Examining Diversity Across MSM Alcohol Use Outlets to Inform HIV Prevention

Introduction: HIV prevalence and risk behavior tends to be higher among MSM who attend alcohol use venues, but there is little research on the diversity that exists across venues. This limits design of appropriate and acceptable interventions in these settings.

Methods: Cross-sectional study of 502 Baltimore MSM recruited using time location sampling August-December 2011, including socio-behavioral data and HIV testing. Descriptive statistics and case study analysis examined HIV and STI prevalence, demographic and behavioral characteristics, socioeconomic vulnerability, and service utilization by recruitment venue for possible variation and identifiable patterns.

Results: 387 eligible MSM were recruited from 18 alcohol use venues. There was substantial venue variation in all domains: HIV prevalence ranged from 22-59% and recent STI ranged from 7-21%. Demographic differences included proportion African-American (6-100%), proportion under 25 (16-89%), and socioeconomic differences such as unemployment (8-57%). Behavioral differences include mean number of past year partners (2-8), UAI with casual partners (12-71%), monthly binge drinking (38-85%), and heroin/cocaine/crack use (20-70%). HIV testing in the past year ranged from 36%-91%; venues with highest proportion of recent testing were characterized by high proportion African-American and younger MSM, and high STIs and known HIV-positive status. 

Conclusions: MSM alcohol use outlets are heterogeneous. Understanding venues based on demographic and behavioral clustering provides insight into characteristics and needs of attendees and holds promise for HIV intervention design. Venues with highest HIV transmission risk also reported highest proportion of recent HIV testing. Venue-based testing strategies should consider venue characteristics to enhance targeting, venue relationships, and complementary resources.