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A Comparison of the Social and Sexual Networks of Crack-Using and Non-Crack Using African American Men who Have Sex with Men

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Abstract

The role of crack cocaine in accelerating the HIV epidemic among heterosexual populations has been well documented. Little is known about crack use as an HIV risk factor among African American men who have sex with men (AA MSM), a group disproportionately infected with HIV. We sought to compare the social and sexual network characteristics of crack-using and non-crack using AA MSM in Baltimore, MD, USA and to examine associations of crack use with sexual risk. Participants were recruited using street-based and internet-based outreach, printed advertisements, word of mouth. Inclusion criteria were being aged 18 years or older, African American or of black race/ethnicity, and have self-reported sex with another male in the prior 90 days. Crack use was operationalized as self-report of crack in the prior 90 days. Logistic regression was used to identify variables that were independently associated with crack use. Of 230 enrolled AA MSM, 37% (n = 84) reported crack use. The sexual networks of crack-using AA MSM were composed of a greater number of HIV-positive sex partners, exchange partners, and partners who were both sex and drug partners and fewer networks with whom they always use condoms as compared to non-crack using AA MSM. Crack use was independently associated with increased odds of bisexual identity and networks with a greater number of exchange partners, overlap of drug and sex partners, and lesser condom use. Results of this study highlight sexual network characteristics of crack-smoking AA MSM that may promote transmission of HIV. HIV interventions are needed that are tailored to address the social context of crack-smoking AA MSM risk behaviors.

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Acknowledgments

The Latino and African American Mens Project (LAAMP) Study Team also wishes to acknowledge all of the study participants who volunteered for this project and the study staff and facilitators for their commitment to the success of this project. We would like to acknowledge and thank the CDC Study Team: Stephen A. Flores, Heather Joseph, David Purcell, Greg Millett, Cathy Zhang, and Helen Ding. This research was funded through a grant from the Centers for Disease Control and Prevention, 1UR6PS000355.

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Authors and Affiliations

  1. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, Second floor, Baltimore, MD, 21205, USA

    Karin Elizabeth Tobin, Danielle German & Carl Latkin

  2. Division of HIV/AIDS Prevention–Prevention Research Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Pilgrim Spikes & Jocelyn Patterson

Authors
  1. Karin Elizabeth Tobin
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  2. Danielle German
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  3. Pilgrim Spikes
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Correspondence to Karin Elizabeth Tobin.

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The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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Tobin, K.E., German, D., Spikes, P. et al. A Comparison of the Social and Sexual Networks of Crack-Using and Non-Crack Using African American Men who Have Sex with Men. J Urban Health 88, 1052–1062 (2011). https://doi.org/10.1007/s11524-011-9611-4

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  • DOI: https://doi.org/10.1007/s11524-011-9611-4

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