Patterns of Social Affiliations and Healthcare Engagement Among Young, Black, Men Who Have Sex With Men

Abstract

Little work has examined how individuals' social affiliations-the venues in which they meet friends and engage in informal social interaction-influence their engagement with public health services. We investigate how links to these local places shape access to information and exposure to health-seeking behavior. Using longitudinal data from a respondent-driven sample of 618 young black men who have sex with men (YBMSM) in Chicago, we identify different sets of social venues that connect YBMSM. We then examine how YBMSM's connections within this network influence their receipt of HIV prevention and treatment services and knowledge of pre-exposure prophylaxis (PrEP). Our results show that YBMSM's positions within Chicago's venue network shape the types of health-related services they access, net of demographic, structural, and community covariates. Men with affiliations that are linked to the city's gay enclave are most likely to know about PrEP, while men with affiliations that are predominately in the black community demonstrate improved HIV treatment outcomes. Outreach engaging MSM beyond venues in gay enclaves is needed.

Pre‐exposure prophylaxis initiation and adherence among Black men who have sex with men (MSM) in three US cities: results from the HPTN 073 study

“…Our findings suggest BMSM are willing to initiate PrEP and that this decision can be supported with interventions and improved access to consistent healthcare .…”

“…Our findings on initiation and adherence to PrEP are comparable to, or exceeded, those reported in large-scale PrEP randomized controlled trials [32,34] results provide additional data [33,41] that support the safety of daily oral PrEP among BMSM. Our findings suggest BMSM are willing to initiate PrEP and that this decision can be supported with interventions and improved access to consistent healthcare [5][6][7][8][9][10][11][12][13][14][15][16]42]. This is particularly salient in that this population faces multiple forms of structural inequalities and studies have shown that these barriers often influence PrEP uptake and utilization among Black MSM [41, [65][66][67].…”

“…Limited research is available on the initiation of and adherence to PrEP among Black MSM in the US . The importance of developing effective interventions and methods for delivering these interventions is essential to reducing the disproportionate HIV burden among BMSM in the United States inclusive of health provider biases .…”

Preferences for HIV test characteristics among young, Black Men Who Have Sex With Men (MSM) and transgender women: Implications for consistent HIV testing

“…HIV testing is the entrance point to a range of HIV prevention and treatment options, such as pre-exposure prophylaxis (PrEP) and ART (antiretroviral therapy) treatment, and is therefore a critical public health tool to help contain the HIV epidemic in the US [ 12 – 20 ]. It is crucial that individuals learn of HIV infection as immediately as possible, as those who are unaware of their HIV infection are more likely to transmit HIV to others due to higher viral loads and higher prevalence of sexual HIV transmission risk behaviors [ 2 , 8 , 21 – 22 ].…”

“…It is crucial that individuals learn of HIV infection as immediately as possible, as those who are unaware of their HIV infection are more likely to transmit HIV to others due to higher viral loads and higher prevalence of sexual HIV transmission risk behaviors [ 2 , 8 , 21 – 22 ]. Testing offers individuals who engage in high risk sex and receive a negative test result the opportunity to consider or adopt PrEP, a highly effective, biomedical HIV prevention method, learn about PEP and/or work towards other risk reduction strategies [ 12 – 13 , 23 – 25 ]. For these reasons, the Centers for Disease Control and Prevention (CDC) has recommended that MSM and transgender women who engage in certain risk behaviors test consistently or every 3–6 months [ 8 , 20 , 25 – 26 ].…”