The Association Between Condomless Anal Sex and Social Support Among Black Men Who Have Sex With Men (MSM) in Six U.S. Cities: A Study Using Data from the HIV Prevention Trials Network BROTHERS Study (HPTN 061)

  • Keith A. Hermanstyne
  • Harold D. GreenJr.
  • Hong-Van Tieu
  • Christopher Hucks-Ortiz
  • Leo Wilton
  • Steven Shoptaw
Original Paper


We assessed how egocentric (i.e., self-generated descriptions of a person’s social contacts) network structure and composition corresponded with reported instances of condomless receptive and insertive anal intercourse with men who were reportedly HIV-infected or of unknown HIV serostatus in a sample of black men who have sex with men (MSM) in six U.S. cities. Ratings showing a higher percentage of network members who provided social participation and medical support were positively associated with reporting condomless sex. There were also significant positive associations between stimulant use and condomless insertive and receptive anal sex. Future research should examine the social processes that underlie these associations and explore ways that social support can affect HIV prevention efforts for black MSM.


Black men who have sex with men Social networks Condomless anal sex HIV prevention 



Keith A. Hermanstyne received support from the UCLA-Robert Wood Johnson Clinical Scholars Program, and Kenneth B. Wells and Nina T. Harawa provided study design feedback and research mentorship on this project.


Hong-Van Tieu reports that the HPTN 061 study was funded at the New York Blood Center by NIH 1-U01-AI06946. Steven Shoptaw received support via the P30 MH058107 Grant.

Compliance with Ethical Standards

Conflict of interest

Keith A. Hermanstyne declares that he has no conflict of interest. Harold D. Green, Jr. declares that he has no conflict of interest. Hong-Van Tieu has received a research grant from Merck. Christopher Hucks-Ortiz declares that he has no conflict of interest. Leo Wilton declares that he has no conflict of interest. Steven Shoptaw reports grants from the National Institute on Mental Health during the conduct of the study and other support from Medicinova, Inc. outside of the submitted work.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of each institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10461_2018_2315_MOESM1_ESM.docx (17 kb)
Supplementary material 1 (DOCX 16 kb)


  1. 1.
    Hall HI, Song R, Tang T, An Q, Prejean J, Dietz P, et al. HIV trends in the United States: diagnoses and estimated incidence. JMIR Public Health Surveill. 2017;3:e8.CrossRefGoogle Scholar
  2. 2.
    Carlos J-A, Bingham TA, Stueve A, Lauby J, Ayala G, Millett GA, et al. The role of peer support on condom use among Black and Latino MSM in three urban areas. AIDS Educ Prev. 2010;22:430–44.CrossRefGoogle Scholar
  3. 3.
    Koblin BA, Tieu H-V, Frye V. Disparities in HIV/AIDS in black men who have sex with men. Lancet. 2012;380:316–8.CrossRefGoogle Scholar
  4. 4.
    Schneider JA, Cornwell B, Ostrow D, Michaels S, Schumm P, Laumann EO, et al. Network mixing and network influences most linked to HIV infection and risk behavior in the HIV epidemic among black men who have sex with men. Am J Public Health. 2013;103:e28–36.CrossRefGoogle Scholar
  5. 5.
    HIV among African American gay and bisexual men. Centers for Disease Control and Prevention. Accessed February 6, 2017.
  6. 6.
    Koblin BA, Mayer KH, Eshleman SH, Wang L, Mannheimer S, Rio CD, et al. Correlates of HIV acquisition in a cohort of black men who have sex with men in the United States: HIV Prevention Trials Network (HPTN) 061. PLoS ONE. 2013;8:e70413.CrossRefGoogle Scholar
  7. 7.
    Millett GA, Jeffries WL, Peterson JL, Malebranche DJ, Lane T, Flores SA, et al. Common roots: a contextual review of HIV epidemics in black men who have sex with men across the African diaspora. Lancet. 2012;380:411–23.CrossRefGoogle Scholar
  8. 8.
    Halkitis PN, Kapadia F, Siconolfi DE, Moeller RW, Figueroa RP, Barton SC, et al. Individual, psychosocial, and social correlates of unprotected anal intercourse in a new generation of young men who have sex with men in New York City. Am J Public Health. 2013;103:889–95.CrossRefGoogle Scholar
  9. 9.
    Millett GA, Flores SA, Peterson JL, Bakeman R. Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. AIDS. 2007;21:2083–91.CrossRefGoogle Scholar
  10. 10.
    Neblett RC, Davey-Rothwell M, Chander G, Latkin CA. Social network characteristics and HIV sexual risk behavior among urban African American women. J Urban Health. 2011;88:54–65.CrossRefGoogle Scholar
  11. 11.
    Latkin CA, German D, Vlahov D, Galea S. Neighborhoods and HIV: a social ecological approach to prevention and care. Am Psychol. 2013;68:210–24.CrossRefGoogle Scholar
  12. 12.
    Amirkhanian YA. Social networks, sexual networks and HIV risk in men who have sex with men. Curr HIV/AIDS Rep. 2014;11:81–92.CrossRefGoogle Scholar
  13. 13.
    Heaney CA, Israel BA. Social networks and social support. In: Glanz K, Rimer BK, Lewis FM, editors. Health behavior and health education: theory, research, and practice. 3rd ed. San Francisco: Jossey-Bass; 2008.Google Scholar
  14. 14.
    Dyer TP, Regan R, Wilton L, Harawa NT, Ou SS, Wang L, et al. Differences in substance use, psychosocial characteristics and HIV-related sexual risk behavior between black men who have sex with men only (BMSMO) and black men who have sex with men and women (BMSMW) in six US cities. J Urban Health. 2013;90:1181–93.CrossRefGoogle Scholar
  15. 15.
    Wong CF, Schrager SM, Holloway IW, Meyer IH, Kipke MD. Minority stress experiences and psychological well-being: the impact of support from and connection to social networks within the Los Angeles house and ball communities. Prev Sci. 2014;15:44–55.CrossRefGoogle Scholar
  16. 16.
    Shah NS, Iveniuk J, Muth SQ, Michaels S, Jose J-A, Laumann EO, et al. Structural bridging network position is associated with HIV status in a younger black men who have sex with men epidemic. AIDS Behav. 2014;18:335–45.CrossRefGoogle Scholar
  17. 17.
    Scott HM, Pollack L, Rebchook GM, Huebner DM, Peterson J, Kegeles SM. Peer social support is associated with recent HIV testing among young black men who have sex with men. AIDS Behav. 2014;18:913–20.CrossRefGoogle Scholar
  18. 18.
    Forney JC, Miller RL, The City Project Study Team. Risk and protective factors related to HIV-risk behavior: a comparison between HIV-positive and HIV-negative young men who have sex with men. AIDS Care. 2012;24:544–52.CrossRefGoogle Scholar
  19. 19.
    Tucker JS, Hu J, Golinelli D, Kennedy DP, Green HD Jr, Wenzel SL. Social network and individual correlates of sexual risk behavior among homeless young men who have sex with men. J Adolesc Health. 2012;51:386–92.CrossRefGoogle Scholar
  20. 20.
    Liu H, Feng T, Liu H, Feng H, Cai Y, Rhodes AG, et al. Egocentric networks of Chinese men who have sex with men: network components, condom use norms, and safer sex. AIDS Patient Care STDs. 2009;23:885–93.CrossRefGoogle Scholar
  21. 21.
    Qiao S, Li X, Stanton B. Social support and HIV-related risk behaviors: a systematic review of the global literature. AIDS Behav. 2014;18:419–41.CrossRefGoogle Scholar
  22. 22.
    Mayer KH, Wang L, Koblin B, Mannheimer S, Magnus M, Rio CD, et al. Concomitant socioeconomic, behavioral, and biological factors associated with the disproportionate HIV infection burden among black men who have sex with men in 6 U. S. cities. PLoS ONE. 2014;9:e87298.CrossRefGoogle Scholar
  23. 23.
    Latkin C, Yang C, Tobin K, Roebuck G, Spikes P, Patterson J. Social network predictors of disclosure of MSM behavior and HIV-positive serostatus among African American MSM in Baltimore, Maryland. AIDS Behav. 2012;16:535–42.CrossRefGoogle Scholar
  24. 24.
    Goedel WC, Schneider JA, Hambrick HR, Kreski NT, Morganstein JG, Park SH, et al. Are anal sex roles associated with preferences for pre-exposure prophylaxis administration modalities among men who have sex with men? Arch Sex Behav. 2018;47:2123–33.CrossRefGoogle Scholar
  25. 25.
    Latkin CA, Tieu H, Fields S, Hanscom BS, Connor M, Hanscom B, et al. Social network factors as correlates and predictors of high depressive symptoms among black men who have sex with men in HPTN 061. AIDS Behav. 2017;21:1163–70.CrossRefGoogle Scholar
  26. 26.
    Killworth PD, Bernard HR. Informant accuracy in social network data. Hum Organ. 1976;1976(35):269–86.CrossRefGoogle Scholar
  27. 27.
    Bernard HR, Killworth P, Kronenfeld D, Sailer L. The problem of informant accuracy: the validity of retrospective data. Annu Rev Anthropol. 1984;13:495–517.CrossRefGoogle Scholar
  28. 28.
    Bernard HR, Hallett T, Iovita A, Johnsen EC, Lyerla R, McCarty C, et al. Counting hard-to-count populations: the network scale-up method for public health. Sex Transm Infect. 2016;86:11–5.Google Scholar
  29. 29.
    Wenzel SL, Green HD, Tucker JS, Golinelli D, Kennedy DP, Ryan G, et al. The social context of homeless women’s alcohol and drug use. Drug Alcohol Depend. 2006;105:16–23.CrossRefGoogle Scholar
  30. 30.
    Nieuwbeerta P, Flap H. Crosscutting social circles and political choice: effects of personal network composition on voting behavior in The Netherlands. Soc Netw. 2000;2000(22):313–35.CrossRefGoogle Scholar
  31. 31.
    Carrington PJ, Scott J, Wasserman S, editors. Models and methods in social network analysis. 1st ed. Cambridge: Cambridge University Press; 2005.Google Scholar
  32. 32.
    Perry BL, Pescosolido BA, Borgatti SP. Egocentric network analysis: foundations, methods, and models. 1st ed. Cambridge: Cambridge University Press; 2018.CrossRefGoogle Scholar
  33. 33.
    Kashy DA, Kenny DA. Dyadic data analysis using multilevel modeling. In: Hox J, Roberts JK, editors. Handbook of advanced multilevel analysis. 1st ed. New York: Routledge; 2011.Google Scholar
  34. 34.
    Kenny DA, Kashy DA, Cook WL, editors. Dyadic data analysis. 1st ed. New York: The Guilford Press; 2006.Google Scholar
  35. 35.
    Margolis AD, Joseph H, Hirshfield S, Chiasson MA, Belcher L, Purcell DW. Anal intercourse without condoms among HIV-positive men who have sex with men recruited from a sexual networking web site, United States. Sex Transm Dis. 2014;41:749–55.CrossRefGoogle Scholar
  36. 36.
    Khosropour CM, Dombrowski JC, Swanson F, Kerani RP, Katz DA, Barbee LA, et al. Trends in serosorting and the association with HIV/STI risk over time among men who have sex with men. J Acquir Immune Defic Syndr. 2016;72:189–97.CrossRefGoogle Scholar
  37. 37.
    Goedel WC, Halkitis PN, Greene RE, Duncan DT. Correlates of awareness of and willingness to use pre-exposure prophylaxis (PrEP) in gay, bisexual, and other men who have sex with men who use geosocial-networking smartphone applications in New York City. AIDS Behav. 2016;20:1435–42.CrossRefGoogle Scholar
  38. 38.
    Goedel WC, Halkitis PN, Greene RE, Hickson DA, Duncan DT. HIV risk behaviors, perceptions, and testing and preexposure prophylaxis (PrEP) awareness/use in Grindr-using men who have sex with men in Atlanta, Georgia. J Assoc Nurses AIDS Care. 2016;27:133–42.CrossRefGoogle Scholar
  39. 39.
    Holloway IW, Pulsipher CA, Gibbs J, Barman-Adhikari A, Rice E. Network influences on the sexual risk behaviors of gay, bisexual and other men who have sex with men using geosocial networking applications. AIDS Behav. 2015;19(Suppl 2):112–22.CrossRefGoogle Scholar
  40. 40.
    Newcomb ME, Mongrella MC, Weis B, McMillen SJ, Mustanski B. Partner disclosure of PrEP use and undetectable viral load on geosocial networking apps: frequency of disclosure and decisions about condomless sex. J Acquir Immune Defic Syndr. 2016;71:200–6.CrossRefGoogle Scholar
  41. 41.
    Mimiaga MJ, Reisner SL, Fontaine Y-M, Bland SE, Driscoll MA, Isenberg D, et al. Walking the line: stimulant use during sex and HIV risk behavior among Black urban MSM. Drug Alcohol Depend. 2010;110:30–7.CrossRefGoogle Scholar
  42. 42.
    Skeer MR, Mimiaga MJ, Mayer KH, O’Cleirigh C, Covahey C, Safren SA. Patterns of substance use among a large urban cohort of HIV-infected men who have sex with men in primary care. AIDS Behav. 2012;16:676–89.CrossRefGoogle Scholar
  43. 43.
    Snowden JM, Wei C, McFarland W, Raymond HF. Prevalence, correlates and trends in seroadaptive behaviours among men who have sex with men from serial cross-sectional surveillance in San Francisco, 2004–2011. Sex Transm Infect. 2014;90:498–504.CrossRefGoogle Scholar
  44. 44.
    Dariotis JK, Sonenstein FL, Gates GJ, Capps R, Astone NM, Pleck JH, et al. Changes in sexual risk behavior as young men transition to adulthood. Perspect Sex Reprod Health. 2008;40:218–25.CrossRefGoogle Scholar
  45. 45.
    Pines HA, Gorbach PM, Weiss RE, Shoptaw S, Landovitz RJ, Javanbakht M, et al. Sexual risk trajectories among MSM in the United States. J Acquir Immune Defic Syndr. 2014;65:579–86.CrossRefGoogle Scholar
  46. 46.
    Newcomb ME, Mustanski B. Developmental change in the effects of sexual partner and relationship characteristics on sexual risk behavior in young men who have sex with men. AIDS Behav. 2016;20:1284–94.CrossRefGoogle Scholar
  47. 47.
    Dangerfield DT, Smith LR, Williams J, Unger J, Bluthenthal R. Sexual positioning among men who have sex with men: a narrative review. Arch Sex Behav. 2016;46:869–84.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Keith A. Hermanstyne
    • 1
  • Harold D. GreenJr.
    • 2
    • 3
  • Hong-Van Tieu
    • 4
    • 5
  • Christopher Hucks-Ortiz
    • 6
  • Leo Wilton
    • 7
    • 8
  • Steven Shoptaw
    • 9
  1. 1.Department of Psychiatry, UCSF Weil Institute for NeurosciencesUniversity of CaliforniaSan FranciscoUSA
  2. 2.Indiana University Network Science InstituteBloomingtonUSA
  3. 3.Center for Applied Network Analysis and Systems ScienceRAND CorporationSanta MonicaUSA
  4. 4.Laboratory of Infectious Disease PreventionNew York Blood CenterNew YorkUSA
  5. 5.Division of Infectious Diseases, Department of MedicineColumbia University Medical CenterNew YorkUSA
  6. 6.Division of HIV ServicesJWCH InstituteLos AngelesUSA
  7. 7.Department of Human DevelopmentState University of New York at BinghamtonBinghamtonUSA
  8. 8.Faculty of HumanitiesUniversity of JohannesburgJohannesburgSouth Africa
  9. 9.Department of Family MedicineUniversity of CaliforniaLos AngelesUSA

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