The Relationship Between Violence Syndemics and Sexual Risk Behaviors Among African American Adolescents: Implications for Future Research.

Abstract Purpose We present a conceptual framework based on a review of the literature to highlight the interconnecting and reinforcing elements of a violence syndemic and how this syndemic influences sexual risk behaviors among African American heterosexual adolescents. Methods We review existing peer-reviewed published research from 2000 to 2020 that links a violence syndemic (i.e., racism and race-related stress, neighborhood and police violence, peer violence, and family violence and disruptions) to adolescent sexual risk behaviors. Empirical findings and theoretical underpinnings are used to document this relationship and illuminate the factors that mediate this relationship. Results Empirical studies support the links between specific types of violence and sexual risk behaviors among African American adolescents. Further, existing studies point to the important relationships among the specific types of violence, supporting a violence syndemic approach. Conclusions While more researchers are examining socio-ecological contextual factors as important predictors for sexual risk behaviors, there remains inadequate understanding about how violence types reinforce one another to heighten sexual risk behaviors among African American heterosexual adolescents. This article presents new directions for adolescent research, especially how a violence syndemic approach can be used to explain sexual risk, but also to refocus intervention design on the complex burdens experienced by this population.