To examine how social networks influence HIV risk among U.S. racial/ethnic minority men who have sex with men (MSM) and whether the associations of social network characteristics with risk vary by race/ethnicity.
A chain-referral sample of 403 African American, 393 Asian/Pacific Islander, and 400 Latino MSM recruited in Los Angeles County, CA completed a questionnaire, which asked about their egocentric social networks, safer sex peer norms, and male anal intercourse partners. HIV-nonconcordant partnerships were those reported by respondents as serodisconcordant or where self and/or partner serostatus was unknown.
Overall, 26% of the sample reported HIV-nonconcordant unprotected anal intercourse (UAI) with a non-primary male partner in the prior six months. In a GEE logistic model that controlled for race/ethnicity, age, nativity, incarceration history, and HIV status, being in a more dense network was associated with less HIV-nonconcordant UAI (adjusted odds ratio [AOR]=0.92, 95% confidence interval [CI]=0.86–0.99, p=0.0467). In addition, the effect of safer sex peer norms on HIV-nonconcordant UAI was moderated by ego-alter closeness (p=0.0021). Safer sex peer norms were protective among those reporting “medium” or “high” ego-alter closeness (AOR=0.70, 95% CI=0.52–0.95, p=0.0213 and AOR=0.48, 95% CI=0.35–0.66, p<0.0001, respectively), but not among those reporting “low” ego-alter closeness (AOR=0.96, 95% CI=0.63–1.46, p=0.8333). The effects of density, closeness, and norms on HIV-nonconcordant UAI did not differ by race/ethnicity.
The significant association of social network characteristics with UAI point to network-level factors as important loci for both ongoing research and HIV prevention interventions among U.S. MSM of color.