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Original article
Neighbourhoods, networks and pre-exposure prophylaxis awareness: a multilevel analysis of a sample of young black men who have sex with men
  1. Yen-Tyng Chen1,2,
  2. Marynia Kolak3,
  3. Dustin T Duncan4,
  4. Phil Schumm5,
  5. Stuart Michaels6,
  6. Kayo Fujimoto7,
  7. John A Schneider1,2
  1. 1 Chicago Center for HIV Elimination, Chicago, Illinois, USA
  2. 2 Department of Medicine, University of Chicago, Chicago, Illinois, USA
  3. 3 Center for Spatial Data Science, University of Chicago, Chicago, Illinois, USA
  4. 4 NYU Spatial Epidemiology Lab, Department of Population Health, School of Medicine, New York University, New York City, New York, USA
  5. 5 Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
  6. 6 NORC at University of Chicago, Chicago, Illinois, USA
  7. 7 Department of Health Promotion & Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
  1. Correspondence to Dr Yen-Tyng Chen, Department of Medicine, University of Chicago, Chicago, IL 60637, USA; ychen22{at}uchicago.edu; yenting1219{at}gmail.com

Abstract

Objective Young black men who have sex with men (YBMSM) in the USA represent a subgroup that has the highest HIV incidence among the overall population. In the USA, pre-exposure prophylaxis (PrEP) is an effective prevention intervention to prevent HIV acquisition when taken regularly. Neighbourhood and network factors may relate to PrEP awareness, but have not been studied in YBMSM. This study aimed to examine the relationship of neighbourhood and network characteristics with PrEP awareness among YBMSM.

Methods We used data collected from a sample of 618 YBMSM in Chicago (2013–2014). Home addresses were collected for participants and enumerated network members. Administrative data (eg, 2014 American Community Survey, Chicago Department of Public Health) were used to describe residence characteristics. Network member characteristics were also collected (eg, sexual partners’ sex-drug use, confidant network members who were also MSM). Multilevel analysis was performed to examine the relationships of neighbourhood and network characteristics to PrEP awareness.

Results Higher neighbourhood-level educational attainment (adjusted odds ratio (aOR) 1.02, p=0.03) and greater primary care density (aOR 1.38, p=0.01) were associated with greater PrEP awareness; greater neighbourhood alcohol outlet density (aOR 0.52, p=0.004) was associated with less PrEP awareness. Sexual network members residing in the same neighbourhood as the participants (aOR 2.58, p=0.03) and discussions around avoiding HIV acquisition with confidants (aOR 2.26, p=0.04) were associated with greater PrEP awareness.

Conclusions The results suggest that neighbourhood and network characteristics can influence PrEP awareness in YBMSM. Additional studies are needed to understand the influences of neighbourhood (eg, MSM serving venues) and network (eg, peer to peer communication) characteristics on dissemination of PrEP information, uptake and adherence and the related mechanisms behind the associations.

  • sexual minorities
  • residence characteristics
  • pre-exposure prophylaxis (PrEP)
  • multilevel analysis
  • network
  • sexual partners

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Footnotes

  • Handling editor Stefan Baral

  • Contributors Y-TC conceptualised the study, designed and conducted multilevel analysis and led the writing of the article. MK prepared the spatial data and conceptualised the study. DTD interpreted the results and conceptualised the study. PS interpreted the results and provided statistical guidance. SM collected the data and interpreted the results. KF collected spatial data and interpreted the results. JAS led the project, interpreted the results and conceptualised the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Institutional Review Board approval was obtained from the NORC at the University of Chicago (IRB00000967).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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