Project SNAP (Social Networks and Partnerships): An innovative examination into the transmission risk behaviors, health beliefs and psychosocial features of HIV-infected and uninfected men who have sex with men (MSM) in the South

Background: HIV acquisition depends on a variety of factors: individual behavior, sexual network, and sex partners' behaviors. Social network analysis investigates relationships among people, including assessment of their network structure, network position and roles, and the interplay among these factors in regard to disease transmission.

Methods: Project SNAP, begun in January 2008, uses social network analysis to describe social and sexual networks, as well as transmission risk behavior of two index groups: MSM recently infected with HIV (<6 months) and HIV-negative high risk MSM. Index participants are recruited via the Internet, community fliers and HIV care providers, while network members (both men and women) are recruited via respondent-driven sampling. SNAP utilizes a mixed-methods approach; all participants complete quantitative surveys while MSM are eligible to participate in an additional qualitative interview.

Results: To date, 16 index MSM (15 HIV-negative, 1 HIV-positive) and 15 network members have been interviewed. The largest network involves 4 index MSM and 2 network members (1 male and 1 female). Index negative MSM (n=15) report a mean age of 26 and 53% (n=8) are men of color. They report a median of 15 lifetime male sex partners (range 2-250); 80% (n=12) have used the Internet to find sex partners; 47% (n=7) report using at least one drug (excluding EtOH) in past 3 months; and 40% (n=6) report at least one previous STD.

Conclusion: An understanding of network structure-particularly among groups at high risk for HIV is critical to inform future biomedical and behavioral HIV prevention interventions.