A Multilevel Analysis of Neighborhood Socioeconomic Disadvantage and Transactional Sex with Casual Partners Among Young Men Who Have Sex with Men Living in Metro Detroit

The role of structural factors when evaluating the vulnerability of human immunodeficiency virus/sexually transmitted infection (HIV/STI) risks among young gay, bisexual, and other men who have sex with men is an important area of focus for HIV prevention. Using cross-sectional data from young men living in Metro Detroit (N = 319; aged 18–29 years; 50% black, 25% white, 15% Latino, 9% other race/ethnicity; 9% HIV-positive), we examined whether transactional sex with casual partners was associated with neighborhood-level socioeconomic disadvantage and individual-level factors (race/ethnicity and sexual identity, socioeconomic status, HIV/STI diagnoses, and substance use). Youth living in greater socioeconomic disadvantage reported more transactional sex (b = 0.11; SE = 0.04; p ≤ 0.01). This relationship was mitigated once individual-level correlates were entered into the model. Multilevel efforts to counteract socioeconomic deficits through community and individual level strategies may alleviate youth's exposure to transactional sex and reduce their vulnerability to HIV/STI risks.

[1]  J. Bauermeister,et al.  Transactional Sex With Regular and Casual Partners Among Young Men Who Have Sex With Men in the Detroit Metro Area , 2017, American journal of men's health.

[2]  P. Polverini.  A curriculum for the new dental practitioner: preparing dentists for a prospective oral health care environment. , 2012, American journal of public health.

[3]  C. Beyrer,et al.  Elevated Risk for HIV Infection among Men Who Have Sex with Men in Low- and Middle-Income Countries 2000–2006: A Systematic Review , 2007, PLoS medicine.

[4]  J. Bauermeister,et al.  Sexuality-Related Work Discrimination and Its Association with the Health of Sexual Minority Emerging and Young Adult Men in the Detroit Metro Area , 2013, Sexuality Research and Social Policy.

[5]  M. Padilla,et al.  “No jobs, more crime. More jobs, less crime”: structural factors affecting the health of Latino men in Detroit , 2012 .

[6]  J. Bauermeister,et al.  Neighborhood Disadvantage and Changes in Condom Use among African American Adolescents , 2011, Journal of urban health.

[7]  E. Rice,et al.  Venue-Based Network Analysis to Inform HIV Prevention Efforts Among Young Gay, Bisexual, and Other Men Who Have Sex With Men , 2014, Prevention Science.

[8]  R. Snow,et al.  Interpersonal Relationships and Social Support in Transitioning Narratives of Black Transgender Women in Detroit , 2014 .

[9]  J. Bauermeister,et al.  The role of provider interactions on comprehensive sexual healthcare among young men who have sex with men. , 2015, AIDS education and prevention : official publication of the International Society for AIDS Education.

[10]  S. Reisner,et al.  Transactional Sex and the HIV Epidemic Among Men Who have Sex with Men (MSM): Results From a Systematic Review and Meta-analysis , 2015, AIDS and Behavior.

[11]  K. Dunkle,et al.  Economically Motivated Relationships and Transactional Sex among Unmarried African American and White Women: Results from a U.S. National Telephone Survey , 2010, Public health reports.

[12]  J. Bauermeister,et al.  Individual and Neighborhood Correlates of HIV testing among african american youth transitioning from adolescence into young adulthood. , 2010, AIDS education and prevention : official publication of the International Society for AIDS Education.

[13]  G. Marks,et al.  Mistaken Assumptions and Missed Opportunities: Correlates of Undiagnosed HIV Infection Among Black and Latino Men Who Have Sex With Men , 2011, Journal of acquired immune deficiency syndromes.

[14]  David R Williams,et al.  Racial and spatial relations as fundamental determinants of health in Detroit. , 2002, The Milbank quarterly.

[15]  S. Kalichman,et al.  Alcohol Use and Sexual Risks for HIV/AIDS in Sub-Saharan Africa: Systematic Review of Empirical Findings , 2007, Prevention Science.

[16]  Patrick M. O'Malley,et al.  National Survey Results on Drug Use from the Monitoring the Future Study, 1975-1995. Volume II: College Students and Young Adults. , 1997 .

[17]  B. Mustanski,et al.  HIV in Young Men Who Have Sex with Men: A Review of Epidemiology, Risk and Protective Factors, and Interventions , 2011, Journal of sex research.

[18]  S. Galea,et al.  Neighborhoods and HIV: a social ecological approach to prevention and care. , 2013, The American psychologist.

[19]  G. Millett,et al.  Modeling the impact of social discrimination and financial hardship on the sexual risk of HIV among Latino and Black men who have sex with men. , 2012, American journal of public health.

[20]  R. Sampson,et al.  Community Structure and Crime: Testing Social-Disorganization Theory , 1989, American Journal of Sociology.

[21]  P. Halkitis,et al.  Incidence of HIV Infection in Young Gay, Bisexual, and Other YMSM: The P18 Cohort Study , 2015, Journal of acquired immune deficiency syndromes.

[22]  P. Aggleton,et al.  Structural approaches to HIV prevention , 2008, The Lancet.

[23]  J. Bauermeister,et al.  Sexuality and HiV/aidS PreVention , 2014 .

[24]  K. Blankenship,et al.  Structural interventions in public health , 2000, AIDS.

[25]  N. E. Walls,et al.  Correlates of Engaging in Survival Sex among Homeless Youth and Young Adults , 2011, Journal of sex research.