AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #74 - Sex and the community: examining the implications of neighborhood and social networks for sexual risk behaviors among urban gay men
Authors: Presenting Author: Dr Brian Kelly - Purdue University
Additional Authors: Dr. Richard Carpiano, Mr. Adam Easterbrook, Dr. Jeffrey Parsons,
Aim: Gay neighborhoods have historically served as vital places for gay men’s socializing, and gay social networks are important sources of social support. Yet, few studies have examined the contributions of these important forms of community to gay men’s health. These aspects are important with regard to the consideration of the influence of meso-level social factors on HIV-related risk. Prevention and intervention scientists have made important strides in expanding examinations of the pathways of risk beyond the individual level. For example, there have been studies of social contexts that gay men inhabit such as circuit parties and public sex environments, and how these contexts bear on gay men’s health. We extend this work by examining neighborhood and social network influences on sexual health among gay men. In doing so, we examine the role of two important facets of community in the health behaviors of urban gay men.
Method / Issue: Informed by theoretical perspectives on community and networks, we test several hypotheses concerning whether gay neighborhood and social network factors promote sexual health or enable sexual risk taking (or have no effect). Specifically, we examine whether these aspects of community are associated with five sexual behaviors (receptive and insertive unprotected anal intercourse [UAI], having a barebacking identity, recent internet use for finding sexual partners, and “Party and Play” [PnP]) using multi-level modeling methods.
Results / Comments: Our analyses of a sample of urban gay men reveal little evidence for the direct effect of gay enclaves on sexual health with the exception of PnP, which was more likely to occur among gay enclave residents. Having a network composed predominantly of other gay men was positively associated with insertive UAI, PnP, and internet use for meeting sexual partners. This network type also mediated the association between gay neighborhoods and higher odds of insertive UAI as well as PnP.
Discussion: This study highlights the importance of two forms of gay community contexts—gay neighborhoods and social networks—for the HIV risk faced by gay men. Improved understanding of the health risks faced by this vulnerable population requires a better contextualization of these risks—one that moves beyond a focus on individual-level factors in their lives and also considers the role of the social contexts in which their health-related decisions and actions take place. Overall, while some role was found for neighborhood conditions—a finding consistent with prior research, the majority of effects are attributable to social networks. These findings highlight the need for network level HIV prevention efforts.
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