Table 1.
Summary of studies on networks and HIV risk and disparities for MSM in the U.S
| Identifier | Data source | Setting | Sample composition | N | Network definition | Outcome measures | Key findings |
|---|---|---|---|---|---|---|---|
| Arnold et al. [20] | Recruited from HBC events, gay venues, and gay pride events | San Francisco | All BMSM and Black Transwomen | 274 | Social network | CAI | Social support for safer sex was found to be associated with lower rates of CAI. Additionally, homophily on sexual identity was associated with lower rates of CAI |
| Birkett et al. [23] | Recruited from a parent study of YMSM | Chicago | 54% BMSM, 22% LMSM, 13% WMSM, 10% Other* MSM | 175 | Sexual network | CAI | Bivariate association found between social/sexual network multiplexity and CAI |
| Carlos et al. [16] | Brothers y Hermanos, RDS | Los Angeles, New York, and Philadelphia | 50% BMSM, 50% LMSM | 1648 | Social network | CAI | Greater MSM network size was related to higher rates of CAI among casual partners for Black MSM, while smaller network size was related to CAI for Latino MSM |
| Choi et al. [19] | Seeds were recruited from MSM venues and events | Los Angeles CA | 34% BMSM, 33% LMSM, 33% Other* MSM | 1196 | Social network | SDCAI with a non-primary partner | Greater density amongst alters was associated with lower rates of SDCAI. Egos with closer ties to their alters were more likely to have SDCAI. Peer norms attenuated this effect in "medium" and "high" closeness ties, but did not effect "low" closeness ties |
| Flores et al. [15] | Community intervention trial for youth | 13 cities in the US | 28% BMSM, 37% LMSM, 22% WMSM, 12% Other* MSM | 10,295 | Social network | CAI | MSM/W were less likely to have high social support than MSM. MSM/W were less likely to have CAI than MSM |
| Fujimoto et al. [33] | YMAP | Houston and Chicago | All BMSM | 365 | Social/sexual network | HIV prevalence | Larger sexual networks were associated with greater odds of being HIV positive |
| Gorbach et al. [38] | NIDA’s Sexual Acquisition and Transmission of HIV—Cooperative Agreement Program | Los Angeles | 53% BMSM, 22% LMSM, 19% WMSM, 6% Other* | 1125 | Sexual network | CAI | Men with more women in their sexual networks reported less CAI, and men with more people living with HIV in their sexual network reported more CAI. Being homeless in the past year was associated with greater odds of CAI |
| Grey et al. [37] | Men’s Atlanta Networks (MAN) Project | Atlanta | 61% BMSM, 39% WMSM | 142 | Sexual network | CAI, HIV prevalence | Black men have higher odds of having an HIV positive partner (increased HIV prevalence in sexual network) and higher odds of having an unknown positive partner (higher undiagnosed seropositivity in sexual network) |
| Hermanstyne et al. [27] | BROTHERS (HPTN 061) | 6 US cities | All BMSM | 1000 | Social network | Seroconversion | Emotional support, medical support, and social participation support were all protective against seroconversion |
| Hernandez-Romieu et al. [31] | Men’s Atlanta Networks (MAN) Project | Atlanta | 60% BMSM, 40% WMSM | 195 | Sexual network | Network HIV prevalence | BMSM were more likely to have HIV positive partners in their networks than WMSM. Young HIV negative BMSM have greater prevalence of HIV in their networks than older HIV negative BMSM. Unemployment was related to higher HIV prevalence within networks |
| Hickson et al. [36] | BROTHERS Study (HPTN 061) | 6 US cities | All BMSM and Black Transwomen | 1306 | Sexual network | SDCAI | Racial homophily in sexual networks was higher for participants living with HIV. SDCAI was more common with commercial partners than with primary or steady non-primary, but was not significantly different from casual partners. Greater frequency of communication was associated with lower rates of SDCAI |
| Jeffries et al. [39] | Brothers y Hermanos | New York and Philadelphia | All BMSM | 1140 | Social network | CAI | Homophobia was related to increased CAI in HIV negative men and SDCAI in men living with HIV. In fully adjusted models, social support and other network variables were insignificant predictors of CAI, while homophobia remained significant |
| Joseph et al. [17] | Three intervention trials | Philadelphia, Chicago, Los Angeles | All BMSM | 584 | Social network | CAI | Larger social network was associated with slightly increased rates of CAI. Social support was found to be related to decreased CAI. Homonegativity was also found to be protective against CAI |
| Kapadia et al. [18] | Baseline visit from a longer prospective cohort study | New York City | 19% BMSM, 45% LMSM, 36% WMSM | 501 | Social network | CAI | For Latino YMSM, greater social network size reduced CAI. Across racial groups, having a sex partner in ones social network was related to higher odds of CAI, as did being in a relationship. There was a trend towards gay community affiliation being related to increased CAI in White and Latino YMSM |
| Lauby et al. [29] | Brothers y Hermanos | Los Angeles, New York, and Philadelphia | 48% BMSM, 52% LMSM | 1286 | Social network | Unrecognized HIV infection, CAI with non-main partner | Social support was associated with lower rates of unrecognized HIV infection. Social support was also associated with lower rates of CAI with non-main partner and higher HIV testing rates. Tests for mediation revealed that these relationships mediated the effect of social support on unrecognized infection |
| Mimiaga et al. [28] | RDS seeds recruited from HIV and social service organizations | Boston | All BMSM | 197 | Social/sexual network | CAI | Social isolation, homelessness, and using poppers at least weekly were all associated in multivariate models with CAI with a male partner |
| Morgan et al. [34] | uConnnect | Chicago | All BMSM | 343 | Social/sexual network | Seroconversion | Participants with more recently infected network members were more likely to seroconvert during the study period, as were participants with more total network members. Having more HIV negative network members and more PrEP using network members was protective against seroconversion |
| Raymond et al.[54] | NHBS, Black Men Testing (SF Dept. of Public Heath), Transwomen Empowered to Advance Community Health (SD Dept. of Public Health), HIV surveillance data, US census data | San Francisco, CA | 32% BMSM, 5% Black transwomen, 11% Latino transwomen, 7% White transwomen, 9% Other* transwomen, 36% WMSM | 523 | Sexual network | SDCAI | BMSM reported higher number of SD partners, and a greater number of SDCAI acts than WMSM or transwomen. HIV prevalence by zip code was related to more SDCAI for transwomen, less SDCAI for WMSM, and was unrelated to sexual behavior for BMSM |
| Schneider et al. [35] | RDS seeds recruited from health clinics, LGBTQ center, substance use treatment groups, and other community based organizations | Chicago | All BMSM | 204 | Social/sexual network | CAI | Men reporting an "enabler" (someone who does not disapprove of a risk behavior) in their social networks were more likely to engage in CAI, but not men reporting an "enabler" in their sexual networks |
| Schneider et al. [30] | uConnnect | Chicago | All BMSM | 618 | Social/sexual network | CAI | Sexual network stability was associated with decreased odds of engaging in CAI (as well as group sex and sex drug use). Confidant network stability predicted decreased sex drug use. Criminal justice involvement was associated with decreased stability in both sex and confidant networks |
| Scott et al. [21] | HPTN 061 (Brothers) | 6 US cities | All BMSM and Black transwomen | 1553 | Social/sexual network | STI incidence, CAI | Larger sexual networks were associated with higher rates of CAI, higher rates of rectal chlamydia and gonorrhea, but not with HIV status or other STI measures. Racism, stigma, and homophobia were also associated with larger sexual networks. In multivariate models having more partners, using poppers, and being HIV positive were associated with higher rates of STIs |
| Shah et al. [41] | RDS seeds recruited from health clinics, LGBTQ center, substance use treatment groups, and other community based organizations | Chicago | 94% Black, 2% White, 2% Other*, 4% transwomen† | 620 | Social/sexual network | HIV prevalence | Moderate and high levels of bridging were associated with greater rates of HIV infection, when controlling for sexual risk behavior and age. Bridging was at least moderately associated with CAI in bivariate models, but was not in the multivariate model |
| Tieu et al. [22] | HPTN 061 (Brothers) | 6 US cities | All BMSM and Black transwomen | 1349 | Social/sexual network | SDCAI | In multivariate models, no network characteristics were associated with SDCAI. For HIV negative men, the odds of SDCAI were higher for those with less than a college degree and those with an anonymous or exchange sex partner |
| Tieu et al. [32] | NYC M2M | NYC | 29% BMSM, 34% LMSM, 38% WMSM | 1267 | Social/sexual network | HIV prevalence | Higher racial homophily was seen among Black participants. Black and Latino men had higher HIV prevalence in their sexual network than White men |
| Tucker et al. [26] | Recruited from homeless service sites and street sites | Los Angeles | 33% BMSM, 21% LMSM, 17% WMSM, 29% Other* MSM | 121 | Social/sexual network | CAI | CAI was higher among participants reporting more family members in their social network. CAI was lower among those with more education, more positive condom beliefs, and ties to individuals attending school. No relationship was found between tangible social support and CAI |
SDCAI serodiscordant CAI, LMSM Latino MSM, WMSM White MSM
*Other refers to other racial/ethnic minority groups
†Racial/ethnic demographics for transwomen were not reported separately