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

Figure 1.

Figure 2.

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

Characteristics	HIV Care		HIV/STI Testing		PrEP Awareness
	aOR	95% CI	aOR	95% CI	aOR	95% CI
Socio-demographic and structural
Age	0.94	0.81-1.08	0.86	0.72-	1.11	0.95-
Sexual orientation (bisexual)	0.61	0.27-1.34	0.74	0.25-	0.39	0.15-
HIV status (HIV+)	4.60	2.17-	0.67	0.25-	1.54	0.61-
Health coverage	1.16	0.49-2.71	1.24	0.41-	1.14	0.49-
Housing instability (in last 12 months)	1.35	0.55-3.32	0.94	0.27-	0.75	0.27-
Criminal justice involvement (ever)	1.19	0.41-3.45	5.75	0.59-	0.72	0.27-
Member of a ball house or gay family	1.67	0.67-4.18	0.85	0.22-	0.63	0.25-
Behavioral factors (controls)	1.49	0.70-3.20	1.07	0.44-	0.82	0.34-
Recreational marijuana use (daily or Condomless Sex	1.21	0.55-2.68	1.92	0.84-	1.37	0.58-
Sex drug use	1.00	0.46-2.19	1.25	0.43-	0.73	0.31-
Group sex	1.06	0.36-3.10	3.10	0.62-	1.20	0.39-
HIV care	—	—	1.11	0.44-	2.93	1.32-
HIV/STI tester	1.01	0.41-2.48	—	—	1.40	0.44-
PrEP aware	2.89	1.29-	1.20	0.44-	—	—
Confidant ego-network features
Number of confidants	1.14	0.83-1.57	0.81	0.53-	1.20	0.79-
At least one confidant who is biological/	2.17	0.57-8.19	1.48	0.36-	0.52	0.12-
At least one confidant who is MSM	0.62	0.27-1.39	1.24	0.43-	0.90	0.35-
At least one confidant who knows they	2.03	0.87-4.72	0.43	0.14-	1.09	0.40-
Sexual ego-network features
Number of partners in past 9 months	1.14	0.87-1.49	1.59	1.09-	0.78	0.50-
At least one partner who is HIV+	1.75	0.71-4.31	1.75	0.52-	2.67	0.88-
At least one partner met through mutual	0.64	0.29-1.38	0.43	0.17-	0.76	0.33-
At least one partner met at bars, clubs, or	2.17	0.61-7.66	1.09	0.25-	1.03	0.22-
At least one partner met in public spaces	1.06	0.43-2.59	2.17	0.69-	1.51	0.47-
At least one partner met online	0.98	0.43-2.23	0.51	0.14-	2.93	0.95-
Facebook network features
Number of Facebook friends	1.01	0.86-1.19	1.25	0.99-	1.10	0.94-
Number of Facebook group affiliations	0.98	0.94-1.01	1.09	0.99-	1.03	0.98-
At least one LGBTQ identity Facebook	0.67	0.26-1.71	1.47	0.47-	0.87	0.30-
At least one Sexual Attraction Facebook	1.06	0.42-2.68	0.33	0.10-	1.12	0.40-
At least one Chat Facebook group	2.82	1.18-	0.72	0.27-	1.46	0.55-
At least one Secret Facebook group	1.08	0.41-2.86	2.61	0.83-	0.69	0.27-
Range of subjects among Facebook	1.04	0.72-1.50	0.84	0.53-	0.86	0.58-

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)

Characteristics	Condom less Sex		Sex Drug Use		Group Sex
	aOR	95% CI	aOR	95%	aOR	9
Socio-demographic and structural factors (controls)
Age	0.95	0.83-1.09	1.06	0.93-	1.11	0
Sexual orientation (bisexual)	1.75	0.73-4.18	0.76	0.32-	1.64	0
HIV status (HIV+)	0.60	0.28-1.29	1.44	0.67-	0.71	0
Health coverage	0.40	0.18-0.91*	1.09	0.41-	0.43	0
Housing instability (in last 12 months)	0.57	0.25-1.31	1.20	0.50-	1.06	0
Criminal justice involvement (ever)	3.65	1.08-	0.87	0.30-	2.00	0
Member of a ball house or gay family	0.43	0.17-1.07	0.80	0.36-	2.70	0
Behavioral factors (controls)
Recreational marijuana use (daily or more)	1.08	0.48-2.43	2.03	0.98-	1.29	0
Condomless Sex	—	—	1.87	0.83-	0.50	0
Sex drug use	1.82	0.83-4.01	—	—	2.35	0
Group sex	0.41	0.14-1.21	1.94	0.68-	—	—
HIV care	1.08	0.50-2.31	0.99	0.45-	1.23	0
HIV/STI tester	1.82	0.78-4.28	1.01	0.37-	3.35	0
PrEP aware	1.54	0.68-3.47	0.77	0.33-	1.54	0
Confidant ego-network features
Number of confidants	1.44	1.04-2.00*	1.01	0.74-	1.23	0
At least one confidant who is biological / play family	0.15	0.05-	0.71	01.22-	1.08	0
At least one confidant who is MSM	0.93	0.42-2.06	2.32	1.09-	1.09	0
At least one confidant who knows they are MSM	1.76	0.74-4.17	1.04	0.47-	0.50	0
Sexual ego-network features
Number of partners in past 9 months	1.13	0.86-1.47	0.97	0.75-	1.41	1
At least one partner who is HIV+	3.53	1.37-9.06*	1.55	0.72-	1.04	0
At least one partner met through mutual friends	0.44	0.22-0.90*	1.59	0.78-	0.62	0
At least one partner met at bars, clubs, or ball events	2.91	0.88-9.58	1.10	0.41-	2.71	0
At least one partner met in public spaces	3.13	1.10-8.96*	1.83	0.73-	0.44	0
At least one partner met online	2.65	1.20-5.85*	2.96	1.28-	5.30	1
Facebook network features
Number of Facebook friends	1.25	1.03-1.51*	1.17	1.01-	0.91	0
Number of Facebook group affiliations	0.98	0.95-1.02	1.03	0.99-	0.97	0
At least one LGBTQ Identity Facebook group	0.36	0.14-0.92*	1.11	0.42-	1.12	0
At least one Sexual Attraction Facebook group	0.78	0.30-2.07	0.88	0.39-	2.00	0
At least one Chat Facebook group	1.07	0.42-2.72	1.45	0.61-	1.08	0
At least one Secret Facebook group	0.78	0.28-2.21	1.20	0.50-	1.60	0
Range of subjects among Facebook groups	1.31	0.91-1.90	0.68	0.48-	0.94	0

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

Characteristics	Percent
Prevention and sex behaviors
Received HIV care (prevention or treatment) from provider	68.3
Tested for HIV or STIs at least 3 times in the last 9 months	83.6
Heard of PrEP	77.2
Condomless sex	59.3
Sex drug use	35.1
Group sex	17.2
Sociodemographic, behavioral and structural factors (controls)
Mean Age	23.47 (2.90; 17, 29)
Sexual orientation (bisexual)	26.1
HIV status (HIV+)	41.4
Health insurance coverage	77.2
Housing instability (in last 12 months)	20.5
Criminal justice involvement (ever)	11.9
Member of a ball house or gay family	31.3
Recreational marijuana use (daily or more)	29.5
Confidant ego-network features
Mean number of confidants	2.21 (1.11; 0, 5)
At least one confidant who is MSM	45.5
At least one confidant who knows respondent is MSM	39.9
At least one confidant who is biological / play family	10.1
Sexual ego-network features
Mean number of partners in past 6 months	2.72 (1.58; 0, 6)
At least one partner who is HIV+	24.6
At least one partner met through mutual friends	47.8
At least one partner met at bars, clubs, or ball events	14.9
At least one partner met in public spaces	20.2
At least one partner met online	46.3
Facebook network features
Number of Facebook friends	44.65 (27.60; 0, 162)
Number of Facebook group affiliations	11.00 (14.01; 1, 89)
At least one LGBTQ identity Facebook group	56.4
At least one Sexual Attraction Facebook group	51.5
At least one Chat Facebook group	60.5
At least one Secret Facebook group	73.7
Mean range of subjects among Facebook groups	3.95 (2.19; 1, 9)

Subject Classification Scheme for Facebook Groups

Subject Category	Definition
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)
Events	Groups that promote events — e.g., nightlife/club events, festivals, community events, live shows, etc.
Recreational Interests	Groups 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 Promotion	Groups 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 being	Groups that provide information and/or support to members with respect to physical, emotional, and spiritual health and well being.
Community	Groups about place-based community life (e.g. school alumni groups, neighborhood alumni groups, church groups, groups about living in Chicago, etc.)