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AIDS and Behavior

, Volume 19, Issue 12, pp 2358–2369 | Cite as

Where You Live Matters: Structural Correlates of HIV Risk Behavior Among Young Men Who Have Sex with Men in Metro Detroit

  • José A. BauermeisterEmail author
  • Lisa Eaton
  • Jack Andrzejewski
  • Jimena Loveluck
  • William VanHemert
  • Emily S. Pingel
Original Paper

Abstract

Structural characteristics are linked to HIV/STI risks, yet few studies have examined the mechanisms through which structural characteristics influence the HIV/STI risk of young men who have sex with men (YMSM). Using data from a cross-sectional survey of YMSM (ages 18–29) living in Detroit Metro (N = 328; 9 % HIV-positive; 49 % Black, 27 % White, 15 % Latino, 9 % Other race), we used multilevel modeling to examine the association between community-level characteristics (e.g., socioeconomic disadvantage; distance to LGBT-affirming institutions) and YMSM’s HIV testing behavior and likelihood of engaging in unprotected anal intercourse with serodiscordant partner(s). We accounted for individual-level factors (race/ethnicity, poverty, homelessness, alcohol and marijuana use) and contextual factors (community acceptance and stigma regarding same-sex sexuality). YMSM in neighborhoods with greater disadvantage and nearer to an AIDS Service Organization were more likely to have tested for HIV and less likely to report serodiscordant partners. Community acceptance was associated with having tested for HIV. Efforts to address YMSM’s exposure to structural barriers in Detroit Metro are needed to inform HIV prevention strategies from a socioecological perspective.

Keywords

Social determinants Neighborhoods Socioeconomic disadvantage Testing 

Resumen

Las características estructurales están asociadas a los riesgos de VIH/ETS; sin embargo, pocos estudios han examinado qué mecanismos influyen en las conductas de riesgo de VIH/ETS de los hombres jóvenes que tienen sexo con hombres (YMSM). Utilizando datos de una encuesta de YMSM (edades 18-29) que viven en el área metropolitana de Detroit (N = 328; 9 % VIH positivo; 49 % Negro, 27 % blancos, 15 % latinos, 9 % Otros raza), utilizamos un modelo multinivel para examinar la asociación entre las características a nivel comunitario (por ejemplo, la desventaja socioeconómica, la distancia a las instituciones LGBT afirman) y dos conducta: el testeo de VIH y la probabilidad de tener relaciones anales sin protección con pareja(s) serodiscordante(s). Incluimos factores individuales (raza/etnia, pobreza, falta de vivienda, uso de alcohol y marihuana) y contextuales (aceptación y estigma comunitario respecto a la sexualidad del mismo sexo). YMSM que viven en barrios con mayor desventaja socioeconómica y con más cercanía a organizaciones que proveen servicios de VIH/SIDA fueron más propensos a haber testeado y menos propensos a reportar relaciones sexuales con parejas serodiscordantes. Aceptación comunitaria se asoció con una mayor probabilidad de haber testeado. Esfuerzos para hacer frente a las barreras estructurales en Detroit son necesarias para elucidar el desarrollo de estrategias de prevención del VIH desde una perspectiva socio-ecológica.

Notes

Acknowledgments

The United for HIV Integration and Policy (UHIP) academic-community partnership included representatives from AIDS Partnership Michigan, the HIV/AIDS Resource Center, Detroit Latin@z, Ruth Ellis Center, and the University of Michigan’s Center for Sexuality & Health Disparities. This work was supported by the MAC AIDS Fund (PI: Bauermeister) and a grant from the Centers for Disease Control and Prevention to Dr. Bauermeister (U22 PS004520). Dr. Eaton was supported by two National Institutes of Health projects (R01MH094230; R01NR013865). The content is solely the responsibility of the authors and does not represent the official views of the funding agencies.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • José A. Bauermeister
    • 1
    Email author
  • Lisa Eaton
    • 2
  • Jack Andrzejewski
    • 1
  • Jimena Loveluck
    • 3
  • William VanHemert
    • 4
  • Emily S. Pingel
    • 1
  1. 1.Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public HealthUniversity of MichiganAnn ArborUSA
  2. 2.University of ConnecticutStorrsUSA
  3. 3.HIV/AIDS Resource CenterYpsilantiUSA
  4. 4.AIDS Partnership MichiganDetroitUSA

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