AIDS and Behavior

, Volume 23, Issue 7, pp 1698–1707 | Cite as

Network Modeling of PrEP Uptake on Referral Networks and Health Venue Utilization Among Young Men Who Have Sex with Men

  • Kayo FujimotoEmail author
  • Peng Wang
  • Charlene A. Flash
  • Lisa M. Kuhns
  • Yucheng Zhao
  • Muhammad Amith
  • John A. Schneider
Original Paper


The objective of this study is to identify individual-level factors and health venue utilization patterns associated with uptake of pre-exposure prophylaxis (PrEP) and to evaluate whether PrEP uptake behavior is further diffused among young men who have sex with men (YMSM) through health venue referral networks. A sample of 543 HIV-seronegative YMSM aged 16–29 were recruited in 2014–2016 in Chicago, IL, and Houston, TX. Stochastic social network models were estimated to model PrEP uptake. PrEP uptake was associated with more utilization of health venues in Houston and higher levels of sexual risk behavior in Chicago. In Houston, both Hispanic and Black YMSM compared to White YMSM were less likely to take PrEP. No evidence was found to support the spread of PrEP uptake via referral networks, which highlights the need for more effective PrEP referral network systems to scale up PrEP implementation among at-risk YMSM.


Social network analysis PrEP Health care delivery system Young men who have sex with men Systems science methodology Exponential random graph models Auto-logistic actor attribute models 



This work was supported by the National Institutes of Health (1R01MH100021, 1R01DA039934, K23-MH109358-02), by Gilead Sciences, Inc. (IN-US-276-D120), and by UTHealth Innovation for Cancer Prevention Research Training Program (Cancer Prevention and Research Institute of Texas grant # RP160015). We acknowledge the contributions to this study of Angela Di Paola, Ju-Yeong Kim, and the YMAP staff in both Houston and Chicago.

Compliance with Ethical Standards

Conflicts of interest

K. Fujimoto, L. Kuhns, and J. Schneider have received research grants from Gilead Sciences, Inc. C. Flash serves on the scientific advisory board of Gilead Sciences, Inc.

Supplementary material

10461_2018_2327_MOESM1_ESM.docx (63 kb)
Supplementary material 1 (DOCX 63 kb)


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Copyright information

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

Authors and Affiliations

  • Kayo Fujimoto
    • 1
    Email author
  • Peng Wang
    • 2
  • Charlene A. Flash
    • 3
  • Lisa M. Kuhns
    • 4
  • Yucheng Zhao
    • 5
  • Muhammad Amith
    • 6
  • John A. Schneider
    • 7
  1. 1.Department of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention ResearchThe University of Texas Health Science Center at HoustonHoustonUSA
  2. 2.Faculty of Business and Law, Centre for Transformative InnovationSwinburne University of TechnologyHawthornAustralia
  3. 3.Division of Infectious Diseases, Department of MedicineBaylor College of MedicineHoustonUSA
  4. 4.Division of Adolescent Medicine, Department of Pediatrics, Feinberg School of MedicineAnn & Robert H. Lurie Children’s Hospital, and Northwestern UniversityChicagoUSA
  5. 5.Department of Biostatistics and Data Science, School of Public HealthThe University of Texas Health Science Center at HoustonHoustonUSA
  6. 6.School of Biomedical InformaticsThe University of Texas Health Science Center at HoustonHoustonUSA
  7. 7.Departments of Medicine and Public Health Sciences and the Chicago Center for HIV EliminationUniversity of ChicagoChicagoUSA

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