Structural Influences on Network and Geospatial Affiliations and Racial Disparities in HIV Among Young Men Who Have Sex with Men in Chicago

Elizabeth McConnell, Michelle Birkett


Background: Black men who have sex with men (MSM), especially young MSM, are more likely to become HIV-positive than MSM of other races, yet also consistently report comparable or fewer individual risk behaviors. Emerging research documents racial/ethnic differences in the individual, venue, and neighborhood level networks of YMSM that may help explain this discrepancy. The objective of this project was to contribute to knowledge about structural mechanisms (e.g., stigma, discrimination, and resource inequality) that shape risk environments, which in turn shape consequences of substance use and other HIV risk behaviors for YMSM of different races/ethnicities. Methods: This study used a mixed methods approach to explore and interpret individual, venue, and neighborhood level patterns in risk environments captured within an existing NIH-funded cohort of YMSM. Using an explanatory sequential design, multilevel network and geospatial data were visualized (Phase 1) and subsequently used to guide interviews with YMSM (Phase 2). Phase 1 network visualizations were generated using data from 463 YMSM (ages 16-30) who lived in Chicago and who provided data about a total of 1,588 sex alters. Phase 2 interviews were conducted with a subset of 33 these participants (11 Black, 11 White, 11 Latino) who were theoretically sampled based on neighborhood affiliation. Grounded theory was used to analyze interview data, resulting in the identification of structural factors that shaped YMSM’s affiliations, which may in turn help explain racial disparities in HIV in this population. Results: Phase 1 network and geospatial visualizations highlighted patterns of White insularity in virtual (e.g., apps) and physical (e.g., neighborhoods) spaces, which were contrasted with patterns of Black and Latino bridging. Phase 2 qualitative findings highlighted YMSM’s affiliations are shaped by multilevel influences at the individual, interpersonal, and structural levels. This presentation will focus on influences at the structural level, which included neighborhood dynamics (i.e., racial segregation, insularity, and bridging); transportation; physical safety; access to resources; and policing. Further, YMSM’s intersectional identities (e.g., race/ethnicity, sexuality, gender expression, and body image) cross-cut and connect these different levels, such that YMSM of different races/ethnicities experience different “Chicagos.” Overall, study findings highlight how these structural factors may create racial/ethnic differences in YMSM’s social and sexual network processes. Implications for social network theory and research will be discussed.

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