The Social Context of HIV Prevention and Care among Black Men Who Have Sex with Men in Three U.S. Cities

The Neighborhoods and Networks (N2) Cohort Study

Dustin Duncan, De Marc A. Hickson, William C. Goedel, Denton Callander, Brandon Brooks, Yen Tyng Chen, Hillary Hanson, Rebecca Eavou, Aditya S. Khanna, Basile Chaix, Seann D. Regan, Darrell P. Wheeler, Kenneth H. Mayer, Steven A. Safren, Sandra Carr Melvin, Cordarian Draper, Veronica Magee-Jackson, Russell Brewer, John A. Schneider

Research output: Contribution to journalArticle

Abstract

Background: In many parts of the world, stark racial disparities in human immunodeficiency virus (HIV) prevalence, incidence, prevention, and care outcomes persist among gay, bisexual, and other men who have sex with men (MSM), with Black MSM significantly impacted in the United States (U.S.). Individual-level characteristics, including sexual behaviors and socioeconomic status, do not fully account for racial/ethnic disparities in HIV among MSM. We hypothesize that neighborhood contexts and network characteristics influence risk for HIV infection as well as HIV-related prevention and care behaviors. As such, the study design includes the use of real-time geospatial methods and in-depth assessments of multiple network typologies to investigate the impact of neighborhood and network-level factors on HIV prevention and treatment among Black MSM residing in longstanding priority HIV elimination areas in the U.S., namely Chicago, Illinois and in the Deep South (Jackson, Mississippi and New Orleans, Louisiana) (n = 450, n = 50, and n = 100, respectively). We describe the design, sampling methods, data collection, data management methods, and preliminary findings of the ongoing 'Neighborhoods and Networks (N2) Cohort Study'. Methods/Design: N2 employs a prospective longitudinal design. The sample includes Black MSM participants in Chicago recruited via respondent-driven sampling and assessed every six months over two years of follow-up. Participants enrolled in Jackson and New Orleans are being recruited through existing health and community services and assessed every six months over one year of follow-up. Mobility within and between neighborhoods is being assessed using global positioning system (GPS) technology. Social and sexual networks among Black MSM are being studied through egocentric network inventories as well as newer methods of creating meso-level networks that involve social media (Facebook) and mobile phone contacts. Key HIV prevention outcomes such as pre-exposure prophylaxis (PrEP) care engagement, and HIV/STI (sexually transmitted infections) biomarkers will be examined at baseline and follow-up. Results: As of 31 December 2018, a total of 361 men were enrolled across all study sites: 259 in Chicago and 102 in the Deep South (75 in New Orleans and 27 in Jackson). At baseline, participants ranged in age from 17 to 65 years old (mean = 34.3, standard deviation = 5.1) with 123 men (34.1%) self-reported as HIV positive. While HIV treatment levels were similar between sites, men in the Deep South reported higher rates of adherence than men in Chicago (63.3% versus 49.4%, p = 0.03). Sexual risk profiles were mainly the same between men from different study sites, with 22.9% of men in Chicago and 28.9% in the Deep South reporting consistent condom use during vaginal and anal sex (p = 0.26). Regarding their home neighborhoods, men in the Deep South were more likely than those in Chicago to characterize theirs as having a good reputation (43.1% versus 24.7%, p < 0.001) and as being safe (37.3% versus 21.2%, p = 0.002). Conclusions: The focus on Black MSM in the N2 Study will allow for a nuanced exploration of the attitudes, beliefs, behaviors, and practices of a diverse group of Black MSM. The study is also positioned to provide novel insight about neighborhood and network characteristics that influence HIV-related behaviors. A health equity framework ensures that Black MSM are not explicitly or implicitly deemed as deviant, disordered, or the non-reference group. Findings from N2 will provide guidance for the implementation of more impactful HIV prevention interventions that engage a diverse population of Black MSM as we work toward HIV elimination in the U.S.

Original languageEnglish (US)
JournalInternational journal of environmental research and public health
Volume16
Issue number11
DOIs
StatePublished - May 30 2019

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Cohort Studies
HIV
Sexually Transmitted Diseases
Sexual Behavior
Social Media
Mississippi
Geographic Information Systems
Cell Phones
Social Welfare
Condoms
Virus Diseases
Social Class
Social Support
Health Services
Biomarkers
Technology
Equipment and Supplies
Incidence
Therapeutics

Keywords

  • African American
  • black
  • gay men’s health
  • geography
  • HIV care
  • HIV prevention
  • men who have sex with men (MSM)
  • minority
  • neighborhoods
  • networks

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

The Social Context of HIV Prevention and Care among Black Men Who Have Sex with Men in Three U.S. Cities : The Neighborhoods and Networks (N2) Cohort Study. / Duncan, Dustin; Hickson, De Marc A.; Goedel, William C.; Callander, Denton; Brooks, Brandon; Chen, Yen Tyng; Hanson, Hillary; Eavou, Rebecca; Khanna, Aditya S.; Chaix, Basile; Regan, Seann D.; Wheeler, Darrell P.; Mayer, Kenneth H.; Safren, Steven A.; Carr Melvin, Sandra; Draper, Cordarian; Magee-Jackson, Veronica; Brewer, Russell; Schneider, John A.

In: International journal of environmental research and public health, Vol. 16, No. 11, 30.05.2019.

Research output: Contribution to journalArticle

Duncan, D, Hickson, DMA, Goedel, WC, Callander, D, Brooks, B, Chen, YT, Hanson, H, Eavou, R, Khanna, AS, Chaix, B, Regan, SD, Wheeler, DP, Mayer, KH, Safren, SA, Carr Melvin, S, Draper, C, Magee-Jackson, V, Brewer, R & Schneider, JA 2019, 'The Social Context of HIV Prevention and Care among Black Men Who Have Sex with Men in Three U.S. Cities: The Neighborhoods and Networks (N2) Cohort Study', International journal of environmental research and public health, vol. 16, no. 11. https://doi.org/10.3390/ijerph16111922
Duncan, Dustin ; Hickson, De Marc A. ; Goedel, William C. ; Callander, Denton ; Brooks, Brandon ; Chen, Yen Tyng ; Hanson, Hillary ; Eavou, Rebecca ; Khanna, Aditya S. ; Chaix, Basile ; Regan, Seann D. ; Wheeler, Darrell P. ; Mayer, Kenneth H. ; Safren, Steven A. ; Carr Melvin, Sandra ; Draper, Cordarian ; Magee-Jackson, Veronica ; Brewer, Russell ; Schneider, John A. / The Social Context of HIV Prevention and Care among Black Men Who Have Sex with Men in Three U.S. Cities : The Neighborhoods and Networks (N2) Cohort Study. In: International journal of environmental research and public health. 2019 ; Vol. 16, No. 11.
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title = "The Social Context of HIV Prevention and Care among Black Men Who Have Sex with Men in Three U.S. Cities: The Neighborhoods and Networks (N2) Cohort Study",
abstract = "Background: In many parts of the world, stark racial disparities in human immunodeficiency virus (HIV) prevalence, incidence, prevention, and care outcomes persist among gay, bisexual, and other men who have sex with men (MSM), with Black MSM significantly impacted in the United States (U.S.). Individual-level characteristics, including sexual behaviors and socioeconomic status, do not fully account for racial/ethnic disparities in HIV among MSM. We hypothesize that neighborhood contexts and network characteristics influence risk for HIV infection as well as HIV-related prevention and care behaviors. As such, the study design includes the use of real-time geospatial methods and in-depth assessments of multiple network typologies to investigate the impact of neighborhood and network-level factors on HIV prevention and treatment among Black MSM residing in longstanding priority HIV elimination areas in the U.S., namely Chicago, Illinois and in the Deep South (Jackson, Mississippi and New Orleans, Louisiana) (n = 450, n = 50, and n = 100, respectively). We describe the design, sampling methods, data collection, data management methods, and preliminary findings of the ongoing 'Neighborhoods and Networks (N2) Cohort Study'. Methods/Design: N2 employs a prospective longitudinal design. The sample includes Black MSM participants in Chicago recruited via respondent-driven sampling and assessed every six months over two years of follow-up. Participants enrolled in Jackson and New Orleans are being recruited through existing health and community services and assessed every six months over one year of follow-up. Mobility within and between neighborhoods is being assessed using global positioning system (GPS) technology. Social and sexual networks among Black MSM are being studied through egocentric network inventories as well as newer methods of creating meso-level networks that involve social media (Facebook) and mobile phone contacts. Key HIV prevention outcomes such as pre-exposure prophylaxis (PrEP) care engagement, and HIV/STI (sexually transmitted infections) biomarkers will be examined at baseline and follow-up. Results: As of 31 December 2018, a total of 361 men were enrolled across all study sites: 259 in Chicago and 102 in the Deep South (75 in New Orleans and 27 in Jackson). At baseline, participants ranged in age from 17 to 65 years old (mean = 34.3, standard deviation = 5.1) with 123 men (34.1{\%}) self-reported as HIV positive. While HIV treatment levels were similar between sites, men in the Deep South reported higher rates of adherence than men in Chicago (63.3{\%} versus 49.4{\%}, p = 0.03). Sexual risk profiles were mainly the same between men from different study sites, with 22.9{\%} of men in Chicago and 28.9{\%} in the Deep South reporting consistent condom use during vaginal and anal sex (p = 0.26). Regarding their home neighborhoods, men in the Deep South were more likely than those in Chicago to characterize theirs as having a good reputation (43.1{\%} versus 24.7{\%}, p < 0.001) and as being safe (37.3{\%} versus 21.2{\%}, p = 0.002). Conclusions: The focus on Black MSM in the N2 Study will allow for a nuanced exploration of the attitudes, beliefs, behaviors, and practices of a diverse group of Black MSM. The study is also positioned to provide novel insight about neighborhood and network characteristics that influence HIV-related behaviors. A health equity framework ensures that Black MSM are not explicitly or implicitly deemed as deviant, disordered, or the non-reference group. Findings from N2 will provide guidance for the implementation of more impactful HIV prevention interventions that engage a diverse population of Black MSM as we work toward HIV elimination in the U.S.",
keywords = "African American, black, gay men’s health, geography, HIV care, HIV prevention, men who have sex with men (MSM), minority, neighborhoods, networks",
author = "Dustin Duncan and Hickson, {De Marc A.} and Goedel, {William C.} and Denton Callander and Brandon Brooks and Chen, {Yen Tyng} and Hillary Hanson and Rebecca Eavou and Khanna, {Aditya S.} and Basile Chaix and Regan, {Seann D.} and Wheeler, {Darrell P.} and Mayer, {Kenneth H.} and Safren, {Steven A.} and {Carr Melvin}, Sandra and Cordarian Draper and Veronica Magee-Jackson and Russell Brewer and Schneider, {John A.}",
year = "2019",
month = "5",
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doi = "10.3390/ijerph16111922",
language = "English (US)",
volume = "16",
journal = "International Journal of Environmental Research and Public Health",
issn = "1661-7827",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
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TY - JOUR

T1 - The Social Context of HIV Prevention and Care among Black Men Who Have Sex with Men in Three U.S. Cities

T2 - The Neighborhoods and Networks (N2) Cohort Study

AU - Duncan, Dustin

AU - Hickson, De Marc A.

AU - Goedel, William C.

AU - Callander, Denton

AU - Brooks, Brandon

AU - Chen, Yen Tyng

AU - Hanson, Hillary

AU - Eavou, Rebecca

AU - Khanna, Aditya S.

AU - Chaix, Basile

AU - Regan, Seann D.

AU - Wheeler, Darrell P.

AU - Mayer, Kenneth H.

AU - Safren, Steven A.

AU - Carr Melvin, Sandra

AU - Draper, Cordarian

AU - Magee-Jackson, Veronica

AU - Brewer, Russell

AU - Schneider, John A.

PY - 2019/5/30

Y1 - 2019/5/30

N2 - Background: In many parts of the world, stark racial disparities in human immunodeficiency virus (HIV) prevalence, incidence, prevention, and care outcomes persist among gay, bisexual, and other men who have sex with men (MSM), with Black MSM significantly impacted in the United States (U.S.). Individual-level characteristics, including sexual behaviors and socioeconomic status, do not fully account for racial/ethnic disparities in HIV among MSM. We hypothesize that neighborhood contexts and network characteristics influence risk for HIV infection as well as HIV-related prevention and care behaviors. As such, the study design includes the use of real-time geospatial methods and in-depth assessments of multiple network typologies to investigate the impact of neighborhood and network-level factors on HIV prevention and treatment among Black MSM residing in longstanding priority HIV elimination areas in the U.S., namely Chicago, Illinois and in the Deep South (Jackson, Mississippi and New Orleans, Louisiana) (n = 450, n = 50, and n = 100, respectively). We describe the design, sampling methods, data collection, data management methods, and preliminary findings of the ongoing 'Neighborhoods and Networks (N2) Cohort Study'. Methods/Design: N2 employs a prospective longitudinal design. The sample includes Black MSM participants in Chicago recruited via respondent-driven sampling and assessed every six months over two years of follow-up. Participants enrolled in Jackson and New Orleans are being recruited through existing health and community services and assessed every six months over one year of follow-up. Mobility within and between neighborhoods is being assessed using global positioning system (GPS) technology. Social and sexual networks among Black MSM are being studied through egocentric network inventories as well as newer methods of creating meso-level networks that involve social media (Facebook) and mobile phone contacts. Key HIV prevention outcomes such as pre-exposure prophylaxis (PrEP) care engagement, and HIV/STI (sexually transmitted infections) biomarkers will be examined at baseline and follow-up. Results: As of 31 December 2018, a total of 361 men were enrolled across all study sites: 259 in Chicago and 102 in the Deep South (75 in New Orleans and 27 in Jackson). At baseline, participants ranged in age from 17 to 65 years old (mean = 34.3, standard deviation = 5.1) with 123 men (34.1%) self-reported as HIV positive. While HIV treatment levels were similar between sites, men in the Deep South reported higher rates of adherence than men in Chicago (63.3% versus 49.4%, p = 0.03). Sexual risk profiles were mainly the same between men from different study sites, with 22.9% of men in Chicago and 28.9% in the Deep South reporting consistent condom use during vaginal and anal sex (p = 0.26). Regarding their home neighborhoods, men in the Deep South were more likely than those in Chicago to characterize theirs as having a good reputation (43.1% versus 24.7%, p < 0.001) and as being safe (37.3% versus 21.2%, p = 0.002). Conclusions: The focus on Black MSM in the N2 Study will allow for a nuanced exploration of the attitudes, beliefs, behaviors, and practices of a diverse group of Black MSM. The study is also positioned to provide novel insight about neighborhood and network characteristics that influence HIV-related behaviors. A health equity framework ensures that Black MSM are not explicitly or implicitly deemed as deviant, disordered, or the non-reference group. Findings from N2 will provide guidance for the implementation of more impactful HIV prevention interventions that engage a diverse population of Black MSM as we work toward HIV elimination in the U.S.

AB - Background: In many parts of the world, stark racial disparities in human immunodeficiency virus (HIV) prevalence, incidence, prevention, and care outcomes persist among gay, bisexual, and other men who have sex with men (MSM), with Black MSM significantly impacted in the United States (U.S.). Individual-level characteristics, including sexual behaviors and socioeconomic status, do not fully account for racial/ethnic disparities in HIV among MSM. We hypothesize that neighborhood contexts and network characteristics influence risk for HIV infection as well as HIV-related prevention and care behaviors. As such, the study design includes the use of real-time geospatial methods and in-depth assessments of multiple network typologies to investigate the impact of neighborhood and network-level factors on HIV prevention and treatment among Black MSM residing in longstanding priority HIV elimination areas in the U.S., namely Chicago, Illinois and in the Deep South (Jackson, Mississippi and New Orleans, Louisiana) (n = 450, n = 50, and n = 100, respectively). We describe the design, sampling methods, data collection, data management methods, and preliminary findings of the ongoing 'Neighborhoods and Networks (N2) Cohort Study'. Methods/Design: N2 employs a prospective longitudinal design. The sample includes Black MSM participants in Chicago recruited via respondent-driven sampling and assessed every six months over two years of follow-up. Participants enrolled in Jackson and New Orleans are being recruited through existing health and community services and assessed every six months over one year of follow-up. Mobility within and between neighborhoods is being assessed using global positioning system (GPS) technology. Social and sexual networks among Black MSM are being studied through egocentric network inventories as well as newer methods of creating meso-level networks that involve social media (Facebook) and mobile phone contacts. Key HIV prevention outcomes such as pre-exposure prophylaxis (PrEP) care engagement, and HIV/STI (sexually transmitted infections) biomarkers will be examined at baseline and follow-up. Results: As of 31 December 2018, a total of 361 men were enrolled across all study sites: 259 in Chicago and 102 in the Deep South (75 in New Orleans and 27 in Jackson). At baseline, participants ranged in age from 17 to 65 years old (mean = 34.3, standard deviation = 5.1) with 123 men (34.1%) self-reported as HIV positive. While HIV treatment levels were similar between sites, men in the Deep South reported higher rates of adherence than men in Chicago (63.3% versus 49.4%, p = 0.03). Sexual risk profiles were mainly the same between men from different study sites, with 22.9% of men in Chicago and 28.9% in the Deep South reporting consistent condom use during vaginal and anal sex (p = 0.26). Regarding their home neighborhoods, men in the Deep South were more likely than those in Chicago to characterize theirs as having a good reputation (43.1% versus 24.7%, p < 0.001) and as being safe (37.3% versus 21.2%, p = 0.002). Conclusions: The focus on Black MSM in the N2 Study will allow for a nuanced exploration of the attitudes, beliefs, behaviors, and practices of a diverse group of Black MSM. The study is also positioned to provide novel insight about neighborhood and network characteristics that influence HIV-related behaviors. A health equity framework ensures that Black MSM are not explicitly or implicitly deemed as deviant, disordered, or the non-reference group. Findings from N2 will provide guidance for the implementation of more impactful HIV prevention interventions that engage a diverse population of Black MSM as we work toward HIV elimination in the U.S.

KW - African American

KW - black

KW - gay men’s health

KW - geography

KW - HIV care

KW - HIV prevention

KW - men who have sex with men (MSM)

KW - minority

KW - neighborhoods

KW - networks

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