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Geographic Mobility, Place Attachment, and the Changing Geography of Sex among African American and Latinx MSM Who Use Substances in Los Angeles

Journal of Urban Health volume 97, pages 609–622 (2020)Cite this article

Abstract

The places that people go and interact with others, along with the characteristics of those places, determine degrees of sexual health risk and concomitant prevention opportunities for gay, bisexual, and other men who have sex with men (MSM). The objective of this paper is to use syndemic theory to guide analyses of 20 in-depth interviews with African American and Hispanic/Latinx MSM living in Los Angeles. We describe the places in which African American and Latinx MSM interviewees live and socialize, and how these places influence sexual behavior, drug use, and access to health care. We find common spatial patterns in mobility, incongruence in residential and sexual places, and differing geographic patterns of sex by men who use geo-social hook-up apps. Significant instability in home life and varying forms of mobility and risk-taking were a response to cumulative disadvantage and intersecting structural forces including poverty, racism, and homophobia. Our results strongly suggest that geographic mobility is a syndemic factor for HIV risk among MSM in Los Angeles, as mobility amplified negative impacts of other syndemic factors. Innovative place-interventions to reduce HIV incidence and disparities in HIV need to acknowledge the synergistic factors that drive higher HIV incidence among AA and Latinx MSM.

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Acknowledgments

We would like to thank Karina Jimenez, Jason Granados, Deanna Nash, Javier Rubio, Brandon Love, India Richter, Fiona Whelan, Marjan Javanbakht, Vince Pancucci, and the Los Angeles LGBT Center team for their immense help, support, and collaboration with this research.

Funding

This work was funded in part by a UCSB Regents Junior Faculty Fellowship, a Programa de Investigacion en Migration Y Salud (PIMSA) award from the Health Initiatives of America, the National Institute of Drug Abuse (R21DA049643 and U01DA036267), and the National Institute of Mental Health (P30MH058107).

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Authors and Affiliations

  1. Department of Geography, University of California, Santa Barbara, CA, USA

    Susan Cassels, Dan Meltzer & Colin Loustalot

  2. Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA

    Amy Ragsdale & Pamina M. Gorbach

  3. Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA

    Steve Shoptaw

  4. Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA

    Pamina M. Gorbach

Authors
  1. Susan Cassels
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  2. Dan Meltzer
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  3. Colin Loustalot
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  4. Amy Ragsdale
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  5. Steve Shoptaw
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  6. Pamina M. Gorbach
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Correspondence to Susan Cassels.

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Cassels, S., Meltzer, D., Loustalot, C. et al. Geographic Mobility, Place Attachment, and the Changing Geography of Sex among African American and Latinx MSM Who Use Substances in Los Angeles. J Urban Health 97, 609–622 (2020). https://doi.org/10.1007/s11524-020-00481-3

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  • DOI: https://doi.org/10.1007/s11524-020-00481-3

Keywords

  • Race
  • Ethnicity
  • Qualitative study
  • Syndemic theory
  • HIV prevention