Sexual Networks and HIV Risk among Black Men Who Have Sex with Men in 6 U.S. Cities

Background Sexual networks may place U.S. Black men who have sex with men (MSM) at increased HIV risk. Methods Self-reported egocentric sexual network data from the prior six months were collected from 1,349 community-recruited Black MSM in HPTN 061, a multi-component HIV prevention intervention feasibility study. Sexual network composition, size, and density (extent to which members are having sex with one another) were compared by self-reported HIV serostatus and age of the men. GEE models assessed network and other factors associated with having a Black sex partner, having a partner with at least two age category difference (age difference between participant and partner of at least two age group categories), and having serodiscordant/serostatus unknown unprotected anal/vaginal intercourse (SDUI) in the last six months. Results Over half had exclusively Black partners in the last six months, 46% had a partner of at least two age category difference, 87% had ≤5 partners. Nearly 90% had sex partners who were also part of their social networks. Among HIV-negative men, not having anonymous/exchange/ trade partners and lower density were associated with having a Black partner; larger sexual network size and having non-primary partners were associated with having a partner with at least two age category difference; and having anonymous/exchange/ trade partners was associated with SDUI. Among HIV-positive men, not having non-primary partners was associated with having a Black partner; no sexual network characteristics were associated with having a partner with at least two age category difference and SDUI. Conclusions Black MSM sexual networks were relatively small and often overlapped with the social networks. Sexual risk was associated with having non-primary partners and larger network size. Network interventions that engage the social networks of Black MSM, such as interventions utilizing peer influence, should be developed to address stable partnerships, number of partners, and serostatus disclosure.

[1]  M. Okano,et al.  Cohort Study , 2020, Definitions.

[2]  O. Laeyendecker,et al.  Antiretroviral Drug Use and HIV Drug Resistance Among HIV-Infected Black Men Who Have Sex With Men: HIV Prevention Trials Network 061 , 2015, Journal of acquired immune deficiency syndromes.

[3]  S. Shoptaw,et al.  Effects of syndemics on HIV viral load and medication adherence in the multicentre AIDS cohort study , 2015, AIDS.

[4]  S. Buchbinder,et al.  Infrequent HIV Testing and Late HIV Diagnosis Are Common Among a Cohort of Black Men Who Have Sex With Men in 6 US Cities , 2014, Journal of acquired immune deficiency syndromes.

[5]  P. Sullivan,et al.  Understanding Racial HIV/STI Disparities in Black and White Men Who Have Sex with Men: A Multilevel Approach , 2014, PloS one.

[6]  K. Mayer,et al.  Exploring the Relationship Between Incarceration and HIV Among Black Men Who Have Sex With Men in the United States , 2014, Journal of acquired immune deficiency syndromes.

[7]  Edward O. Laumann,et al.  Structural Bridging Network Position is Associated with HIV Status in a Younger Black Men Who Have Sex with Men Epidemic , 2014, AIDS and Behavior.

[8]  Julia Zhu,et al.  HIV Infection and Awareness among Men Who Have Sex with Men–20 Cities, United States, 2008 and 2011 , 2013, PloS one.

[9]  S. Buchbinder,et al.  Correlates of HIV Acquisition in a Cohort of Black Men Who Have Sex with Men in the United States: HIV Prevention Trials Network (HPTN) 061 , 2013, PloS one.

[10]  B. Mustanski,et al.  Racial Differences in Same-Race Partnering and the Effects of Sexual Partnership Characteristics on HIV Risk in MSM: A Prospective Sexual Diary Study , 2013, Journal of acquired immune deficiency syndromes.

[11]  R. Burt,et al.  Social network analysis: foundations and frontiers on advantage. , 2013, Annual review of psychology.

[12]  Emily C. Pike,et al.  Investigating a Sexual Network of Black Men Who Have Sex With Men: Implications for Transmission and Prevention of HIV Infection in the United States , 2012, Journal of acquired immune deficiency syndromes.

[13]  P. Sullivan,et al.  Discussion of HIV Status by Serostatus and Partnership Sexual Risk Among Internet-Using MSM in the United States , 2012, Journal of acquired immune deficiency syndromes.

[14]  T. Hart,et al.  Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis , 2012, The Lancet.

[15]  J. Chmiel,et al.  Application of Syndemic Theory to Black Men Who Have Sex with Men in the Multicenter AIDS Cohort Study , 2012, Journal of Urban Health.

[16]  A. Lansky,et al.  Comparison of Demographic and Behavioral Characteristics of Men Who Have Sex With Men by Enrollment Venue Type in the National HIV Behavioral Surveillance System , 2012, Sexually transmitted diseases.

[17]  Melissa R. Wong,et al.  Differences in Risk Behaviors and Partnership Patterns Between Younger and Older Men Who Have Sex With Men in New York City , 2011, Journal of acquired immune deficiency syndromes.

[18]  D. Pieniążek,et al.  Demographic but not geographic insularity in HIV transmission among young black MSM , 2011, AIDS.

[19]  W. Mcfarland,et al.  Improved measures of racial mixing among men who have sex with men using Newman's assortativity coefficient , 2011, Sexually Transmitted Infections.

[20]  A. Oster,et al.  HIV risk among young African American men who have sex with men: a case-control study in Mississippi. , 2011, American journal of public health.

[21]  Ruiguang Song,et al.  Estimated HIV Incidence in the United States, 2006–2009 , 2011, PloS one.

[22]  G. Marks,et al.  Older partner selection, sexual risk behaviour and unrecognised HIV infection among black and Latino men who have sex with men , 2011, Sexually Transmitted Infections.

[23]  H. Tieu,et al.  Sexual Partner Characteristics, Serodiscordant/Serostatus Unknown Unprotected Anal Intercourse and Disclosure Among Human Immunodeficiency Virus-Infected and Uninfected Black Men Who Have Sex With Men in New York City , 2011, Sexually transmitted diseases.

[24]  R. Wiegand,et al.  Understanding disparities in HIV infection between black and white MSM in the United States , 2011, AIDS.

[25]  David R. Holtgrave,et al.  Persistently High Prevalence and Unrecognized HIV Infection Among Men Who Have Sex With Men in Baltimore: The BESURE Study , 2011, Journal of Acquired Immune Deficiency Syndromes.

[26]  Patrick S Sullivan,et al.  Number of casual male sexual partners and associated factors among men who have sex with men: Results from the National HIV Behavioral Surveillance system , 2011, BMC public health.

[27]  A. Greenberg,et al.  Elevated HIV prevalence despite lower rates of sexual risk behaviors among black men in the District of Columbia who have sex with men. , 2010, AIDS patient care and STDs.

[28]  D. Celentano,et al.  Prevalence of HIV Infection and Prior HIV Testing among Young Men Who have Sex with Men. The Baltimore Young Men’s Survey , 2010, AIDS and Behavior.

[29]  and Projections Working Group on Measuring Concurrent Modelling.  HIV: consensus indicators are needed for concurrency , 2010, The Lancet.

[30]  S. Kalichman,et al.  Sexual partner selection and HIV risk reduction among Black and White men who have sex with men. , 2010, American journal of public health.

[31]  Irene A Doherty,et al.  Sexual Mixing Patterns and Heterosexual HIV Transmission Among African Americans in the Southeastern United States , 2009, Journal of acquired immune deficiency syndromes.

[32]  Richard Rothenberg,et al.  HIV transmission networks , 2009, Current opinion in HIV and AIDS.

[33]  W. Mcfarland,et al.  Racial Mixing and HIV Risk Among Men Who Have Sex with Men , 2009, AIDS and Behavior.

[34]  S. Reisner,et al.  Sexual Mixing Patterns and Partner Characteristics of Black MSM in Massachusetts at Increased Risk for HIV Infection and Transmission , 2009, Journal of Urban Health.

[35]  W. Mcfarland,et al.  Same race and older partner selection may explain higher HIV prevalence among black men who have sex with men , 2007, AIDS.

[36]  R. Bakeman,et al.  Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors , 2007, AIDS.

[37]  R. Rothenberg.  Maintenance of endemicity in urban environments: a hypothesis linking risk, network structure and geography , 2006, Sexually Transmitted Infections.

[38]  M. Gottlieb,et al.  Pneumocystis pneumonia--Los Angeles. , 2006, MMWR. Morbidity and mortality weekly report.

[39]  R. Wolitski,et al.  Greater risk for HIV infection of black men who have sex with men: a critical literature review. , 2006, American journal of public health.

[40]  S. Buchbinder,et al.  Risk factors for HIV infection among men who have sex with men , 2006, AIDS.

[41]  D. Wohlfeiler,et al.  Using Gay Men’s Sexual Networks to Reduce Sexually Transmitted Disease (STD)/Human Immunodeficiency Virus (HIV) Transmission , 2005, Sexually transmitted diseases.

[42]  Teresa Cabral,et al.  Identification of networks of sexually transmitted infection: a molecular, geographic, and social network analysis. , 2005, The Journal of infectious diseases.

[43]  Irene A. Doherty,et al.  Determinants and consequences of sexual networks as they affect the spread of sexually transmitted infections. , 2005, The Journal of infectious diseases.

[44]  Adaora A Adimora,et al.  Social context, sexual networks, and racial disparities in rates of sexually transmitted infections. , 2005, The Journal of infectious diseases.

[45]  S. Buchbinder,et al.  High-risk behaviors among men who have sex with men in 6 US cities: baseline data from the EXPLORE Study. , 2003, American journal of public health.

[46]  T. Hart,et al.  Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. , 2003, American journal of public health.

[47]  D. Malebranche,et al.  Black men who have sex with men and the HIV epidemic: next steps for public health. , 2003, American journal of public health.

[48]  N. Harawa,et al.  The effect of partner characteristics on HIV infection among African American men who have sex with men in the Young Men's Survey, Los Angeles, 1999-2000. , 2003, AIDS education and prevention : official publication of the International Society for AIDS Education.

[49]  M. Newman,et al.  Mixing patterns in networks. , 2002, Physical review. E, Statistical, nonlinear, and soft matter physics.

[50]  J. Wylie,et al.  Gonorrhoea and chlamydia core groups and sexual networks in Manitoba , 2002, Sexually transmitted infections.

[51]  J. Potterat,et al.  Sexual networks and sexually transmitted infections: A tale of two cities , 2001, Journal of Urban Health.

[52]  John J. Potterat,et al.  The Atlanta Urban Networks Study: a blueprint for endemic transmission , 2000, AIDS.

[53]  R. Rothenberg,et al.  Sociometric risk networks and risk for HIV infection. , 1997, American journal of public health.

[54]  Stanley Wasserman,et al.  Social Network Analysis: Methods and Applications , 1994, Structural analysis in the social sciences.

[55]  John Scott.  What is social network analysis , 2010 .

[56]  Ronald S. Burt,et al.  Network items and the general social survey , 1984 .

[57]  L. Radloff.  The CES-D Scale , 1977 .

[58]  Armando Teixeira-Pinto,et al.  Estimated HIV Incidence in the United States, 2003–2010 , 2017, Journal of acquired immune deficiency syndromes.

[59]  Petra Himmel,et al.  Network Epidemiology A Handbook For Survey Design And Data Collection , 2016 .

[60]  J. Bohlius,et al.  Current Opinion in HIV and AIDS , 2016 .

[61]  S. Buchbinder,et al.  Nondisclosure of HIV status in a clinical trial setting: antiretroviral drug screening can help distinguish between newly diagnosed and previously diagnosed HIV infection. , 2014, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[62]  David Ostrow,et al.  Network mixing and network influences most linked to HIV infection and risk behavior in the HIV epidemic among black men who have sex with men. , 2013, American journal of public health.

[63]  David R. Holtgrave,et al.  HIV Among Black Men Who Have Sex with Men (MSM) in the United States: A Review of the Literature , 2013, AIDS and Behavior.

[64]  Tom A. B. Snijders,et al.  Social Network Analysis , 2011, International Encyclopedia of Statistical Science.

[65]  G. Marks,et al.  Prevalence and protective value of serosorting and strategic positioning among Black and Latino men who have sex with men. , 2010, Sexually transmitted diseases.

[66]  W. Mcfarland,et al.  Racial/Ethnic Differences in Seroadaptive and Serodisclosure Behaviors Among Men Who Have Sex with Men , 2010, AIDS and Behavior.

[67]  H. Tieu,et al.  Sexual Partnering and HIV Risk among Black Men Who Have Sex with Men: New York City , 2009, Journal of Urban Health.

[68]  A. Klovdahl,et al.  Social networks and the spread of infectious diseases: the AIDS example. , 1985, Social science & medicine.