Skip to main content

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

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.

This is a preview of subscription content, access via your institution.

References

  1. Centers for Disease Control and Prevention. HIV Surveillance Report, 2018 (Updated). Published May 2020.

  2. Millett GA, Flores SA, Peterson JL, Bakeman R. Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. Aids. 2007;21(15):2083–91.

    Article  PubMed  Google Scholar 

  3. Garofalo R, Mustanski B, Johnson A, Emerson E. Exploring factors that underlie racial/ethnic disparities in HIV risk among young men who have sex with men. J Urban Health. 2010;87(2):318–23.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Baral S, Logie CH, Grosso A, Wirtz AL, Beyrer C. Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics. BMC Public Health. 2013;13:482.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Buot ML, Docena JP, Ratemo BK, et al. Beyond race and place: distal sociological determinants of HIV disparities. PLoS One. 2014;9(4):e91711.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Frye V, Latka MH, Koblin B, Halkitis PN, Putnam S, Galea S, et al. The urban environment and sexual risk behavior among men who have sex with men. J Urban Health. 2006;83(2):308–24.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Millett GA, Peterson JL, Flores SA, Hart TA, Jeffries WL 4th, 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.

    Article  PubMed  Google Scholar 

  8. Oster AM, Russell K, Wiegand RE, Valverde E, Forrest DW, Cribbin M, et al. HIV infection and testing among Latino men who have sex with men in the United States: the role of location of birth and other social determinants. PLoS One. 2013;8(9):e73779.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  9. Maulsby C, Millett G, Lindsey K, Kelley R, Johnson K, Montoya D, et al. A systematic review of HIV interventions for black men who have sex with men (MSM). BMC Public Health. 2013;13:625.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Newcomb ME, Mustanski B. Racial differences in same-race partnering and the effects of sexual partnership characteristics on HIV risk in MSM: a prospective sexual diary study. J Acquir Immune Defic Syndr. 2013;62(3):329–33.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Clerkin EM, Newcomb ME, Mustanski B. Unpacking the racial disparity in HIV rates: the effect of race on risky sexual behavior among Black young men who have sex with men (YMSM). J Behav Med. 2011;34(4):237–43.

    Article  PubMed  Google Scholar 

  12. Feldman MB. A critical literature review to identify possible causes of higher rates of HIV infection among young black and Latino men who have sex with men. J Natl Med Assoc. 2010;102(12):1206–21.

    Article  PubMed  Google Scholar 

  13. Mustanski B, Birkett M, Kuhns LM, Latkin CA, Muth SQ. The role of geographic and network factors in racial disparities in HIV among young men who have sex with men: an egocentric network study. AIDS Behav. 2015;19(6):1037–47.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Mustanski B, Morgan E, D'Aquila R, Birkett M, Janulis P, Newcomb ME. Individual and network factors associated with racial disparities in HIV among young men who have sex with men: results from the RADAR cohort study. J Acquir Immune Defic Syndr. 2019;80(1):24–30.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Goodreau SM, Rosenberg ES, Jenness SM, Luisi N, Stansfield SE, Millett GA, et al. Sources of racial disparities in HIV prevalence in men who have sex with men in Atlanta, GA, USA: a modelling study. Lancet HIV. 2017;4(7):e311–20.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lewis NM, Wilson K. HIV risk behaviours among immigrant and ethnic minority gay and bisexual men in North America and Europe: a systematic review. Soc Sci Med. 2017;179:115–28.

    Article  PubMed  Google Scholar 

  17. Lewis NM. Urban encounters and sexual health among gay and bisexual immigrant men: perspectives from the settlement and aids service sectors. Geogr Rev. 2016;106(2):235–56.

    Article  Google Scholar 

  18. Dyer TP, Shoptaw S, Guadamuz TE, Plankey M, Kao U, Ostrow D, et al. Application of syndemic theory to black men who have sex with men in the Multicenter AIDS Cohort Study. J Urban Health. 2012;89(4):697–708.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Singer M, Clair S. Syndemics and public health: reconceptualizing disease in bio-social context. Med Anthropol Q. 2003;17(4):423–41.

    Article  PubMed  Google Scholar 

  20. Stall R, Mills TC, Williamson J, Hart T, Greenwood G, Paul J, et al. Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. Am J Public Health. 2003;93(6):939–42.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Carey JW, Mejia R, Bingham T, Ciesielski C, Gelaude D, Herbst JH, et al. Drug use, high-risk sex behaviors, and increased risk for recent HIV infection among men who have sex with men in Chicago and Los Angeles. AIDS Behav. 2009;13(6):1084–96.

    Article  PubMed  Google Scholar 

  22. Walters SM, Braksmajer A, Coston B, et al. A syndemic model of exchange sex among HIV-positive men who have sex with men. Arch Sex Behav. 2020.

  23. Shoptaw S. HIV positive gay men, MSM, and substance use: perspectives on HIV prevention. In: Wilton L, editor. Understanding prevention for HIV positive gay men. New York, NY: Springer; 2017.

  24. Hoots. Updated data on linkage to human immunodeficiency virus care and antiretroviral treatment among men who have sex with men-20 cities, United States (Pg 808, Vol 216, 2017). J Infect Dis. 2017;216(7):922.

    Article  Google Scholar 

  25. Bianchi FT, Reisen CA, Zea MC, Poppen PJ, Shedlin MG, Penha MM. The sexual experiences of Latino men who have sex with men who migrated to a gay epicentre in the USA. Culture Health & Sexuality. 2007;9(5):505–18.

    Article  Google Scholar 

  26. Sanchez MA, Hernandez MT, Hanson JE, et al. The effect of migration on HIV high-risk behaviors among Mexican migrants. Jaids-J Acq Imm Def. 2012;61(5):610–7.

    Article  Google Scholar 

  27. Kissinger P, Althoff M, Burton N, Schmidt N, Hembling J, Salinas O, et al. Prevalence, patterns and predictors of substance use among Latino migrant men in a new receiving community. Drug Alcohol Depen. 2013;133(3):814–24.

    Article  Google Scholar 

  28. Kissinger P, Kovacs S, Anderson-Smits C, Schmidt N, Salinas O, Hembling J, et al. Patterns and predictors of HIV/STI risk among Latino migrant men in a new receiving community. AIDS Behav. 2012;16(1):199–213.

    Article  PubMed  Google Scholar 

  29. Shedlin MG, Decena CU, Oliver-Velez D. Initial acculturation and HIV risk among new Hispanic immigrants. Journal of the National Medical Association. 2005;97(7):32s–7s.

    PubMed  PubMed Central  Google Scholar 

  30. Kobrak P, Ponce R, Zielony R. New arrivals to New York City: vulnerability to HIV among urban migrant young gay men. Arch Sex Behav. 2015;44(7):2041–53.

    Article  PubMed  Google Scholar 

  31. Hermanstyne KA, Green HD Jr, Cook R, Tieu HV, Dyer TV, Hucks-Ortiz C, et al. Social network support and decreased risk of seroconversion in black MSM: results of the BROTHERS (HPTN 061) study. J Acquir Immune Defic Syndr. 2018;78(2):163–8.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Aldrich R. Homosexuality and the city: an historical overview. Urban Stud. 2004;41(9):1719–37.

    Article  Google Scholar 

  33. Weston K. Get thee to a big city: sexual imaginary and the great gay migration. Glq-a Journal of Lesbian and Gay Studies. 1995;2(3):253–77.

    Article  Google Scholar 

  34. Gates GJ, Newport F. Special report: 3.4% of US adults identify as LGBT. Washington, DC: Gallup; 2012.

  35. American Community Survey. County-to-county migration flows: 2013–2017 ACS. 2019.

  36. Migration Policy Institute. State Immigration Data Profiles. 2014.

  37. Javanbakht M, Ragsdale A, Shoptaw S, Gorbach PM. Transactional sex among men who have sex with men: differences by substance use and HIV status. J Urban Health. 2018;

  38. Fulcher JA, Shoptaw S, Makgoeng SB, Elliott J, Ibarrondo FJ, Ragsdale A, et al. Brief report: recent methamphetamine use is associated with increased rectal mucosal inflammatory cytokines, regardless of HIV-1 serostatus. J Acquir Immune Defic Syndr. 2018;78(1):119–23.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  39. Okafor CN, Gorbach PM, Ragsdale A, Quinn B, Shoptaw S. Correlates of preexposure prophylaxis (PrEP) use among men who have sex with men (MSM) in Los Angeles, California. J Urban Health. 2017;94(5):710–5.

    Article  PubMed  PubMed Central  Google Scholar 

  40. ATLAS. ti Scientific Software Development GmbH [computer program]. Version Version 8; 2019.

  41. Amirkhanian YA. Social networks, sexual networks and HIV risk in men who have sex with men. Current HIV/AIDS Reports. 2014;11(1):81–92.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Saleh LD, van den Berg JJ, Chambers CS, Operario D. Social support, psychological vulnerability, and HIV risk among African American men who have sex with men. Psychol Health. 2016;31(5):549–64.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Dilley JW, McFarland W, Sullivan P, Discepola M. Psychosocial correlates of unprotected anal sex in a cohort of gay men attending an HIV-negative support group. AIDS Educ Prev. 1998;10(4):317–26.

    CAS  PubMed  Google Scholar 

  44. Lee J, Cassels S. Immigrant integration, social support, and the sexual risk behaviors of men who have sex with men. Arch Sex Behav. 2020;34(4):282–95.

  45. Koblin BA, Egan JE, Nandi V, et al. Congruence of home, social and sex neighborhoods among men who have sex with men, NYCM2M study. J Urban Health. 2016;

  46. El-Sadr WM, Rabkin M, DeCock KM. Population health and individualized care in the global AIDS response: synergy or conflict? AIDS. 2016;30(14):2145–8.

    Article  PubMed  Google Scholar 

  47. Lazarus JV, Barton SE, Bernardino JI. Taking the long-view in a personalised approach to HIV care. Lancet HIV. 2017;4(11):e483–5.

    Article  PubMed  Google Scholar 

  48. Grimsrud A, Bygrave H, Doherty M, Ehrenkranz P, Ellman T, Ferris R, et al. Reimagining HIV service delivery: the role of differentiated care from prevention to suppression. J Int AIDS Soc. 2016;19(1):21484.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Salamanca P, Janulis P, Elliott M, Birkett M, Mustanski B, Phillips G 2nd. An investigation of racial and ethnic homophily on grindr among an ongoing cohort study of YMSM. AIDS Behav. 2018.

  50. Gesink D, Wang S, Guimond T, Kimura L, Connell J, Salway T, et al. Conceptualizing geosexual archetypes: mapping the sexual travels and egocentric sexual networks of gay and bisexual men in Toronto, Canada. Sex Transm Dis. 2018;45(6):368–73.

    Article  PubMed  Google Scholar 

  51. Zou HC, Fan S. Characteristics of men who have sex with men who use smartphone Geosocial networking applications and implications for HIV interventions: a systematic review and meta-analysis. Arch Sex Behav. 2017;46(4):885–94.

    Article  PubMed  Google Scholar 

Download references

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).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Susan Cassels.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Accepted:

  • Published:

  • Issue Date:

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

Keywords

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