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Social-Environmental Resilience, PrEP Uptake, and Viral Suppression among Young Black Men Who Have Sex with Men and Young Black Transgender Women: the Neighborhoods and Networks (N2) Study in Chicago

Abstract

Young black men who have sex with men (YBMSM) and young black transgender women (TGW) have experienced a stark disparity in HIV prevention and care. Resilience, collective resources to adapt stressors or adversities, may improve HIV prevention and care outcomes. The present study investigated the association of resilience-based factors with PrEP uptake and viral suppression from a socioecological perspective among YBMSM and young black TGW. Data were from the baseline cycle of the Neighborhoods and Networks (N2) Study, an ongoing cohort study of 16–34-year-old YBMSM and young black TGW in Chicago (n = 324). Confidant network-level and neighborhood affiliation variables were created to measure the social-environmental context of resilience. All analyses were stratified by participants’ HIV status (184 HIV-negative participants and 140 HIV-positive participants). Among HIV-negative participants, having a parental figure within an individual’s confidant network was significantly associated with a greater likelihood of PrEP use. Among HIV-positive participants, confidant network members’ awareness of an individual’s HIV status was associated with viral suppression. Social support resources from confidant networks could improve HIV prevention and care engagement among YBMSM and young black TGW. Understanding the social and environmental contexts of resilience resource is critical for HIV prevention and care engagement.

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References

  1. CDC. Lifetime risk of HIV diagnosis in the United States [press release]. Available at: https://www.cdc.gov/nchhstp/newsroom/2016/croi-press-release-risk.html.

  2. Becasen JS, Denard CL, Mullins MM, Higa DH, Sipe TA. Estimating the prevalence of HIV and sexual behaviors among the US transgender population: a systematic review and meta-analysis, 2006-2017. Am J Public Health. 2019:e1–8. https://doi.org/10.2105/AJPH.2018.304727

  3. Millett GA, Peterson JL, Flores SA, Hart TA, 4th Jeffries WL, Wilson PA, et al. Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis. Lancet. 2012;380(9839):341–8.

  4. Sullivan PS, Rosenberg ES, Sanchez TH, Kelley CF, Luisi N, Cooper HL, et al. Explaining racial disparities in HIV incidence in black and white men who have sex with men in Atlanta, GA: a prospective observational cohort study. Ann Epidemiol. 2015;25(6):445–54.

    Article  Google Scholar 

  5. Bauermeister JA, Connochie D, Eaton L, Demers M, Stephenson R. Geospatial indicators of space and place: a review of multilevel studies of HIV prevention and care outcomes among young men who have sex with men in the United States. J Sex Res. 2017;54(4–5):446–64.

    Article  Google Scholar 

  6. Tieu H-V, Koblin BA, Latkin C, et al. Neighborhood and network characteristics and the HIV care continuum among gay, bisexual, and other men who have sex with men. J Urban Health. 2018. https://doi.org/10.1007/s11524-018-0266-2.

  7. Katz I, Jha AK. HIV in the United States: getting to zero transmissions by 2030. JAMA. 2019;321(12):1153–4.

    Article  Google Scholar 

  8. Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.

    CAS  Article  Google Scholar 

  9. Cohen MS, McCauley M, Gamble TR. HIV treatment as prevention and HPTN 052. Curr Opin HIV AIDS. 2012;7(2):99–105.

    CAS  Article  Google Scholar 

  10. Myers JE, Braunstein SL, Xia Q, et al. Redefining prevention and care: a status-neutral approach to HIV. Open Forum Infect Dis. 2018;5(6). https://doi.org/10.1093/ofid/ofy097.

  11. Fallon SA, Park JN, Ogbue CP, Flynn C, German D. Awareness and acceptability of pre-exposure HIV proylaxis among men wo have sex with men in Baltimore. AIDS Behav. 2017;21(5):1268–77.

    Article  Google Scholar 

  12. Eaton LA, Driffin DD, Bauermeister J, Smith H, Conway-Washington C. Minimal awareness and stalled uptake of pre-exposure prophylaxis (PrEP) among at risk, HIV-negative, black men who have sex with men. AIDS Patient Care STDs. 2015;29(8):423–9.

    Article  Google Scholar 

  13. Arrington-Sanders R, Fields E, Greenberg L, Henry-Reid L, Stines Pehoua S, Korelitz J, … Boyer CB. Does venue type matter for HIV-related risk behavior in urban adolescent and young adult men who have sex with men? Youth Soc. 2017:51(8);1081–1103. https://doi.org/10.1177/0044118X17723655.

  14. Ezell JM, Ferreira MJ, Duncan DT, Schneider JA. The social and sexual networks of black transgender women and black men who have sex with men: results from a representative sample. Transgend Health. 2018;3(1):201–9.

    Article  Google Scholar 

  15. Finlayson T, Cha S, Xia M, et al. Changes in HIV preexposure prophylaxis awareness and use among men who have sex with men — 20 urban areas, 2014 and 2017. MMWR Morb Mortal Wkly Rep. 2019;68(27):597. https://doi.org/10.15585/mmwr.mm6827a1.

  16. Reisner SL, Jadwin-Cakmak L, White Hughto JM, Martinez M, Salomon L, Harper GW. Characterizing the HIV prevention and care continua in a sample of transgender youth in the U.S. AIDS Behav. 2017;21(12):3312–27.

    Article  Google Scholar 

  17. Singh S, Mitsch A, Wu B. HIV care outcomes among men who have sex with men with diagnosed HIV infection — United States, 2015. MMWR Morb Mortal Wkly Rep. 2017;66:69–974.

    Article  Google Scholar 

  18. Dulin AJ, Dale SK, Earnshaw VA, et al. Resilience and HIV: a review of the definition and study of resilience. AIDS Care. 2018;30(sup5):S6–S17.

    Article  Google Scholar 

  19. Ransome Y, Thurber KA, Swen M, Crawford ND, German D, Dean LT. Social capital and HIV/AIDS in the United States: knowledge, gaps, and future directions. SSM-Population Health. 2018;5:73–85.

    Article  Google Scholar 

  20. Herrick AL, Stall R, Goldhammer H, Egan JE, Mayer KH. Resilience as a research framework and as a cornerstone of prevention research for gay and bisexual men: theory and evidence. AIDS Behav. 2014;18(1):1–9.

    Article  Google Scholar 

  21. Buttram ME. The social environmental elements of resilience among vulnerable African American/Black men who have sex with men. J Hum Behav Soc Environ. 2015;25(8):923–33.

    Article  Google Scholar 

  22. Kunzweiler CP, Bailey RC, Mehta SD, et al. Factors associated with viral suppression among HIV-positive Kenyan gay and bisexual men who have sex with men. AIDS Care. 2018;30(sup5):S76–88.

    Article  Google Scholar 

  23. McNair OS, Gipson JA, Denson D, Thompson DV, Sutton MY, Hickson DA. The associations of resilience and HIV risk behaviors among black gay, bisexual, other men who have sex with men (MSM) in the deep south: the MARI study. AIDS Behav. 2018;22(5):1679–87.

    Article  Google Scholar 

  24. Meanley S, Tingler R, Chittamuru D, Bauermeister JA. Applying resilience theory models to contextualize economic-dependent partnerships as a risk factor for HIV among young men who have sex with men. AIDS Care. 2018;30(sup4):42–50.

    Article  Google Scholar 

  25. Storholm ED, Huang W, Siconolfi DE, et al. Sources of resilience as mediators of the effect of minority stress on stimulant use and sexual risk behavior among young black men who have sex with men. AIDS Behav. 2019;23:3384–3395. https://doi.org/10.1007/s10461-019-02572-y.

  26. McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q. 1988;15(4):351–77.

    CAS  Article  Google Scholar 

  27. Ransome Y, Zarwell M, Robinson WT. Participation in community groups increases the likelihood of PrEP awareness: New Orleans NHBS-MSM Cycle, 2014. PLoS One. 2019;14(3):e0213022.

    CAS  Article  Google Scholar 

  28. Zarwell M, Robinson WT. Development of a social capital scale for constructed families of gay, bisexual, and other men who have sex with men. PLoS One. 2018;13(12):e0208781.

    Article  Google Scholar 

  29. Buttram ME. The social environmental context of resilience among substance-using African American/Black men who have sex with men. J Homosex. 67;6:816–832. https://doi.org/10.1080/00918369.2018.1557952.

  30. Graham SM, Micheni M, Secor A, et al. HIV care engagement and ART adherence among Kenyan gay, bisexual, and other men who have sex with men: a multi-level model informed by qualitative research. AIDS Care. 2018;30(sup5):S97–S105.

    Article  Google Scholar 

  31. O’Leary A, Jemmott JB, Stevens R, Rutledge SE, Icard LD. Optimism and education buffer the effects of syndemic conditions on HIV status among African American men who have sex with men. AIDS Behav. 2014;18(11):2080–8.

    Article  Google Scholar 

  32. Kubicek K, McNeeley M, Holloway IW, Weiss G, Kipke MD. “It’s like our own little world”: resilience as a factor in participating in the ballroom community subculture. AIDS Behav. 2013;17(4):1524–39.

    Article  Google Scholar 

  33. Behler RL, Cornwell BT, Schneider JA. Patterns of social affiliations and healthcare engagement among young, black, men who have sex with men. AIDS Behav. 2018;22:806–818. https://doi.org/10.1007/s10461-016-1668-3.

  34. Hightow-Weidman L, LeGrand S, Choi SK, Egger J, Hurt CB, Muessig KE. Exploring the HIV continuum of care among young black MSM. PLoS One. 2017;12(6):e0179688.

    Article  Google Scholar 

  35. Schneider JA, Kozloski M, Michaels S, Skaathun B, Voisin D, Lancki N, et al. Criminal justice involvement history is associated with better HIV care continuum metrics among a population-based sample of young black MSM. AIDS. 2017;31(1):159–65.

    Article  Google Scholar 

  36. Morgan E, Skaathun B, Michaels S, Young L, Khanna A, Friedman SR, et al. Marijuana use as a sex-drug is associated with HIV risk among black MSM and their network. AIDS Behav. 2016;20(3):600–7.

    Article  Google Scholar 

  37. Eaton LA, Driffin DD, Kegler C, Smith H, Conway-Washington C, White D, et al. The role of stigma and medical mistrust in the routine health care engagement of black men who have sex with men. Am J Public Health. 2015;105(2):e75–82.

    Article  Google Scholar 

  38. Reback CJ, Rünger D, Fletcher JB. Drug use is associated with delayed advancement along the HIV care continuum among transgender women of color. AIDS Behav. 2019. https://doi.org/10.1007/s10461-019-02555-z.

  39. Jin H, Restar A, Biello K, Kuhns L, Reisner S, Garofalo R, et al. Burden of HIV among young transgender women: factors associated with HIV infection and HIV treatment engagement. AIDS Care. 2019;31(1):125–30.

    Article  Google Scholar 

  40. Earnshaw VA, Bogart LM, Dovidio JF, Williams DR. Stigma and racial/ethnic HIV disparities: moving toward resilience. Am Psychol. 2013;68(4):225–36.

    Article  Google Scholar 

  41. Gahagan J, Colpitts E. Understanding and measuring LGBTQ pathways to health: a scoping review of strengths-based health promotion approaches in LGBTQ health research. J Homosex. 2017;64(1):95–121.

    Article  Google Scholar 

  42. Duncan TD, Hickson AD, Goedel CW, et al. The social context of HIV prevention and care among black men who have sex with men in three U.S. Cities: the neighborhoods and networks (N2) cohort study. Int J Environ Res Public Health. 2019;16:1922.

  43. Howard Brown Health Center. Available at: https://howardbrown.org/. Accessed 28 Aug 2019.

  44. Schneider J, Cornwell B, Jonas A, et al. Network dynamics of HIV risk and prevention in a population-based cohort of young Black men who have sex with men. Netw Sci. 2017:1–29. https://doi.org/10.1017/nws.2016.27.

  45. Dehlin JM, Issema R, Eavou R, et al. The motivational PrEP cascade guides interpretation of early PrEP linkage to care for young black men who have sex with men: the case of Chicago’s PrEPLine. AIDS Educ Prev. 2019;31(6):491–504. https://doi.org/10.1521/aeap.2019.31.6.491.

  46. Schneider J, Michaels S, Bouris A. Family network proportion and HIV risk among black men who have sex with men. J Acquir Immune Defic Syndr. 2012;61(5):627–35.

    Article  Google Scholar 

  47. Phillips G, Raman A, Felt D, Han Y, Mustanski B. Factors associated with PrEP support and disclosure among YMSM and transgender individuals assigned male at birth in Chicago. AIDS Behav. 2019;23:2749–2760. https://doi.org/10.1007/s10461-019-02561-1.

  48. Cook CL, Staras SA, Zhou Z, Chichetto N, Cook RL. Disclosure of HIV serostatus and condomless sex among men living with HIV/AIDS in Florida. PLoS One. 2018;13(12):e0207838.

    Article  Google Scholar 

  49. Serovich JM, Laschober TC, Brown MJ, Kimberly JA. Evaluation of HIV disclosure behavior following a randomized controlled disclosure intervention for men who have sex with men living with HIV. Arch Sex Behav. 2018;47(7):2051–9.

    Article  Google Scholar 

  50. Cao W, Wong HM, Chang C, Agudile EP, Ekström AM. Behavioral interventions promoting HIV serostatus disclosure to sex partners among HIV-positive men who have sex with men: a systematic review. Int J Public Health. 2019;64(7):985–98.

    Article  Google Scholar 

  51. Eaton LA, Earnshaw VA, Maksut JL, Thorson KR, Watson RJ, Bauermeister JA. Experiences of stigma and health care engagement among Black MSM newly diagnosed with HIV/STI. J Behav Med. 2018;41(4):458–66.

    Article  Google Scholar 

  52. Cahill S, Taylor SW, Elsesser SA, Mena L, Hickson D, Mayer KH. Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts. AIDS Care. 2017;29(11):1351–8.

    Article  Google Scholar 

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Acknowledgments

The Neighborhoods and Networks (N2) Cohort Study is funded through a grant from the National Institute on Mental Health (Grant Number: R01MH112406) and a cooperative agreement with the Centers for Disease Control and Prevention under the Minority HIV/AIDS Research Initiative (Grant Number: U01PS005122). Mr. Goedel is supported by the Brown University Clinical and Community-Based HIV/AIDS Research Training Fellowship, funded by the National Institute of Mental Health (Grant Number: R25MH083620). We thank the participants for engaging in this research.

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Correspondence to Yen-Tyng Chen.

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Chen, YT., Duncan, D.T., Issema, R. et al. Social-Environmental Resilience, PrEP Uptake, and Viral Suppression among Young Black Men Who Have Sex with Men and Young Black Transgender Women: the Neighborhoods and Networks (N2) Study in Chicago. J Urban Health 97, 728–738 (2020). https://doi.org/10.1007/s11524-020-00425-x

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Keywords

  • Men who have sex with men
  • Transgender women
  • Resilience
  • Social networks
  • Neighborhoods