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Where You Live Matters: Structural Correlates of HIV Risk Behavior Among Young Men Who Have Sex with Men in Metro Detroit

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Abstract

Structural characteristics are linked to HIV/STI risks, yet few studies have examined the mechanisms through which structural characteristics influence the HIV/STI risk of young men who have sex with men (YMSM). Using data from a cross-sectional survey of YMSM (ages 18–29) living in Detroit Metro (N = 328; 9 % HIV-positive; 49 % Black, 27 % White, 15 % Latino, 9 % Other race), we used multilevel modeling to examine the association between community-level characteristics (e.g., socioeconomic disadvantage; distance to LGBT-affirming institutions) and YMSM’s HIV testing behavior and likelihood of engaging in unprotected anal intercourse with serodiscordant partner(s). We accounted for individual-level factors (race/ethnicity, poverty, homelessness, alcohol and marijuana use) and contextual factors (community acceptance and stigma regarding same-sex sexuality). YMSM in neighborhoods with greater disadvantage and nearer to an AIDS Service Organization were more likely to have tested for HIV and less likely to report serodiscordant partners. Community acceptance was associated with having tested for HIV. Efforts to address YMSM’s exposure to structural barriers in Detroit Metro are needed to inform HIV prevention strategies from a socioecological perspective.

Resumen

Las características estructurales están asociadas a los riesgos de VIH/ETS; sin embargo, pocos estudios han examinado qué mecanismos influyen en las conductas de riesgo de VIH/ETS de los hombres jóvenes que tienen sexo con hombres (YMSM). Utilizando datos de una encuesta de YMSM (edades 18-29) que viven en el área metropolitana de Detroit (N = 328; 9 % VIH positivo; 49 % Negro, 27 % blancos, 15 % latinos, 9 % Otros raza), utilizamos un modelo multinivel para examinar la asociación entre las características a nivel comunitario (por ejemplo, la desventaja socioeconómica, la distancia a las instituciones LGBT afirman) y dos conducta: el testeo de VIH y la probabilidad de tener relaciones anales sin protección con pareja(s) serodiscordante(s). Incluimos factores individuales (raza/etnia, pobreza, falta de vivienda, uso de alcohol y marihuana) y contextuales (aceptación y estigma comunitario respecto a la sexualidad del mismo sexo). YMSM que viven en barrios con mayor desventaja socioeconómica y con más cercanía a organizaciones que proveen servicios de VIH/SIDA fueron más propensos a haber testeado y menos propensos a reportar relaciones sexuales con parejas serodiscordantes. Aceptación comunitaria se asoció con una mayor probabilidad de haber testeado. Esfuerzos para hacer frente a las barreras estructurales en Detroit son necesarias para elucidar el desarrollo de estrategias de prevención del VIH desde una perspectiva socio-ecológica.

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References

  1. Marks G, Crepaz N, Janssen RS. Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS. 2006;20:1447–50.

    Article  PubMed  Google Scholar 

  2. Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. JAIDS. 2005;39:446–53.

    PubMed  Google Scholar 

  3. Colfax GN, Buchbinder SP, Cornelisse PG, Vittinghoff E, Mayer K, Celum C. Sexual risk behaviors and implications for secondary HIV transmission during and after HIV seroconversion. AIDS. 2002;16:1529–35.

    Article  PubMed  Google Scholar 

  4. The U.S. White House. National HIV/AIDS Strategy for the United States. Washington: White House; 2010.

    Google Scholar 

  5. Auerbach JD, Parkhurst JO, Caceres CF. Addressing social drivers of HIV/AIDS for the long-term response: conceptual and methodological considerations. Glob Public Health. 2011;6:S293–309.

    Article  PubMed  Google Scholar 

  6. Gupta GR, Parkhurst JO, Ogden JA, Aggleton P, Mahal A. Structural approaches to HIV prevention. Lancet. 2008;372:764–75.

    Article  PubMed  Google Scholar 

  7. Michigan Department of Community Health. Annual HIV Surveillance Report for Michigan; 2014.

  8. Farley R, Danzinger S, Holzer HJ. The evolution of racial segregation Detroit Divided. New York: Russell Sage Foundation; 2000. p. 144–77.

    Google Scholar 

  9. Rosenberg ES, Millett GA, Sullivan PS, del Rio C, Curran JW. Understanding the HIV disparities between black and white men who have sex with men in the USA using the HIV care continuum: a modelling study. Lancet. 2014;1:e112–8.

    Article  PubMed  Google Scholar 

  10. Millett GA, Peterson JL, Flores SA, Hart TA, Jeffries WL, Wilson PA, 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. Lancet. 2012;380:341–8.

    Article  PubMed  Google Scholar 

  11. Arnold M, Hsu L, Pipkin S, McFarland W, Rutherford GW. Race, place and AIDS: the role of socioeconomic context on racial disparities in treatment and survival in San Francisco. Soc Sci Med. 2009;69:121–8.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Blankenship KM, et al. Structural interventions: concepts, challenges and opportunities for research. J Urban Health. 2006;83:59–72.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Bowleg L, Raj A. Shared communities, structural contexts, and HIV risk: prioritizing the HIV risk and prevention needs of black heterosexual men. Am J Public Health. 2012;102:S173–7.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Sumartojo E. Structural factors in HIV prevention: concepts, examples, and implications for research. AIDS. 2000;14:S3–10.

    Article  PubMed  Google Scholar 

  15. Egan JE, Frye V, Kurtz SP, Latkin C, Chen M, Tobin K, et al. Migration neighborhoods and networks: approaches to understanding how urban environmental conditions affect syndemic adverse health outcomes among gay bisexual and other men who have sex with men. AIDS Behav. 2011;15:35–50.

    Article  Google Scholar 

  16. Frye V, Latka MH, Koblin B, Halkitis PN, Putnam S, Galea S, Vlahov D. The urban environment and sexual risk behavior among men who have sex with men. J Urban Health. 2006;83:308–24.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Cubbin C, Santelli J, Brindis CD, Braveman P. Neighborhood context and sexual behaviors among adolescents: findings from the national longitudinal study of adolescent health. Perspect Sex Reprod Health. 2005;37:125–34.

    Article  PubMed  Google Scholar 

  18. Browning CR, Burrington LA, Leventhal T, Brooks-Gunn J. Neighborhood structural inequality, collective efficacy, and sexual risk behavior among urban youth. J Health Soc Behav. 2008;49:269–85.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Kerrigan D, Witt S, Glass B, Chung SE, Ellen J. Perceived neighborhood social cohesion and condom use among adolescents vulnerable to HIV/STI. AIDS Beh. 2006;10:723–9.

    Article  Google Scholar 

  20. Latkin CA, German D, Vlahov D, Galea S. Neighborhoods and HIV: a social ecological approach to prevention and care. Am Psychol. 2013;68:210–24.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Bauermeister JA, Elkington KS, Huebner D. Sexuality and HIV/AIDS prevention. In: Tolman DL, Diamond LM, Bauermeister JA, George WH, Pfaus JG, Ward LM, editors. APA handbook of sexuality and psychology. Washington: APA; 2014. p. 697–724.

    Google Scholar 

  22. Goodman RM, Speers MA, McLeroy K, Fawcett S, Kegler M, Parker E, Smith SR, Sterling TD, Wallerstein N. Identifying and defining the dimensions of community capacity to provide a basis for measurement. Health Educ Behav. 1998;25:258–78.

    Article  CAS  PubMed  Google Scholar 

  23. Kawachi I. Social cohesion and health. In: Tarlov AR, St. Peter RF, editors. The society and population health reader a state and community perspective. The New Press: New York; 2000. p. 57–74.

    Google Scholar 

  24. Ramirez-Valles J. The protective effects of community involvement for HIV risk behavior: a conceptual framework. Health Educ Res. 2002;17:389–403.

    Article  CAS  PubMed  Google Scholar 

  25. Frye V, Koblin B, Chin J, Beard J, Blaney S, Halkitis P, et al. Neighborhood-level correlates of consistent condom use among men who have sex with men: a multi-level analysis. AIDS Behav. 2010;14:974–85.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Buttram ME, Kurtz SE. Risk and protective factors associated with gay neighborhood residence. Am J Mens Health. 2013;7:110–8.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Mills TC, Stall R, Pollack L, Paul JP, Binson D, Canchola J, Catania JA. Health-related characteristics of men who have sex with men: a comparison of those living in “gay ghettos” with those living elsewhere. Am J Public Health. 2001;91:980–3.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Bauermeister JA, Tross S, Ehrhardt AA. A review of HIV/AIDS system-level interventions. AIDS Behav. 2009;13:430–48.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Weinhardt LS, Carey MP, Johnson BT, Bickham NL. Effects of HIV counseling and testing on sexual risk behavior : a meta-analytic review. Am J Public Health. 1999;89:1397–405.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  30. Law DCG, Serre ML, Christakos G, Leone PA, Miller WC. Spatial analysis and mapping of sexually transmitted diseases to optimise intervention and prevention strategies. Sex Transm Infect. 2004;80:294–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  31. Scribner RA, Johnson SA, Cohen DA, Robinson W, Farley TA, Gruenewald P. Geospatial methods for identification of core groups for HIV/AIDS. Subst Use Misuse. 2008;43:203–21.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Geanuracos CG, Cunningham SD, Weiss G, Forte D, Reid LMH, Ellen JM. Use of geographic information systems for planning HIV prevention interventions for high-risk youths. Am J Public Health. 2007;97:1974–81.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Leibowitz A, Taylor SL. Distance to public test sites and HIV testing. Med Care Res Rev. 2007;64:568–84.

    Article  PubMed  Google Scholar 

  34. Zenilman JM, Ellish N, Fresia A, Glass G. The geography of sexual partnerships in Baltimore: applications of core theory dynamics using a geographic information system. Sex Transm Dis. 1999;26:75–81.

    Article  CAS  PubMed  Google Scholar 

  35. Bauermeister JA, Meanley S, Hickok A, Pingel E, Vanhemert W, Loveluck J. Sexuality-related work discrimination and its association with the health of sexual minority emerging and young adult men in the Detroit Metro Area. Sex Res Soc Policy. 2014;11:1–10.

    Article  Google Scholar 

  36. Bauermeister JA, Pingel E, Zimmerman M, Couper M, Carballo-Dieguez A, Strecher VJ. Data quality in HIV/AIDS web-based surveys: handling invalid and suspicious data. Field Method. 2012;24:272–91.

    Article  Google Scholar 

  37. Teitcher JE, Bockting WO, Bauermeister JA, Hoefer CJ, Miner MH, Klitzman RL. Detecting, preventing, and responding to “fraudsters” in Internet research: ethics and tradeoffs. J Law Med Ethics. 2015;43:116–33.

    Article  PubMed  Google Scholar 

  38. Carballo-Diéguez A, Dolezal C, Ventuneac A. Sexual practices assessment schedule. New York: HIV Center for Clinical and Behavioral Studies, Columbia University & New York State Psychiatric Institute; 2002.

    Google Scholar 

  39. Kidder DP, Wolitski RJ, Royal S, Aidala A, Courtenay-Quirk C, Holtgrave DR, et al. Access to housing as a structural intervention for homeless and unstably housed people living with HIV: rationale, methods, and implementation of the housing and health study. AIDS Behav. 2007;11:149–61.

    Article  PubMed  Google Scholar 

  40. ESRI. ArcGIS desktop. Redlands: Environmental Systems Research Institute; 2011.

  41. Herek GM, Glunt EK. Identity and community among gay and bisexual men in the AIDS era: preliminary findings from the Sacramento men’s health study. In: Herek GM, Greene B, editors. AIDS, identity, and community: psychological perspectives on the HIV epidemic and lesbians and gay men. Sage: Newbury Park; 1995. p. 55–84.

    Chapter  Google Scholar 

  42. Sampson RJ, Raudenbush SW, Earls F. Neighborhoods and violent crime: a multilevel study of collective efficacy. Science. 1997;277:918–24.

    Article  CAS  PubMed  Google Scholar 

  43. Raudenbush A, Bryk A, Congdon R. HLM 7 for windows. Lincolnwood: Scientific Software International, Inc.; 2011.

    Google Scholar 

  44. Raudenbush SW, Bryk A. Hierarchical linear models: applications and data analysis methods. Thousand Oaks: Sage Publications; 2002.

    Google Scholar 

  45. Bauermeister JA, Zimmerman MA, Caldwell CH. Neighborhood disadvantage and changes in condom use among African American adolescents. J Urban Health. 2011;88:66–83.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Johns MM, Bauermeister JA, Zimmerman MA. Individual and neighborhood correlates of HIV testing among African American youth transitioning from adolescence into young adulthood. AIDS Educ Prev. 2010;22:509–22.

    Article  PubMed Central  PubMed  Google Scholar 

  47. Frieden TR. A framework for public health action: the health impact pyramid. Am J Public Health. 2010;100:590–5.

    Article  PubMed Central  PubMed  Google Scholar 

  48. Rehm J, Shield KD, Joharchi N, Shuper PA. Alcohol consumption and the intention to engage in unprotected sex: systematic review and meta-analysis of experimental studies. Addiction. 2012;107:51–9.

    Article  PubMed  Google Scholar 

  49. Farley R, Danzinger S, Holzer HJ. The persistence of residential segregation. Detroit Divid. New York: Russell Sage Foundation; 2000.

    Google Scholar 

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Acknowledgments

The United for HIV Integration and Policy (UHIP) academic-community partnership included representatives from AIDS Partnership Michigan, the HIV/AIDS Resource Center, Detroit Latin@z, Ruth Ellis Center, and the University of Michigan’s Center for Sexuality & Health Disparities. This work was supported by the MAC AIDS Fund (PI: Bauermeister) and a grant from the Centers for Disease Control and Prevention to Dr. Bauermeister (U22 PS004520). Dr. Eaton was supported by two National Institutes of Health projects (R01MH094230; R01NR013865). The content is solely the responsibility of the authors and does not represent the official views of the funding agencies.

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Authors and Affiliations

  1. Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA

    José A. Bauermeister, Jack Andrzejewski & Emily S. Pingel

  2. University of Connecticut, Storrs, CT, USA

    Lisa Eaton

  3. HIV/AIDS Resource Center, Ypsilanti, MI, USA

    Jimena Loveluck

  4. AIDS Partnership Michigan, Detroit, MI, USA

    William VanHemert

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  1. José A. Bauermeister
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  6. Emily S. Pingel
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Correspondence to José A. Bauermeister.

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On behalf of the United for HIV/AIDS Integration and Policy (UHIP) Partnership.

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Bauermeister, J.A., Eaton, L., Andrzejewski, J. et al. Where You Live Matters: Structural Correlates of HIV Risk Behavior Among Young Men Who Have Sex with Men in Metro Detroit. AIDS Behav 19, 2358–2369 (2015). https://doi.org/10.1007/s10461-015-1180-1

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