Social Network Dynamics, HIV, and Risk Reduction Among Younger Black MSM

描述（由申请人提供）：本研究项目拨款申请（R01）要求资金用于在以社区为基础的年轻黑人男性（16-29岁）与男性发生性行为（YBMSM）的样本中，对性药物使用背景下社会网络如何影响风险和降低风险的做法进行基本调查，以确定干预减少艾滋病毒传播的关键点。YBMSM根植于异质黑人社区。从一个YBMSM个体的角度来看，他的社会网络通常包括亲密的知己，如主要伴侣、亲戚和朋友，他们可能对他的行为和伴侣的选择产生支持或敌对的影响。随着时间的推移，这些朋友中的许多人可能会在一个人的网络中的非性和性组成部分之间交叉。此外，许多其他结构和机构，如舞厅社区、拘留中心/监狱和互联网社交网站，塑造了YBMSM的网络和规范。YBMSM是如何在这些丰富和动态的社会环境中定位的，以及他们的社会网络对性伴侣选择、性/药物相关实践和与特定伴侣的风险降低行为的相当大的影响，直到最近才开始探索。我们的分析方法侧重于应用于YBMSM的奥尔巴赫“社会驱动因素”模型的组成部分，特别关注该团队擅长研究的两个组成部分：规范和网络。这些因素塑造了个体的行为和实践，并受到诸如性毒品使用等情境因素的调节。基于我们的前期工作，我们发现1)危险行为（UAI、性-毒品使用、群体性行为）的二元混合；2)来自社会网络成员的影响；3)非性社交网络的组成与YBMSM的风险和生物医学预防干预有关。然而，到目前为止，网络和其他“社会驱动因素”在男同性恋者中感染艾滋病毒之间的因果关系一直难以捉摸。因此，我们利用3波纵向队列方法，旨在：1)描述16-29岁青年女性社会网络的动态，并估计特定网络属性（如知己组成和成分大小）与后续风险/风险降低行为之间的关系，包括他们与各种社会结构和制度的相互作用；2)在该样本及其扩展网络中，随着时间的推移，检查社会网络、规范、风险/降低风险的做法与艾滋病毒/性传播感染之间的关系；3)确定性毒品使用等情境因素在社会网络特征、规范和风险/风险降低实践之间的关系中起中介作用的程度；4)探索得知一个人是艾滋病毒阳性如何影响社会网络、规范和风险/风险降低实践。这项研究是发展基于科学的网络干预措施的必要步骤，可以补充针对不同YBMSM群体及其扩展网络的组合干预措施。

DESCRIPTION (provided by applicant): This research program grant application (R01) requests funds to conduct basic investigation of how social networks affect risk and risk reduction practices longitudinally in the context of sex-drug use within a community-based sample of younger Black men (16-29) who have sex with men (YBMSM) in order to identify critical points for intervention to reduce HIV transmission. YBMSM are embedded within heterogeneous Black communities. From the perspective of an individual YBMSM, his social network often include close confidants such as primary partners, relatives and friends who may exert supportive or antagonistic influences on his behavior and choice of partner(s). Many of these friends may crossover between the non-sexual and sexual components of one's network over time. Additionally, numerous other structures and institutions such as the ballroom community, detention centers/jails and internet social networking sites shape YBMSM networks and norms. How YBMSM are positioned within these rich and dynamic social environments and the considerable influence their social networks have on sex partner selection, sexual/drug related practices and risk-reduction behavior with specific partners has only recently begun to be explored. Our analytic approach focuses on components of the Auerbach 'social drivers' model applied to YBMSM, with particular attention to two components that this team is well positioned to study: norms and networks. These factors shape individuals' behaviors and practices modulated by situational factors such as sex-drug use. Based upon our preliminary work, we found that 1) dyadic mixing by risk behaviors (UAI, sex-drug use, group sex); 2) influences from social network members; and 3) composition of non-sexual social networks are associated with risk and biomedical prevention interventions in cross-sectional analyses of YBMSM. Thus far however, causal associations between networks and other 'social drivers' of HIV infection among BMSM, have been elusive. Accordingly, utilizing a 3 wave longitudinal cohort approach we aim to: 1) Describe the dynamics of social networks among YBMSM ages 16-29, and estimate the relationships between specific network attributes (e.g., confidant composition and component size) and subsequent risk/risk reduction behaviors, including their interaction with various social structures and institutions; 2) Examine the relationships between social networks, norms, risk/risk reduction practices and HIV/STI infection over time among this sample and their extended networks; 3) Determine the extent to which situational factors such as sex-drug use mediates the relationship between social network characteristics, norms and risk/risk reduction practices over time; and 4) Explore how learning that one is HIV positive affects social networks, norms and risk/risk reduction practices. This research is a necessary step in the development of scientifically-based network interventions that can complement combination interventions targeted to diverse YBMSM groups and their extended networks. PUBLIC HEALTH RELEVANCE: This research program grant application requests funds to conduct basic investigation of how social networks affect risk and risk reduction practices longitudinally in the context of sex-drug use within a community-based sample of younger Black men (16-29) who have sex with men (YBMSM) in order to identify critical points for intervention to reduce HIV transmission. The aim is to understand how YBMSM are positioned within rich and dynamic social environments and the considerable influence their social networks have on sex partner selection, sexual/drug related practices and risk-reduction behavior with specific partners. This research is a necessary step in the development of scientifically-based network interventions that can complement combination interventions targeted to diverse YBMSM groups and their extended networks.