Spatial Polygamy, Substance Use and Sexual Behavior among Young Men who have Sex with Men in New York City

Background: Previous studies that have examined the influence of the neighborhood context on substance use and sexual behaviors among young men who have sex with men (YMSM) predominantly focus on residential neighborhoods, with little attention to other neighborhood contexts such as neighborhoods where YMSM socialize or have sex.   

Methods: In this study, we used baseline data from a prospective cohort study of racially/ethnically diverse YMSM in New York City, n=598 participants (ages 18-19 years old at baseline) who provided information on multiple neighborhood contexts including neighborhoods within which they resided, socialized in and engaged in sexual activity in.  This information was used to assess spatial polygamy by 1) determining the amount of concordance between residential, social and sex neighborhoods and 2) associations between neighborhood concordance and self-reported substance use and sexual behaviors. 

Results: Approximately two-third of participants reported concordance between residential/socializing, residential/sex and sex/socializing neighborhoods, whereas 25% reported concordance between all 3 residential/socializing/sex neighborhoods. In multivariate models, controlling for sociodemographic characteristics, neighborhood concordance between all 3 neighborhood types was associated with increased odds of alcohol use (AOR=1.88), marijuana use (AOR=1.82) and unprotected oral sex (AOR= 1.50).

Conclusions:  These findings suggest that spatial polygamy, or multiple neighborhood contexts are prevalent among urban YMSM and these different contexts may influence substance use and sexual behaviors.  Thus, future research among YMSM populations should consider multiple neighborhood contexts in order to provide a more nuanced understanding of how and which neighborhood contexts influence substance use and sexual behaviors of YMSM.