Individual and Network Factors Associated With Racial Disparities in HIV Among Young Men Who Have Sex With Men: Results From the RADAR Cohort Study

Mustanski, Brian; Morgan, Ethan; D’Aquila, Richard T.; Birkett, Michelle; Janulis, Patrick; Newcomb, Michael E.

doi:10.1097/qai.0000000000001886

Cited by 102 publications

(80 citation statements)

References 29 publications

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“…In our study, we found minor differences in mean degree by race/ethnicity, with the fewest ongoing main and casual partnerships among black and Hispanic men, respectively, and a white/black difference of nearly 3 one-time partners per year. By this measure alone, network risks were lower among black MSM, consistent with previous research (41,42). However, we found other network features that could be contributing to these disparities.…”

Section: Discussionsupporting

confidence: 91%

Egocentric Sexual Networks of Men Who Have Sex with Men in the United States: Results from the ARTnet Study

Weiss

Goodreau

Morris

et al. 2019

Preprint

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In this paper, we present an overview and descriptive results from the first egocentric network study of MSM from across the United States (U.S.): the ARTnet study. ARTnet was designed to support prevention research for human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) that are transmitted across partnership networks. ARTnet implemented a population-based egocentric network study design that sampled egos from the target population and asked them to report on the number, attributes, and timing of their sexual partnerships. Such data provide the foundation needed for estimating and simulating stochastic network models that are used for disease projection and intervention planning. ARTnet collected data online from 2017 to 2019, with a final sample of 4904 participants who reported on 16198 sexual partnerships. The analytic aims of the study were to characterize the joint distribution of three network parameters needed for modeling: degree distributions, assortative mixing, and partnership length, with heterogeneity by partnership type (main, casual and one-time), demography, and geography. Participants had an average of 1.19 currently active partnerships ("mean degree"), which was higher for casual partnerships (0.74) than main partnerships (0.45). The mean rate of one-time partnership acquisition was 0.16 per week (8.5 partners per year). Main partnerships lasted 272.5 weeks on average, while casual partnerships lasted 133.0 weeks. There was strong but heterogenous assortative mixing by race/ethnicity for all groups. The mean absolute age difference was 9.5 years, with main partners differing by 6.3 years compared to 10.8 years for casual partners. Our analysis suggests that MSM may be at sustained risk for HIV/STI acquisition and transmission through high network degree of sexual partnerships. The ARTnet network study provides a robust and reproducible foundation for understanding the dynamics of HIV/STI epidemiology among U.S. MSM and supporting the implementation science that seeks to address persistent challenges in HIV/STI prevention.

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Section: Discussionsupporting

confidence: 91%

Egocentric Sexual Networks of Men Who Have Sex with Men in the United States: Results from the ARTnet Study

Weiss

Goodreau

Morris

et al. 2019

Preprint

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“…6,17 Empirical studies across multiple populations of MSM have suggested some racial differences in network degree, although the results are not consistent. 22,26,27 We found that the level of bias in degree measurements was higher for black MSM compared to white MSM, and conversely the accuracy of baseline ongoing status was highest in white-white partnerships. We had hypothesized that the groups with higher HIV incidence (black MSM) would overestimate degree less than groups with lower incidence (white MSM), which would strengthen the role of network factors in understanding disparities.…”

Section: Discussionmentioning

confidence: 77%

Assessment of Bias in Estimates of Sexual Network Degree using Prospective Cohort Data

Uong

Rosenberg

Goodreau

et al. 2019

Preprint

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Background: Sexual network degree, a count of ongoing partnerships, plays a critical role in the transmission dynamics of human immunodeficiency virus (HIV) and other sexually transmitted infections (STI). Researchers often quantify degree using self-reported cross-sectional data on the day of survey, which may result in bias because of uncertainty about future sexual activity. Methods: We evaluated the bias of a cross-sectional degree measure with a prospective cohort study of men who have sex with men (MSM). At baseline, we asked men about whether recent sexual partnerships were ongoing. We confirmed the true, ongoing status of those partnerships at baseline at follow-up. With logistic regression, we estimated the partnership-level predictors of baseline measure accuracy. With Poisson regression, we estimated the longitudinally confirmed degree as a function of baseline predicted degree. Results: Across partnership types, the baseline ongoing status measure was 70% accurate, with higher negative predictive value (91%) than positive predictive value (39%). Partnership exclusivity and racial pairing were associated with higher accuracy. Baseline degree generally overestimated confirmed degree. Bias, or number of ongoing partners different than predicted at baseline, was -0.28 overall, ranging from -1.91 to -0.41 for MSM with any ongoing partnerships at baseline. Comparing MSM of the same baseline degree, the level of bias was stronger for black compared to white MSM, and for younger compared to older MSM. Conclusions: Research studies may overestimate degree when it is quantified cross-sectionally. Adjustment and structured sensitivity analyses may account for bias in studies of HIV or STI prevention interventions.

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“…The FRP may not have strong explanatory power for racial disparities, similarly to how differences in sexual behaviors between racial groups have not fully explained disparities. 9,46 Limitations. There are several limitations to our analysis.…”

Section: Discussionmentioning

confidence: 99%

The HIV/STI Epidemic Potential of Dynamic Sexual Networks of Men Who Have Sex With Men in Atlanta and San Francisco

Anderson

Weiss

Morris

et al. 2020

Preprint

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Background: The potential speed through which a pathogen may circulate in a network is a function of network connectivity. Network features like degree (number of ongoing partnerships) determine the cross-sectional network connectivity. The overall transmission potential of a pathogen involves connectivity over time, which can be measured using the forward reachable path (FRP). We modeled dynamic sexual networks of MSM in San Francisco and Atlanta to estimate the FRP as a predictor of HIV/STI epidemic potential. Methods: We used exponential random graph models to obtain parameter estimates for each city's sexual network and then simulated the complete networks over time. The FRP was estimated in each city overall and stratified by demographics. Results: The overall mean and median FRPs were higher in San Francisco than in Atlanta, suggesting a greater epidemic potential for HIV and STIs in San Francisco. At one year, in both cities, the average FRP among casual partnerships was highest in the youngest age group and lowest in the oldest age group, contrasting with the cross-sectional network parameters we estimated, where the youngest age category had the lowest mean degree and the oldest age category had the highest mean degree. Conclusions: The FRP results correspond to the observed STI epidemics but not HIV epidemics between the cities. In San Francisco, rates of HIV have been declining over the last few years, whereas they have been steady in Atlanta. The FRP by age group resulted in fundamentally different conclusions about connectivity in the network compared with the cross-sectional network measures.

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Individual and Network Factors Associated With Racial Disparities in HIV Among Young Men Who Have Sex With Men: Results From the RADAR Cohort Study

Cited by 102 publications

References 29 publications

Egocentric Sexual Networks of Men Who Have Sex with Men in the United States: Results from the ARTnet Study

Egocentric Sexual Networks of Men Who Have Sex with Men in the United States: Results from the ARTnet Study

Assessment of Bias in Estimates of Sexual Network Degree using Prospective Cohort Data

The HIV/STI Epidemic Potential of Dynamic Sexual Networks of Men Who Have Sex With Men in Atlanta and San Francisco

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