Where you live matters: Protective structural correlates of HIV risk behavior among young men who have sex with men in Metro Detroit
Methods: Using data from a cross-sectional survey of YMSM (ages 18-29) living in Detroit Metro (N=345; 10% HIV-positive; 49% Black, 26.7% White, 15.1% Latino, 9.3% Other race), we used multilevel modeling to examine the association between community-level characteristics (e.g., density of African American households in neighborhood; distance to LGBT-affirming institutions) and YMSM’s HIV testing behavior and number of partners with whom they had unprotected anal intercourse. In our neighborhood-level analyses, we accounted for individual-level factors (race/ethnicity, poverty, homelessness, residential instability, and HIV/STI diagnoses).
Results: Our multilevel models indicated that YMSM living in more densely populated African American neighborhoods were more likely to have ever tested for HIV and to engage in receptive (URAI) and insertive (UIAI) unprotected anal intercourse, respectively. Greater distance to AIDS Service Organizations was associated with lower odds of HIV testing and greater URAI partners. Distance to LGBT bars was associated to HIV testing, whereas distance to LGBT organizations was related to UIAI partners. After accounting for neighborhood effects, YMSM with a history of prior STIs and who reported recent residential instability were more likely to report engaging in HIV risk behaviors.
Conclusions: We discuss the implications of our findings for HIV/STI prevention, including the notion that efforts to counteract structural barriers in Detroit Metro may aid to address the HIV/STI disparities faced by YMSM.
Learning Areas:Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health
Describe how social and geographic characteristics influence young MSM's HIV/AIDS risk behaviors. Demonstrate how geographic indicators may be useful to advocate for the sustainability of HIV prevention and care services.
Keyword(s): Accessibility, Social Services
Qualified on the content I am responsible for because: I am a Master of Public Health Candidate, 2016 in Health Behavior and Education at the University of Michigan School of Public Health. I currently work on research related to sexuality and health disparities, particularly those related to men who have sex with men and HIV/AIDS.
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.