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The Multiplex Social Environments of Young Black Men Who Have Sex with Men: How Online and Offline Social Structures Impact HIV Prevention and Sex Behavior Engagement

Lindsay E. Young
Lindsay E. Young
, 
Kayo Fujimoto
Kayo Fujimoto
, 
Leigh Alon
Leigh Alon
, 
Liang Zhang
Liang Zhang
 and 
John A. Schneider
John A. Schneider
   | Aug 01, 2019
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Article Category: research-article
Published Online: Aug 01, 2019
Page range: 70 - 95
DOI: https://doi.org/10.21307/joss-2019-007
© 2019 Lindsay E. Young et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1.

Conceptual framework for an environmental perspective on the production of HIV prevention and sex behavior outcomes (adapted from Rhodes, Singer, Bourgois, Friedman, and Strathdee, 2005)
Conceptual framework for an environmental perspective on the production of HIV prevention and sex behavior outcomes (adapted from Rhodes, Singer, Bourgois, Friedman, and Strathdee, 2005)

Figure 2.

A hypothetical multiplex egocentric network. The egocentric network is comprised of an Ego, or study respondent, (black circle), their identified peers (gold circles), and their identified Facebook groups (pink squares). Three types of co-existing and overlapping relationships are shown between ego and his/her/their peers: (1) confidant ties (lines in red); (2) sex partner ties (lines in green); and (3) Facebook friendship ties (lines in blue). A fourth type of relationship is shown between ego and Facebook groups to show an ego’s Facebook group affiliations (dashed lines). In total, ego has 4 confidants, 3 sex partners, 10 Facebook friends, and 8 Facebook group affiliations. Dyadic multiplexity (when two individuals interact in more than one relational context) is shown by the presence of multiple ties between the ego and a peer.
A hypothetical multiplex egocentric network. The egocentric network is comprised of an Ego, or study respondent, (black circle), their identified peers (gold circles), and their identified Facebook groups (pink squares). Three types of co-existing and overlapping relationships are shown between ego and his/her/their peers: (1) confidant ties (lines in red); (2) sex partner ties (lines in green); and (3) Facebook friendship ties (lines in blue). A fourth type of relationship is shown between ego and Facebook groups to show an ego’s Facebook group affiliations (dashed lines). In total, ego has 4 confidants, 3 sex partners, 10 Facebook friends, and 8 Facebook group affiliations. Dyadic multiplexity (when two individuals interact in more than one relational context) is shown by the presence of multiple ties between the ego and a peer.

Odd ratios from multiple logistic regressions showing predictive factors for prevention outcomes among young Black men who have sex with men in Chicago, USA

CharacteristicsHIV CareHIV/STI TestingPrEP Awareness
aOR95% CIaOR95% CIaOR95% CI
Socio-demographic and structural
  Age0.940.81-1.080.860.72-1.110.95-
  Sexual orientation (bisexual)0.610.27-1.340.740.25-0.390.15-
  HIV status (HIV+)4.602.17-0.670.25-1.540.61-
  Health coverage1.160.49-2.711.240.41-1.140.49-
  Housing instability (in last 12 months)1.350.55-3.320.940.27-0.750.27-
  Criminal justice involvement (ever)1.190.41-3.455.750.59-0.720.27-
  Member of a ball house or gay family1.670.67-4.180.850.22-0.630.25-
Behavioral factors (controls)1.490.70-3.201.070.44-0.820.34-
  Recreational marijuana use (daily or Condomless Sex1.210.55-2.681.920.84-1.370.58-
  Sex drug use1.000.46-2.191.250.43-0.730.31-
  Group sex1.060.36-3.103.100.62-1.200.39-
  HIV care——1.110.44-2.931.32-
  HIV/STI tester1.010.41-2.48——1.400.44-
  PrEP aware2.891.29-1.200.44-——
Confidant ego-network features
  Number of confidants1.140.83-1.570.810.53-1.200.79-
  At least one confidant who is biological/2.170.57-8.191.480.36-0.520.12-
  At least one confidant who is MSM0.620.27-1.391.240.43-0.900.35-
  At least one confidant who knows they2.030.87-4.720.430.14-1.090.40-
Sexual ego-network features
  Number of partners in past 9 months1.140.87-1.491.591.09-0.780.50-
  At least one partner who is HIV+1.750.71-4.311.750.52-2.670.88-
  At least one partner met through mutual0.640.29-1.380.430.17-0.760.33-
  At least one partner met at bars, clubs, or2.170.61-7.661.090.25-1.030.22-
  At least one partner met in public spaces1.060.43-2.592.170.69-1.510.47-
  At least one partner met online0.980.43-2.230.510.14-2.930.95-
Facebook network features
  Number of Facebook friends1.010.86-1.191.250.99-1.100.94-
  Number of Facebook group affiliations0.980.94-1.011.090.99-1.030.98-
  At least one LGBTQ identity Facebook0.670.26-1.711.470.47-0.870.30-
  At least one Sexual Attraction Facebook1.060.42-2.680.330.10-1.120.40-
  At least one Chat Facebook group2.821.18-0.720.27-1.460.55-
  At least one Secret Facebook group1.080.41-2.862.610.83-0.690.27-
  Range of subjects among Facebook1.040.72-1.500.840.53-0.860.58-

Odd ratios from multiple logistic regressions showing predictive factors for sex behavior outcomes among young Black men who have sex with men in Chicago, USA (N=268)

CharacteristicsCondom less SexSex Drug UseGroup Sex
aOR95% CIaOR95%aOR9
Socio-demographic and structural factors (controls)
  Age0.950.83-1.091.060.93-1.110
  Sexual orientation (bisexual)1.750.73-4.180.760.32-1.640
  HIV status (HIV+)0.600.28-1.291.440.67-0.710
  Health coverage0.400.18-0.91*1.090.41-0.430
  Housing instability (in last 12 months)0.570.25-1.311.200.50-1.060
  Criminal justice involvement (ever)3.651.08-0.870.30-2.000
  Member of a ball house or gay family0.430.17-1.070.800.36-2.700
Behavioral factors (controls)
  Recreational marijuana use (daily or more)1.080.48-2.432.030.98-1.290
  Condomless Sex——1.870.83-0.500
  Sex drug use1.820.83-4.01——2.350
  Group sex0.410.14-1.211.940.68-——
  HIV care1.080.50-2.310.990.45-1.230
  HIV/STI tester1.820.78-4.281.010.37-3.350
  PrEP aware1.540.68-3.470.770.33-1.540
Confidant ego-network features
  Number of confidants1.441.04-2.00*1.010.74-1.230
  At least one confidant who is biological / play family0.150.05-0.7101.22-1.080
  At least one confidant who is MSM0.930.42-2.062.321.09-1.090
  At least one confidant who knows they are MSM1.760.74-4.171.040.47-0.500
Sexual ego-network features
  Number of partners in past 9 months1.130.86-1.470.970.75-1.411
  At least one partner who is HIV+3.531.37-9.06*1.550.72-1.040
  At least one partner met through mutual friends0.440.22-0.90*1.590.78-0.620
  At least one partner met at bars, clubs, or ball events2.910.88-9.581.100.41-2.710
  At least one partner met in public spaces3.131.10-8.96*1.830.73-0.440
  At least one partner met online2.651.20-5.85*2.961.28-5.301
Facebook network features
  Number of Facebook friends1.251.03-1.51*1.171.01-0.910
  Number of Facebook group affiliations0.980.95-1.021.030.99-0.970
  At least one LGBTQ Identity Facebook group0.360.14-0.92*1.110.42-1.120
  At least one Sexual Attraction Facebook group0.780.30-2.070.880.39-2.000
  At least one Chat Facebook group1.070.42-2.721.450.61-1.080
  At least one Secret Facebook group0.780.28-2.211.200.50-1.600
  Range of subjects among Facebook groups1.310.91-1.900.680.48-0.940

Characteristics of young Black men who have sex with men in Chicago, USA (N=268)

CharacteristicsPercent
Prevention and sex behaviors
  Received HIV care (prevention or treatment) from provider68.3
  Tested for HIV or STIs at least 3 times in the last 9 months83.6
  Heard of PrEP77.2
  Condomless sex59.3
  Sex drug use35.1
  Group sex17.2
Sociodemographic, behavioral and structural factors (controls)
  Mean Age23.47 (2.90; 17, 29)
  Sexual orientation (bisexual)26.1
  HIV status (HIV+)41.4
  Health insurance coverage77.2
  Housing instability (in last 12 months)20.5
  Criminal justice involvement (ever)11.9
  Member of a ball house or gay family31.3
  Recreational marijuana use (daily or more)29.5
Confidant ego-network features
  Mean number of confidants2.21 (1.11; 0, 5)
  At least one confidant who is MSM45.5
  At least one confidant who knows respondent is MSM39.9
  At least one confidant who is biological / play family10.1
Sexual ego-network features
  Mean number of partners in past 6 months2.72 (1.58; 0, 6)
  At least one partner who is HIV+24.6
  At least one partner met through mutual friends47.8
  At least one partner met at bars, clubs, or ball events14.9
  At least one partner met in public spaces20.2
  At least one partner met online46.3
Facebook network features
  Number of Facebook friends44.65 (27.60; 0, 162)
  Number of Facebook group affiliations11.00 (14.01; 1, 89)
  At least one LGBTQ identity Facebook group56.4
  At least one Sexual Attraction Facebook group51.5
  At least one Chat Facebook group60.5
  At least one Secret Facebook group73.7
  Mean range of subjects among Facebook groups3.95 (2.19; 1, 9)

Subject Classification Scheme for Facebook Groups

Subject CategoryDefinition
Sexual Attraction *Groups that underscore physical/sexual attractiveness and that enable partner “cruising”, flirtatious exchange, sexual networking, and sexual expression
Chat *Groups that provide a casual forum for posting and conversational exchange among members; posts tend not to be subject specific and content tends to be random (e.g., gossip groups)
LGBTQ Identity *Groups that are about gay pride or gay identity; the focus is on celebrating gay identity and “being” in the LGBTQ community (e.g., LGBTQ advocacy groups)
Ballroom Culture *Ballroom Houses are queer surrogate kinship groups that take on the role structure of traditional hetero-normative families (e.g., mothers, fathers, children, siblings) and participate in gender expression competitions/performances. These are groups for members of specific Ballroom Houses and Gay Families, groups about Ballroom culture, groups about performance styles (e.g., vogueing)
EventsGroups that promote events — e.g., nightlife/club events, festivals, community events, live shows, etc.
Recreational InterestsGroups about past time interests and hobbies pursued for fun, amusement, or entertainment. Examples include: sports, gaming, dance, poetry, art, reading, listening to music, watching TV etc.
Personal / Professional PromotionGroups that promote an individual’s image and/or talent for that person’s gain; groups that enable professional networking, promote personal businesses and jobs, money-making opportunities, career advancement etc.
Health & Well beingGroups that provide information and/or support to members with respect to physical, emotional, and spiritual health and well being.
CommunityGroups about place-based community life (e.g. school alumni groups, neighborhood alumni groups, church groups, groups about living in Chicago, etc.)
eISSN:
1529-1227
Language:
English
Publication timeframe:
Volume Open
Journal Subjects:
Social Sciences, other
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