ABSTRACT
This chapter examines the nature and pathways of interaction in infectious disease syndemics, presents a number of cases of this phenomenon, and discusses the importance of environmentally mediated syndemics. It shows that syndemics are not a minor element in infectious diseases but, in fact, are a fundamental component of the human-pathogen story. The chapter considers two levels of interaction: between humans and their physical environments and between diseases and human bodies. It also considers on two more levels of interaction: among infectious diseases and among infectious and non-infectious diseases. The chapter discusses the social structuring of disease clustering. Research in various sites in sub-Saharan Africa affirms that SAVA has added to the disease burden of countries already carrying disproportionate levels of disease clustering. In the poorest areas of the world and in very poor populations the world over a fateful interaction occurs between HIV and malnutrition.
