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Economic, Legal, and Social Hardships Associated with HIV Risk among Black Men who have Sex with Men in Six US Cities

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Abstract

We assessed whether economic, legal, and social hardships were associated with human immunodeficiency virus (HIV) risk among a sample of Black men who have sex with men (MSM) and whether associations were moderated by city of residence. The study analyzed baseline and follow-up data from HIV Prevention Trials Network 061 (N = 1553). Binary logistic regression assessed associations between hardships and HIV risk indicators. Multivariate regressions were used to test if city of residence had a moderating effect for hardships and HIV risks. Adjusted analyses showed that Black MSM with recent job loss were more likely to engage in condomless insertive anal intercourse (adjusted odds ratios (AOR) = 1.37, 95 % CI 1.01–1.87) and that those with recent financial crisis were more likely to have had two or more male sexual partners in the past 6 months (AOR = 1.65; 95 % CI 1.18–2.29). Black MSM with recent convictions were more likely to have a sexually transmitted infection at 6 months (AOR = 3.97; 95 % CI 1.58–9.94), while those who were unstably housed were more likely to have a sexually transmitted infection at 12 months (AOR = 1.71; 95 %CI 1.02 = 2.86). There were no city of residence and hardship interaction effects on HIV risks. Hardships are important factors that influence HIV risk for Black MSM. Integrating strategies that address structural factors that influence HIV risk may enhance HIV prevention interventions implementation efforts.

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Acknowledgments

We are grateful to Dr. Lei Wang (Fred Hutchinson Cancer Research Center) and Ting Yuan-Lin Fred Hutchinson Cancer Research Center for their assistance with data management. We also with to thank Dr. Margaret H. Kearney (University of Rochester), Dr. Dianne Liebel (University of Rochester), Dr. Deborah Donnell (Fred Hutchinson Cancer Research Center), Dr. Thomas Coates (University of California Los Angeles), and Dr. Ward Cates (FHI 360) for their helpful reviews and comments on draft versions of this manuscript.

Author information

Authors and Affiliations

  1. School of Nursing, University of Rochester, Rochester, NY, USA

    LaRon E. Nelson

  2. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada

    LaRon E. Nelson

  3. College of Community and Public Affairs, State University of New York at Binghamton, Binghamton, NY, USA

    Leo Wilton

  4. Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa

    Leo Wilton

  5. Faculty of Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada

    Rahim Moineddin

  6. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Nanhua Zhang & Ting Sa

  7. Dalla Lana School of Public Health, Divisions of Epidemiology and Social & Behavioural Health Sciences, University of Toronto, Toronto, ON, Canada

    Arjumand Siddiqi

  8. College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA

    Nina Harawa

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

    Rotrease Regan

  10. School of Public Health, Department of Epidemiology and Biostatistics, University of Maryland College Park, College Park, MD, USA

    Typhanye Penniman Dyer

  11. School of Public Health, George Washington University, Washington, DC, USA

    Christopher C. Watson

  12. New York Blood Center, New York, NY, USA

    Beryl Koblin

  13. Rollins School of Public Health, Hubert Department of Global Health and School of Medicine, Department of Medicine, Emory University, Atlanta, GA, USA

    Carlos del Rio

  14. San Francisco Department of Public Health, HIV Research Section, San Francisco, CA, USA

    Susan Buchbinder

  15. School of Social Welfare, State University of New York Albany, Albany, NY, USA

    Darrell P. Wheeler

  16. Fenway Health, The Fenway Institute, Boston, MA, USA

    Kenneth H. Mayer

  17. Gillings School of Public Health, Department of Health Behavior, University of North Carolina Chapel Hill, Chapel Hill, NC, USA

    Arjumand Siddiqi

  18. David Geffen School of Medicine, General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, CA, USA

    Nina Harawa

  19. School of Medicine, Division of Infectious Diseases, Emory University, Atlanta, GA, USA

    Rotrease Regan

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  1. LaRon E. Nelson
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  2. Leo Wilton
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  4. Nanhua Zhang
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  15. Kenneth H. Mayer
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for the HPTN 061 Study Team

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Correspondence to LaRon E. Nelson.

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This research was supported by cooperative award 5UM1AI068619 to HIV Prevention Trials Network from the National Institute of Allergy & Infectious Diseases, National Institute of Mental Health, and National Institute of Drug Abuse.

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Nelson, L.E., Wilton, L., Moineddin, R. et al. Economic, Legal, and Social Hardships Associated with HIV Risk among Black Men who have Sex with Men in Six US Cities. J Urban Health 93, 170–188 (2016). https://doi.org/10.1007/s11524-015-0020-y

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