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Chen YT, Shrader CH, Duncan DT, Rudolph AE, Regan SD, Kim B, Pagkas-Bather J, Knox J, Fujimoto K, Schneider JA. Using GPS-defined venue-based affiliation networks among Black sexually minoritized men and transgender women to identify locations for HIV prevention interventions. Ann Epidemiol 2024; 96:80-87. [PMID: 38971348 DOI: 10.1016/j.annepidem.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/28/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024]
Abstract
PURPOSE HIV biomedical intervention uptake is suboptimal among Black sexually minoritized men (SMM) and transgender women (TW). Venues where people meet and interact shape HIV-related risk and prevention behaviors. We aimed to construct GPS-defined venue-based affiliation networks and identify the unique set of venues that could maximize reach of HIV biomedical interventions among Black SMM and TW. METHODS We used baseline survey and GPS data from 272 Black SMM and TW in the Neighborhoods and Networks (N2) Cohort Study in Chicago, Illinois (2018-2019). We mapped participants' GPS data to the nearest pre-identified SMM- and TW-friendly venue (n = 222) to construct affiliation networks. Network analyses were performed to identify influential venues that can yield high reach to intervention candidates. RESULTS Participants were affiliated with 75.5 % of all pre-identified venues based on GPS data. Two influential venues were identified in the non-PrEP use network, which when combined, could reach 52.5 % of participants not taking PrEP. Participants that could be reached through these two influential venues reported more non-main sex partners than participants not affiliated with either venue (p = 0.049). CONCLUSION We demonstrate a potential for GPS-defined venue-based affiliation networks to identify unique combinations of venues that could maximize the impact of HIV prevention interventions.
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Affiliation(s)
- Yen-Tyng Chen
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA.
| | - Cho-Hee Shrader
- Arizona State University, College of Nursing and Health Innovation, Phoenix, AZ, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Dustin T Duncan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Seann D Regan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Byoungjun Kim
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Jade Pagkas-Bather
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA; Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Justin Knox
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY, USA; New York State Psychiatric Institute, HIV Center for Clinical and Behavioral Studies, New York, NY, USA; Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Kayo Fujimoto
- Center for Health Promotion and Prevention Research, Department of Health Promotion & Behavioral Science, Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science at Houston, Houston, TX, USA
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA; Department of Medicine, University of Chicago, Chicago, IL, USA; Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
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Craker L, Rodriguez E, Johnson AL, Silvey R, Skvoretz J, Kanamori M. Examining physical and virtual sexual and drug risk venue co-attendance among PrEP-eligible Latinx sexual minority men. Sci Rep 2024; 14:17004. [PMID: 39043861 PMCID: PMC11266483 DOI: 10.1038/s41598-024-67814-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 07/16/2024] [Indexed: 07/25/2024] Open
Abstract
Disparities in Latinx sexual minority men (LSMM) pre-exposure prophylaxis (PrEP) initiation and adherence demonstrate the need for innovative strategies to improve outcomes along the PrEP Care Continuum. The purpose of this study was to examine physical and virtual risk venue co-attendance among LSMM of varying stages of PrEP use living in South Florida, an Ending the HIV Epidemic (EHE) priority jurisdiction. Venue co-attendance may be leveraged to support equitable dissemination and implementation (D&I) of HIV and drug use preventive interventions to LSMM. Ninety-four LSMM completed surveys on PrEP use and identified physical and virtual sexual and drug risk venues (where men seek sex partners and/or have sex or access or use drugs). Bivariate analyses examined differences in demographics and venue endorsement by PrEP status. Exponential random graph models examined endorsement of venues by PrEP status. One-mode projection visualizations portray the structure of venue co-attendance networks by PrEP status. Participants identified 49 physical and virtual sexual and drug risk venues. A homophily effect of PrEP status on venue endorsement was identified for both sexual and drug risk venues. Network size and density differed by PrEP status and whether the venue was identified as a sexual or drug risk location. Online dating apps, bars, and saunas had the highest centrality in each network type suggesting their potential role in implementing preventive programming. This study identified specific sexual and drug risk venues that may be leveraged to both disseminate targeted PrEP and harm reduction information and to implement interventions to improve PrEP uptake and adherence among LSMM living in EHE priority jurisdictions.
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Affiliation(s)
- Lacey Craker
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street Suite 1010, Miami, FL, 33136, USA
| | - Edda Rodriguez
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street Suite 1010, Miami, FL, 33136, USA
| | - Ariana L Johnson
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street Suite 1010, Miami, FL, 33136, USA
| | - Rebe Silvey
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street Suite 1010, Miami, FL, 33136, USA
| | - John Skvoretz
- Department of Sociology, University of South Florida, Tampa, FL, USA
| | - Mariano Kanamori
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street Suite 1010, Miami, FL, 33136, USA.
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Menezes NP, Mehta SH, Wesolowski A, Clipman SJ, Srikrishnan AK, Kumar MS, Zook KJ, Lucas GM, Latkin C, Solomon SS. Network centrality and HIV prevention service use among people who inject drugs: Findings from a sociometric network cohort in New Delhi, India. Addiction 2024; 119:570-581. [PMID: 37967827 PMCID: PMC11003398 DOI: 10.1111/add.16379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 09/21/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND AND AIMS Network centrality, an indicator of an individual's importance and potential to drive behavioral change, is rarely used to select peer educators. Individual-level predictors of network centrality might be useful to identify people who inject drugs (PWID) for potential roles as peer navigators or change agents in network-based interventions in settings where sociometric data are unavailable. We assessed the relationship between network centrality and HIV prevention service engagement to determine whether centrally-positioned PWID share measurable commonalities. DESIGN Observational study and survey using baseline data from a sociometric network cohort of PWID, enumerated using network software and biometric data (2017-2020). Network ties corresponded to direct injection partnerships in the prior month. SETTING New Delhi, India. PARTICIPANTS A total of 2512 PWID who were ≥18 years, provided written informed consent, and reported illicit injection drug use within the 24 months before study enrollment. MEASUREMENTS Interviewer-administered questionnaires measured demographics and substance use behaviors. Central versus peripheral network position was categorized using betweenness centrality 75th%ile . Logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals (95%CI) between network position and HIV testing, medication for opioid use disorder (MOUD), or syringe service use. Lasso models selected predictors of central network position among 20 covariates detailing demographic, biologic, and substance use information. Predictive accuracy was evaluated using model performance metrics. FINDINGS Overall, median age was 26 years (interquartile range 22-34); 99% were male; 628 were classified as central. Compared with PWID at the periphery, central PWID were more likely to use MOUD (aOR: 1.59, 95%CI: 1.30-1.94) and syringe services (aOR: 2.91, 95%CI: 2.25, 3.76) in the prior six months. Findings for HIV testing were inconclusive (aOR: 1.30, 95%CI: 1.00-1.69). The lasso variable selector identified several predictors of network centrality: HIV and hepatitis C infection, number of PWID seen in the prior month, injecting heroin and buprenorphine (vs. heroin only) six months prior, sharing injection equipment six months prior, experiencing drug overdose in the past year, and moderate/severe depression (vs. none/mild). Average agreement between model-predicted vs. observed values was 0.75; area under the receiver operator curve was 0.69. CONCLUSIONS In a socioeconomic network of people who inject drugs (PWID) in New Delhi, India, there are common characteristics among individuals based on their network position (central vs. peripheral) but individual-level predictors have only moderate predictive accuracy. Although central network members appear to be more likely to use HIV prevention services than peripheral network members, their potential as change agents may be limited by other factors that impede their ability to adopt or promote HIV prevention service use.
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Affiliation(s)
- Neia Prata Menezes
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States
| | - Shruti H. Mehta
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States
| | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States
| | - Steven J. Clipman
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, United States
| | | | | | - Katie J.C. Zook
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, United States
| | - Gregory M. Lucas
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, United States
| | - Carl Latkin
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, United States
- Department of Health, Behaviour and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, United States
| | - Sunil S. Solomon
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, United States
- Y.R. Gaitonde Centre for AIDS Research and Education, Chennai, India
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Comulada WS, Rotheram-Borus MJ, Arnold EM, Norwood P, Lee SJ, Ocasio MA, Flynn R, Nielsen K, Bolan R, Klausner J, Swendeman D. Using Machine Learning to Identify Predictors of Sexually Transmitted Infections Over Time Among Young People Living With or at Risk for HIV Who Participated in ATN Protocols 147, 148, and 149. Sex Transm Dis 2023; 50:739-745. [PMID: 37643402 PMCID: PMC10592122 DOI: 10.1097/olq.0000000000001854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND Sexually transmitted infections (STIs) among youth aged 12 to 24 years have doubled in the last 13 years, accounting for 50% of STIs nationally. We need to identify predictors of STI among youth in urban HIV epicenters. METHODS Sexual and gender minority (gay, bisexual, transgender, gender-diverse) and other youth with multiple life stressors (homelessness, incarceration, substance use, mental health disorders) were recruited from 13 sites in Los Angeles and New Orleans (N = 1482). Self-reports and rapid diagnostic tests for STI, HIV, and drug use were conducted at 4-month intervals for up to 24 months. Machine learning was used to identify predictors of time until new STI (including a new HIV diagnosis). RESULTS At recruitment, 23.9% of youth had a current or past STI. Over 24 months, 19.3% tested positive for a new STI. Heterosexual males had the lowest STI rate (12%); African American youth were 23% more likely to acquire an STI compared with peers of other ethnicities. Time to STI was best predicted by attending group sex venues or parties, moderate but not high dating app use, and past STI and HIV seropositive status. CONCLUSIONS Sexually transmitted infections are concentrated among a subset of young people at highest risk. The best predictors of youth's risk are their sexual environments and networks. Machine learning will allow the next generation of research on predictive patterns of risk to be more robust.
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Affiliation(s)
- W. Scott Comulada
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Mary Jane Rotheram-Borus
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | | | - Peter Norwood
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Sung-Jae Lee
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Manuel A. Ocasio
- Department of Pediatrics, School of Medicine, Tulane University, New Orleans, LA
| | - Risa Flynn
- Los Angeles LGBT Center, Los Angeles, CA
| | - Karin Nielsen
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | | | - Jeffrey Klausner
- Department of Infectious Diseases, Keck School of Medicine, University of Southern CA
| | - Dallas Swendeman
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Adolescent Medicine Trials Network (ATN) CARES Team
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
- Department of Pediatrics, School of Medicine, Tulane University, New Orleans, LA
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
- Nova Southeastern University, Fort Lauderdale, FL
- School of Public Health, Portland State University, Portland, OR
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA
- Friends Research Institute Inc, Los Angeles, CA
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Fujimoto K, Paraskevis D, Kuo JC, Hallmark CJ, Zhao J, Hochi A, Kuhns LM, Hwang LY, Hatzakis A, Schneider JA. Integrated molecular and affiliation network analysis: Core-periphery social clustering is associated with HIV transmission patterns. SOCIAL NETWORKS 2022; 68:107-117. [PMID: 34262236 PMCID: PMC8274587 DOI: 10.1016/j.socnet.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This study investigates the two-mode core-periphery structures of venue affiliation networks of younger Black men who have sex with men (YBMSM). We examined the association between these structures and HIV phylogenetic clusters, defined as members who share highly similar HIV strains that are regarded as a proxy for sexual affiliation networks. Using data from 114 YBMSM who are living with HIV in two large U.S. cities, we found that HIV phylogenetic clustering patterns were associated with social clustering patterns whose members share affiliation with core venues that overlap with those of YBMSM. Distinct HIV transmission patterns were found in each city, a finding that can help to inform tailored venue-based and network intervention strategies.
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Affiliation(s)
- Kayo Fujimoto
- Department of Health Promotion, The University of Texas Health Science Center at Houston, 7000 Fannin Street, UCT 2514, Houston, TX 77030
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jacky C. Kuo
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, 7000 Fannin Street, Houston, TX 77030
| | | | - Jing Zhao
- Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030
| | - Andre Hochi
- Department of Health Promotion, The University of Texas Health Science Center at Houston, 7000 Fannin Street, UCT 2514, Houston, TX 77030
| | - Lisa M Kuhns
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children’s Hospital, and Northwestern University, Feinberg School of Medicine, Department of Pediatrics, 225 E. Chicago Avenue, #161, Chicago, IL 60611
| | - Lu-Yu Hwang
- Department of Epidemiology, Human Genetics, and Environmental Science, The University of Texas Health Science Center at Houston, 7000 Fannin Street, Houston, TX 77030
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - John A. Schneider
- Department of Medicine and Public Health Sciences and the Chicago Center for HIV Elimination, University of Chicago, 5837 South Maryland Avenue MC 5065, Chicago, IL 60637
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Kanamori MJ, Williams ML, Fujimoto K, Shrader CH, Schneider J, de La Rosa M. A Social Network Analysis of Cooperation and Support in an HIV Service Delivery Network for Young Latino MSM in Miami. JOURNAL OF HOMOSEXUALITY 2021; 68:887-900. [PMID: 31553688 PMCID: PMC7093249 DOI: 10.1080/00918369.2019.1667160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Purpose: The study aimed to identify HIV prevention, testing, and care services prioritizing young Latino men who have sex with men (MSM) in an HIV service delivery network in Miami-Dade County, Florida, by visually describing structural features and processes of collaboration within and between health and social venues.Methods: The study used cross-sectional data from 40 social and healthcare venues providing goods and services to young Latino MSM. Each venue provided information surrounding HIV-related services provided and collaborations with other venues. Network visualization analyses were performed using UCINET6 and NetDraw2.160.Results: The most commonly used services offered by health and social venues were free condoms and HIV education materials. Collaborations both within and between health and social venues components of the network existed. Not all health and social venues provided services to young Latino MSM.Conclusion: Health venues can reach and incorporate hard to reach populations, such as non-English speaking and undocumented young Latino MSM, to provide HIV-related services using service delivery venue social networks.
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Affiliation(s)
- Mariano J Kanamori
- Department of Public Health Sciences, Division of Prevention Science and Community Health, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Mark L Williams
- Department of Health Policy and Management, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Kayo Fujimoto
- Department of Health Promotion & Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Cho Hee Shrader
- Department of Public Health Sciences, Division of Prevention Science and Community Health, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - John Schneider
- University of Chicago Medicine and Biological Sciences Department, University of Chicago Medicine, Chicago, Illinois, USA
| | - Mario de La Rosa
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
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XIANG Y, FUJIMOTO K, LI F, WANG Q, DEL VECCHIO N, SCHNEIDER J, ZHI D, TAO C. Identifying influential neighbors in social networks and venue affiliations among young MSM: a data science approach to predict HIV infection. AIDS 2021; 35:S65-S73. [PMID: 33306549 PMCID: PMC8058230 DOI: 10.1097/qad.0000000000002784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Young MSM (YMSM) bear a disproportionate burden of HIV infection in the United States and their risks of acquiring HIV may be shaped by complex multilayer social networks. These networks are formed through not only direct contact with social/sex partners but also indirect anonymous contacts encountered when attending social venues. We introduced a new application of a state-of-the-art graph-based deep learning method to predict HIV infection that can identify influential neighbors within these multiple network contexts. DESIGN AND METHODS We used empirical network data among YMSM aged 16-29 years old collected from Houston and Chicago in the United States between 2014 and 2016. A computational framework GAT-HIV (Graph Attention Networks for HIV) was proposed to predict HIV infections by identifying influential neighbors within social networks. These networks were formed by multiple relations constituted of social/sex partners and shared venue attendances, and using individual-level variables. Further, GAT-HIV was extended to combine multiple social networks using multigraph GAT methods. A visualization tool was also developed to highlight influential network members for each individual within the multiple social networks. RESULTS The multigraph GAT-HIV models obtained average AUC values of 0.776 and 0.824 for Chicago and Houston, respectively, performing better than empirical predictive models (e.g. AUCs of random forest: 0.758 and 0.798). GAT-HIV on single networks also delivered promising prediction performances. CONCLUSION The proposed methods provide a comprehensive and interpretable framework for graph-based modeling that may inform effective HIV prevention intervention strategies among populations most vulnerable to HIV.
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Affiliation(s)
- Yang XIANG
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Kayo FUJIMOTO
- Department of Health Promotion & Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Fang LI
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Qing WANG
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Natascha DEL VECCHIO
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA
| | - John SCHNEIDER
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA
- Departments of Medicine and Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Degui ZHI
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Cui TAO
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA
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Fujimoto K, Wang P, Li DH, Kuhns LM, Amith M, Schneider JA. Collective Avoidance of Social and Health Venues and HIV Racial Inequities: Network Modeling of Venue Avoidance on Venue Affiliation, Social Networks, and HIV Risk. HEALTH EDUCATION & BEHAVIOR 2020; 47:202-212. [PMID: 32090656 DOI: 10.1177/1090198119876240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many younger Black men who have sex with men (YBMSM) are exposed to homonegativity, societal stigma, and racial discrimination in their social environment. This study uses a social network modeling methodology to identify aspects of the social environment that are not often described, that is, the places and spaces or "venues" where YBMSM socialize or where they receive HIV prevention services. In particular, we identify the structural features of avoidance of these venues as an indicator of negative experiences, using bipartite exponential random graph models. Our study theorizes that YBMSM avoid certain venues en masse through information diffusion among social network members. We specify two social mechanisms of collective venue avoidance-(1) homophily (i.e., ego-alter similarity in venue avoidance) and (2) popular opinion leaders (as early adopters)-and test the corresponding hypotheses that (Hypothesis 1) socially connected individuals avoid venues together and that (Hypothesis 2) popular individuals would be more likely to avoid venues. Based on data collected from YBMSM aged 16 to 29 years between 2014 and 2016 in Houston, Texas (N = 227) and Chicago, Illinois (N = 241), results indicate that Hypothesis 1 was supported in both cities but that Hypothesis 2 was supported only in Chicago. The findings suggest that the structural patterns of venue avoidance are different between cities and may inform dissemination of prevention messages and delivery of venue- and social influence-based HIV interventions.
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Affiliation(s)
- Kayo Fujimoto
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Peng Wang
- Swinburne University of Technology, Hawthorn, Victoria, Australia
| | | | - Lisa M Kuhns
- Northwestern University, Chicago, IL, USA.,Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | - Muhammad Amith
- The University of Texas Health Science Center at Houston, Houston, TX, USA
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9
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Frank K. Rethinking Risk, Culture, and Intervention in Collective Sex Environments. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:3-30. [PMID: 29748787 DOI: 10.1007/s10508-018-1153-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 11/28/2017] [Accepted: 01/11/2018] [Indexed: 05/16/2023]
Abstract
This article provides a narrative overview of research on HIV/STI risk and collective sexual behavior based on an inclusive analysis of research on environments where people gather for sexual activity-sex clubs, swingers' clubs, bathhouses, parks, private sex parties, etc. The aim is to analyze how collective sex has been approached across disciplines to promote conversation across paradigms and suggest new lines of inquiry. Attention to context-such as the location of sex-was a necessary redress to universalizing models of sexual risk-taking behavior, leading to insights rooted in the particularities of each environment and its users. However, the identification of ever more precise risk groups or environmental idiosyncrasies eventually becomes theoretically restrictive, leading to an overestimation of the uniqueness of sexual enclaves, and of the difference between any given enclave and the broader social milieu. Using a theoretical framework of transgression to interpret the interdisciplinary literature, similarities in the spatial and social organization of collective sex environments are identified. Insights generated from this complementary perspective are then applied to understandings of collective sex: first, the example of male-female (MF) "swingers" is used to illustrate the need to establish, rather than assume, the distinctiveness of each non-normative sexual enclave, and to broaden the conceptualization of context; second, questions are raised about the practicality of interventions in collective sex environments. Finally, new lines of intellectual inquiry are suggested to shed light not just on collective sex but on sociosexual issues more generally, such as increasing protective sexual health behavior or negotiating consent in sexual encounters.
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Affiliation(s)
- Katherine Frank
- Department of Sociology, University of Nevada, Las Vegas, Las Vegas, NV, 89557, USA.
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10
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Patel RR, Luke DA, Proctor EK, Powderly WG, Chan PA, Mayer KH, Harrison LC, Dhand A. Sex Venue-Based Network Analysis to Identify HIV Prevention Dissemination Targets for Men Who Have Sex with Men. LGBT Health 2018; 5:78-85. [PMID: 29324178 DOI: 10.1089/lgbt.2017.0018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The aim of this study was to identify sex venue-based networks among men who have sex with men (MSM) to inform HIV preexposure prophylaxis (PrEP) dissemination efforts. METHODS Using a cross-sectional design, we interviewed MSM about the venues where their recent sexual partners were found. Venues were organized into network matrices grouped by condom use and race. We examined network structure, central venues, and network subgroups. RESULTS Among 49 participants, the median age was 27 years, 49% were Black and 86% reported condomless anal sex (ncAS). Analysis revealed a map of 54 virtual and physical venues with an overlap in the ncAS and with condom anal sex (cAS) venues. In the ncAS network, virtual and physical locations were more interconnected. The ncAS venues reported by Blacks were more diffusely organized than those reported by Whites. CONCLUSION The network structures of sex venues for at-risk MSM differed by race. Network information can enhance HIV prevention dissemination efforts among subpopulations, including PrEP implementation.
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Affiliation(s)
- Rupa R Patel
- 1 Division of Infectious Diseases, Washington University in St. Louis , St. Louis, Missouri
| | - Douglas A Luke
- 2 Center for Public Health Systems Science, Washington University in St. Louis , St. Louis, Missouri
| | - Enola K Proctor
- 3 Brown School, Washington University in St. Louis , St. Louis, Missouri
| | - William G Powderly
- 1 Division of Infectious Diseases, Washington University in St. Louis , St. Louis, Missouri
| | - Philip A Chan
- 4 Division of Infectious Diseases, Brown University , Providence, Rhode Island
| | - Kenneth H Mayer
- 5 Division of Infectious Diseases, Beth Israel Deaconess Medical Center , Boston, Massachusetts
- 6 Division of Infectious Diseases, Harvard Medical School , Boston, Massachusetts
- 7 The Fenway Institute , Fenway Health, Boston, Massachusetts
| | - Laura C Harrison
- 1 Division of Infectious Diseases, Washington University in St. Louis , St. Louis, Missouri
| | - Amar Dhand
- 8 Department of Neurology, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts
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Shelton RC, Lee M, Brotzman LE, Crookes DM, Jandorf L, Erwin D, Gage-Bouchard EA. Use of social network analysis in the development, dissemination, implementation, and sustainability of health behavior interventions for adults: A systematic review. Soc Sci Med 2018; 220:81-101. [PMID: 30412922 DOI: 10.1016/j.socscimed.2018.10.013] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 10/15/2018] [Accepted: 10/18/2018] [Indexed: 11/30/2022]
Abstract
Interest in conceptualizing, measuring, and applying social network analysis (SNA) in public health has grown tremendously in recent years. While these studies have broadened our understanding of the role that social networks play in health, there has been less research that has investigated the application of SNA to inform health-related interventions. This systematic review aimed to capture the current applied use of SNA in the development, dissemination, implementation, and sustainability of health behavior interventions for adults. We identified 52 articles published between 2004 and 2016. A wide variety of study settings were identified, most commonly in the US context and most often related to sexual health and HIV prevention. We found that 38% of articles explicitly applied SNA to inform some aspect of interventions. Use of SNA to inform intervention development (as opposed to dissemination, implementation, or sustainability) was most common. The majority of articles represented in this review (n = 39) were quantitative studies, and 13 articles included a qualitative component. Partial networks were most represented across articles, and over 100 different networks measures were assessed. The most commonly described measures were network density, size, and degree centrality. Finally, very few articles defined SNA and not all articles using SNA were theoretically-informed. Given the nascent and heterogeneous state of the literature in this area, this is an important time for the field to coalesce on terminology, measures, and theoretical frameworks. We highlight areas for researchers to advance work on the application of SNA in the design, dissemination, implementation and sustainability of behavioral interventions.
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Affiliation(s)
- Rachel C Shelton
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722 West 168th Street, New York, NY, 10032, USA.
| | - Matthew Lee
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722 West 168th Street, New York, NY, 10032, USA.
| | - Laura E Brotzman
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722 West 168th Street, New York, NY, 10032, USA.
| | - Danielle M Crookes
- Columbia University Mailman School of Public Health, Department of Epidemiology, 722 West 168th Street, New York, NY, 10032, USA.
| | - Lina Jandorf
- Icahn School of Medicine at Mount Sinai, Department of Oncological Sciences, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Deborah Erwin
- Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, USA.
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12
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Kubicek K. Setting an Agenda to Address Intimate Partner Violence Among Young Men Who Have Sex With Men: A Conceptual Model and Review. TRAUMA, VIOLENCE & ABUSE 2018; 19:473-487. [PMID: 27756778 DOI: 10.1177/1524838016673599] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Research investigating intimate partner violence (IPV) among sexual minorities is limited. The research that does exist has found that rates of IPV are similar to or higher than the rates found for heterosexual women, the most commonly studied population in this area. This limited research has resulted in a dearth of prevention/intervention programs targeted for these populations. While some may argue that existing IPV programs can be used for these populations, this review presents an argument for more targeted work with sexual minority populations, using young men who have sex with men (YMSM) as an example. Drawing on the framework of intersectionality, this article argues that the intersectionality of age, sexual identity, and gender combines to create a spectrum of unique factors that require specific attention. This framework allows for the identification of known correlates for IPV as well as factors that may be unique to YMSM or other sexual minority populations. The article presents a conceptual model that suggests new areas of research as well as a foundation for the topics and issues that should be addressed in an intervention.
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Affiliation(s)
- Katrina Kubicek
- 1 Community, Health Outcomes and Intervention Research Program, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
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13
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Chan PA, Crowley C, Rose JS, Kershaw T, Tributino A, Montgomery MC, Almonte A, Raifman J, Patel R, Nunn A. A Network Analysis of Sexually Transmitted Diseases and Online Hookup Sites Among Men Who Have Sex With Men. Sex Transm Dis 2018; 45:462-468. [PMID: 29465663 PMCID: PMC5995630 DOI: 10.1097/olq.0000000000000784] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sexually transmitted diseases (STDs) are increasing among gay, bisexual, and other men who have sex with men (MSM). Little is known about the use of websites and mobile phone applications to meet sexual partners ("hookup sites") and association with STD diagnoses. METHODS We performed a demographic and behavioral assessment of 415 MSM presenting to the Rhode Island STD clinic. Bivariate and multivariable analyses assessed associations between using hookup sites and testing positive for syphilis, gonorrhea, or chlamydia. Venue-based affiliation networks were created to evaluate hookup sites and their association with STD diagnoses. RESULTS Among 415 MSM, 78% reported meeting a partner online in the last 12 months, and 25% tested positive for at least one STD. Men who met partners online were more likely to be white (67% vs. 54%, P = 0.03) and have more than 10 lifetime partners (87% vs. 58%, P < 0.05). The most commonly used hookup sites included Grindr (78%), Scruff (35%), and Tinder (22%). In the multivariable analysis, only Scruff use was associated with testing positive for an STD (odds ratio, 2.28; 95% confidence interval, 1.09-4.94). However, among men who met partners online, 75% of men diagnosed as having an STD had met a sexual partner on Grindr, including 100% of those who were diagnosed as having gonorrhea. CONCLUSIONS Use of hookup sites was nearly ubiquitous among MSM undergoing STD screening. Specific hookup sites were significantly associated with STD diagnoses among MSM. Greater efforts are needed to promote STD screening and prevention among MSM who meet partners online.
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Affiliation(s)
- Philip A. Chan
- Department of Medicine, Brown University, Providence, RI
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence RI
| | | | | | - Trace Kershaw
- School of Public Health, Yale University, New Haven, CT
| | - Alec Tributino
- Department of Medicine, Brown University, Providence, RI
| | | | - Alexi Almonte
- Department of Medicine, Brown University, Providence, RI
| | - Julia Raifman
- School of Public Health, Boston University, Boston, MA
| | - Rupa Patel
- Department of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Amy Nunn
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence RI
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Zhong L, Zhang Q, Li X. Modeling the Intervention of HIV Transmission across Intertwined Key Populations. Sci Rep 2018; 8:2432. [PMID: 29402964 PMCID: PMC5799486 DOI: 10.1038/s41598-018-20864-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 01/26/2018] [Indexed: 11/23/2022] Open
Abstract
The HIV transmissions between multiple key populations make interventions difficult, particularly with multiple transmission behaviors. It remains unclear how significant the role of bridge individuals (who connect multiple communities) is in HIV transmission, and how to develop more effective intervention strategies targeting different transmission modes across key populations. In this research, we proposed a 2-layer social network framework to simulate the HIV transmissions across female sex workers (FSWs) and persons who inject drugs (PWID) through two behaviors: unprotected sex and needle-sharing. We proposed a set of intervention strategies based on the topological properties of individuals in the social network and estimated the efficacy of these strategies. Simulation studies demonstrated that bridge individuals played a significant role in HIV transmissions across the two networks. Prevention on such bridge individuals could help reduce both the scale and speed of HIV transmissions.
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Affiliation(s)
- Lu Zhong
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Kowloon, Hong Kong, SAR, China
| | - Qingpeng Zhang
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Kowloon, Hong Kong, SAR, China.
- Shenzhen Research Institute of City University of Hong Kong, Shenzhen, Guangdong, China.
| | - Xiaoming Li
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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15
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Gonsalves GS, Crawford FW, Cleary PD, Kaplan EH, Paltiel AD. An Adaptive Approach to Locating Mobile HIV Testing Services. Med Decis Making 2018; 38:262-272. [PMID: 28699382 PMCID: PMC5748375 DOI: 10.1177/0272989x17716431] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Public health agencies suggest targeting "hotspots" to identify individuals with undetected HIV infection. However, definitions of hotspots vary. Little is known about how best to target mobile HIV testing resources. METHODS We conducted a computer-based tournament to compare the yield of 4 algorithms for mobile HIV testing. Over 180 rounds of play, the algorithms selected 1 of 3 hypothetical zones, each with unknown prevalence of undiagnosed HIV, in which to conduct a fixed number of HIV tests. The algorithms were: 1) Thompson Sampling, an adaptive Bayesian search strategy; 2) Explore-then-Exploit, a strategy that initially draws comparable samples from all zones and then devotes all remaining rounds of play to HIV testing in whichever zone produced the highest observed yield; 3) Retrospection, a strategy using only base prevalence information; and; 4) Clairvoyance, a benchmarking strategy that employs perfect information about HIV prevalence in each zone. RESULTS Over 250 tournament runs, Thompson Sampling outperformed Explore-then-Exploit 66% of the time, identifying 15% more cases. Thompson Sampling's superiority persisted in a variety of circumstances examined in the sensitivity analysis. Case detection rates using Thompson Sampling were, on average, within 90% of the benchmark established by Clairvoyance. Retrospection was consistently the poorest performer. LIMITATIONS We did not consider either selection bias (i.e., the correlation between infection status and the decision to obtain an HIV test) or the costs of relocation to another zone from one round of play to the next. CONCLUSIONS Adaptive methods like Thompson Sampling for mobile HIV testing are practical and effective, and may have advantages over other commonly used strategies.
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Affiliation(s)
- Gregg S Gonsalves
- Department of the Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA (GSG)
- Yale Law School, New Haven, CT, USA (GSG)
| | - Forrest W Crawford
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA (FWC)
- Department of Ecology & Evolutionary Biology, Yale University, New Haven, CT, USA (FWC)
- Yale School of Management, New Haven, CT, USA (FWC, EHK, ADP)
| | - Paul D Cleary
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA (PDC, EHK, ADP)
| | - Edward H Kaplan
- Yale School of Management, New Haven, CT, USA (FWC, EHK, ADP)
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA (PDC, EHK, ADP)
- School of Engineering & Applied Science, Yale University, New Haven, CT, USA (EHK)
| | - A David Paltiel
- Yale School of Management, New Haven, CT, USA (FWC, EHK, ADP)
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA (PDC, EHK, ADP)
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16
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Freese TE, Padwa H, Oeser BT, Rutkowski BA, Schulte MT. Real-World Strategies to Engage and Retain Racial-Ethnic Minority Young Men Who Have Sex with Men in HIV Prevention Services. AIDS Patient Care STDS 2017; 31:275-281. [PMID: 28530444 DOI: 10.1089/apc.2016.0310] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Racial/ethnic minority young men who have sex with men (YMSM)-particularly African Americans and Hispanics/Latinos-are at particularly high risk for HIV infection. Devising strategies to improve engagement and retention in HIV prevention services among minority YMSM is critical if the United States is going to achieve the National HIV/AIDS Strategy goal of reducing HIV health-related disparities. This article presents findings from a national summit on racial/ethnic YMSM services convened by the Substance Abuse and Mental Health Services Administration-funded Center of Excellence on Racial and Ethnic Minority Young Men Who Have Sex with Men and Other Lesbian, Gay, Bisexual, and Transgender Populations (YMSM + LGBT CoE) in September 2015. The summit included (1) subgroup discussions focused on issues related to treatment access, outreach/engagement/retention, continuing care/recovery support, and health literacy for minority YMSM; and (2) a ranking process, where the NIATx Nominal Group Technique was used to identify the strategies and approaches that summit participants believed to be most promising for engaging and retaining minority YMSM in HIV prevention services. Analyses of results from summit activities highlight four key cross-cutting strategies-utilizing peers, providing holistic care, making services fun, and utilizing technology-as critical for engaging minority YMSM in HIV prevention care. Examples of programs that utilize these strategies and implications of these findings for policy and practice are discussed.
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Affiliation(s)
- Thomas E. Freese
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, California
| | - Howard Padwa
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, California
| | - Brandy T. Oeser
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, California
| | - Beth A. Rutkowski
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, California
| | - Marya T. Schulte
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, California
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Multiplex Competition, Collaboration, and Funding Networks Among Health and Social Organizations: Toward Organization-based HIV Interventions for Young Men Who Have Sex With Men. Med Care 2017; 55:102-110. [PMID: 27676400 DOI: 10.1097/mlr.0000000000000595] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Young men who have sex with men (YMSM) have the highest rates of human immunodeficiency virus (HIV) infection in the United States. Decades into the HIV epidemic, the relationships that YMSM-serving health and social organizations have with one another has not been studied in depth. OBJECTIVES The aim of this study was to examine the competition, collaboration, and funding source structures of multiplex organization networks and the mechanisms that promote fruitful relationships among these organizations. RESEARCH DESIGN The study data collection method was a survey of health and social organizations from 2013-2014 in 2 cities, Chicago, IL and Houston, TX. SUBJECTS Study participants were representatives from 138 health and social organizations. MEASURES Responses to survey questions were used to reconstruct competition, collaboration, and combined competition-collaboration networks. RESULTS While taking into consideration the collaborative relationships among organizations, we provide statistical evidence that organizations of similar type, similar social media use patterns, comparable patterns of funding, and similar network contexts tended to compete with one another. This competition was less likely to be accompanied by any sort of collaboration if the organizations shared common funding sources. CONCLUSIONS Competition that excludes potential collaboration may be detrimental to mobilizing the collective efforts that serve local YMSM communities. System-level interventions may provide promising approaches to scaling-up HIV prevention and treatment efforts so as to encourage organizations to form partnerships with otherwise competing providers.
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Fujimoto K, Wang P, Ross MW, Williams ML. Venue-Mediated Weak Ties in Multiplex HIV Transmission Risk Networks Among Drug-Using Male Sex Workers and Associates. Am J Public Health 2015; 105:1128-35. [PMID: 25880956 DOI: 10.2105/ajph.2014.302474] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We investigated the structural characteristics of a multiplex HIV transmission risk network of drug-using male sex workers and their associates. METHODS Using a sample of 387 drug-using male sex workers and their male and female associates in Houston, Texas, we estimated an exponential random graph model to examine the venue-mediated relationships between individuals, the structural characteristics of relationships not linked to social venues, and homophily. We collected data in 2003 to 2004. The network comprised social, sexual, and drug-using relationships and affiliations with social venues. RESULTS Individuals affiliated with the same social venues, bars, or street intersections were more likely to have nonreciprocated (weak) ties with others. Sex workers were less likely than were other associates to have reciprocated (strong) ties to other sex workers with the same venues. Individuals tended to have reciprocated ties not linked to venues. Partner choice tended to be predicated on homophily. CONCLUSIONS Social venues may provide a milieu for forming weak ties in HIV transmission risk networks centered on male sex workers, which may foster the efficient diffusion of prevention messages as diverse information is obtained and information redundancy is avoided.
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Affiliation(s)
- Kayo Fujimoto
- Kayo Fujimoto is with the Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center, Houston. Peng Wang is with the School of Behavioural Science, Department of Psychology, University of Melbourne, Melbourne, Australia. Michael W. Ross is with the Department of Family Medicine and Community Health, University of Minnesota, Minneapolis. Mark L. Williams is with the Department of Health Policy and Management, Robert Stempel College of Public Health & Social Work, Florida International University, Miami
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