Online Program

Jobs and jail: How social conditions and social networks influence sexual exchange among African American male substance users

Monday, November 4, 2013

Andrea Heckert, MPH, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
Elizabeth Costenbader, PhD, FHI 360, Durham, NC
William A. Zule, DrPH, Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC
Background: Black male substance-users in the Southeastern US experience some of the highest HIV and other STI rates in the country. Little research has explored how social conditions shape social networks driving HIV-risk behavior including the sale of sex for drugs or money among this population. Methods: Data are from in-depth interviews (n=16) and cross-sectional network study survey data (n=201) from two North Carolina-based studies. Inductive thematic analysis of the qualitative data documented emergent themes regarding the social conditions experienced by black men belonging to high-risk sexual and drug-using networks where sexual exchange is pervasive. Logistic regression models were used to test the association between personal network composition and social support function on the sale of sex for drugs or money. Results: Peer employment and history of incarceration were both associated with selling sex and drug when accounting for all other variables in the model. These findings will be discussed in relation to the qualitative data which revealed a pattern of structural, symbolic and everyday experiences of violence. Historic experiences of social marginalization have resulted in rigid masculine identity scripts, disproportionate incarceration, and limited economic opportunities which has rendered sexual exchange a normative behavior. Conclusions: Findings from this mixed-methods study will inform culturally-responsive network-based interventions to prevent and control transmission of HIV and other STI among this population. Skills- and norms-based interventions that develop new and bolster existing health-promoting network ties, facilitate multifaceted social support through lay health advising, and strengthen health-promoting dynamics within social networks will be discussed.

Learning Areas:

Advocacy for health and health education
Planning of health education strategies, interventions, and programs
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Discuss how to capitalize on the strengths and minimize the limitations of qualitative and quantitative methods in research intended to inform intervention design Discuss how the findings from this mixed methods study will inform culturally-responsive network-based interventions to prevent and control transmission of HIV and other STI among African American substance-using men

Keyword(s): Substance Abuse, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I completed all of the analyses and interpretation of the two data sets for this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.