndemic” (a portmanteau for “synergistic epidemic”). This term was introduced for the first time by the American medical anthropologist Merrill Singer (McKeesport, Pennsylvania, USA, 1950), who developed the conceptual framework of the so-called “syndemics theory” in the mid-1990s. Singer noted that women from ethnic minorities reported multiple comorbidities and co-occurring conditions, such as human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), violence, substance abuse, and poverty/marginalization. Sexual and gender communities have been disproportionately affected by the COVID-19 pandemic, even though the precise magnitude and extent of such an impact are unknown. Very few studies have explored this topic. For instance, some works have found that the implementation of some non-pharmaceutical interventions, such as social distancing, cancelations/bans, and other restrictions, can be associated with discriminatory attitudes among queer people, especially those living with HIV. Furthermore, the United States CDCs have reported how sexual and gender minorities are at higher risk for contracting COVID-19 and developing complications, in that they have a higher likelihood of suffering from underlying comorbidities that represent major risk factors for COVID-19. Sexual orientation and gender identity are major modifying factors for the “Health Belief Model” during the COVID-19 pandemic and should be incorporated within theoretical/conceptual frameworks when public health professionals, mathematical modellers, and relevant stakeholders devise and implement COVID-19-related preventative interventions.

Dr. Nicola Luigi Bragazzi got their medical degree (MD) in general medicine and surgery from Genoa University (Genoa, Italy) in 2011, their PhD in biophysics from Marburg University (Marburg, Germany) in 2014 and their specialization in Public Health, Epidemiology, and Biostatistics from Genoa University (Genoa, Italy) in 2017. They collaborate with the Cochrane Association as Cochrane Reviewer for the Cochrane Epilepsy Group. They have been awarded as Young Knight of the Italian Republic by President Carlo Azeglio Ciampi in 2005. They are currently working in the field of infectious disease and vaccination modelling and big data mining in biomedicine at York University, Toronto, ON, Canada

Related publication: 'The COVID-19 Pandemic Seen from a Syndemic Perspective: The LGBTQIA2SP+ Community' https://pubmed.ncbi.nlm.nih.gov/34698177/