Role of Housing Vacancy on the HIV/STI risk behaviors of young men who have sex with men

Background: Where you live matters. Neighborhood characteristics are linked to HIV/STI risks, yet few have examined how neighborhood characteristics influence the HIV/STI risk of young men who have sex with men (YMSM).

Methods: Using data from a cross-sectional survey of YMSM (ages 18-29) living in the Detroit Metro Area (N=429; 10% HIV-positive; 51% Black, 25% White, 14% Latino, 10% Other race; 6% transgender identified), we used a multilevel Poisson model to examine the association between neighborhood characteristics, individual factors, and number of recent partners with whom YMSM had unprotected receptive anal intercourse (URAI). In our neighborhood-level analyses, we accounted for individual-level factors (gender, race, SES, HIV status, prior STIs, partners’ serostatus, residential instability, and transactional sex). Neighborhood data was extracted from the 2010 US Census and linked to participants' data.

Results: Our multilevel models indicated that YMSM living in areas with greater housing vacancy were more likely to report multiple URAI partners (RR=1.61). Accounting for neighborhood effects, YMSM with a STI history (RR=1.58), who reported recent residential instability (RR=2.01), and who had serodiscordant/serounknown partners (RR=3.60) reported a greater number of URAI partners.  Once transactional sex was included in the analysis, we noted a potential mediation pathway, as both housing vacancy and residential instability became non-significant.

Conclusions: We discuss the implications of our findings for HIV/STI prevention, including the notion that efforts to counteract structural barriers and/or revitalize housing in Detroit Metro may aid to address the HIV/STI disparities faced by YMSM.