Understanding substance use and incident HIV/STI among young black MSM Project Summary/Abstract Racial/ethnic disparities in HIV have been a hallmark of the US HIV epidemic for decades, with black/African Americans experiencing higher rates of HIV infection than white Americans. These disparities are also observed in men who have sex with men (MSM), among whom the highest incidence rates are in young black/African American MSM (YBAAMSM). Despite a rich literature demonstrating the prevalent levels of drug and alcohol use among MSM and the potential relationships between these substances and high-risk sexual behaviors, individual risk behaviors do not explain why black MSM and YBAAMSM are more likely to become infected with HIV, compared to other MSM. Studies of self-reported use have collectively demonstrated no greater substance use among black MSM than among white MSM. However, a key finding of our previous R01, which examined factors associated with prevalent and incident HIV infection among a prospective cohort of black and white MSM in Atlanta, was that black MSM had substantially lower validity of self-reported drug use, compared to white MSM. Biomarker-classified drug use was also more predictive of HIV seroconversions than self-reported sexual behavior measures, suggesting that, in this population, substance use may be a marker of high-risk partners and environments. Furthermore, the racial disparity in prevalent HIV infection was most associated with differences in network and community factors rather than individual factors. Despite emerging data on sexual partners and structures among YBAAMSM, little is known about the overlap of sexual and substance-use networks, though this might amplify HIV/STI transmission risk. Therefore, we propose to conduct a new prospective cohort study of 300 HIV-negative YBAAMSM in Atlanta, GA, to understand prospective patterns of biomarker-supported substance use in YBAAMSM, as well as its antecedents, contexts, and consequences. This new project will build on the strong institutional infrastructure, community partnerships, theoretical frameworks, analytical approaches, and multidisciplinary research that contributed to the success of our previous cohort study. Results will provide a more detailed understanding of the multilevel associations between substance use and HIV risk, and will yield new opportunities for combination interventions that address the syndemics of HIV/STI and drug use among YBAAMSM.

Public Health Relevance

Profound disparities in HIV incidence exist for young black/African American MSM compared to other subgroups of MSM. Substance use is prevalent and associated with HIV infection for young black/African American MSM, but the mechanisms by which substances impart added HIV risk are unclear. A cohort study of HIV-negative black MSM ages 18-29 is proposed to further understanding of the relationships between substances and HIV/STI incidence and risk behaviors, and suggest possible interventions.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA038196-05
Application #
9488467
Study Section
Special Emphasis Panel (ZDA1)
Program Officer
Lambert, Elizabeth
Project Start
2014-06-15
Project End
2019-05-31
Budget Start
2018-06-01
Budget End
2019-05-31
Support Year
5
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Emory University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
066469933
City
Atlanta
State
GA
Country
United States
Zip Code
30322
Sullivan, Patrick S; Giler, Robertino Mera; Mouhanna, Farah et al. (2018) Trends in the use of oral emtricitabine/tenofovir disoproxil fumarate for pre-exposure prophylaxis against HIV infection, United States, 2012-2017. Ann Epidemiol 28:833-840
Jones, Jeb; Hoenigl, Martin; Siegler, Aaron J et al. (2017) Assessing the Performance of 3 Human Immunodeficiency Virus Incidence Risk Scores in a Cohort of Black and White Men Who Have Sex With Men in the South. Sex Transm Dis 44:297-302
Rolle, Charlotte-Paige; Rosenberg, Eli S; Luisi, Nicole et al. (2017) Willingness to use pre-exposure prophylaxis among Black and White men who have sex with men in Atlanta, Georgia. Int J STD AIDS 28:849-857
Rolle, Charlotte-Paige; Rosenberg, Eli S; Siegler, Aaron J et al. (2017) Challenges in Translating PrEP Interest Into Uptake in an Observational Study of Young Black MSM. J Acquir Immune Defic Syndr 76:250-258
Chapin-Bardales, Johanna; Rosenberg, Eli Samuel; Sullivan, Patrick Sean (2017) Trends in racial/ethnic disparities of new AIDS diagnoses in the United States, 1984-2013. Ann Epidemiol 27:329-334.e2
Rosenberg, Eli Samuel; Grey, Jeremy Alexander; Sanchez, Travis Howard et al. (2016) Rates of Prevalent HIV Infection, Prevalent Diagnoses, and New Diagnoses Among Men Who Have Sex With Men in US States, Metropolitan Statistical Areas, and Counties, 2012-2013. JMIR Public Health Surveill 2:e22
Rosenberg, Eli S; Millett, Gregorio A; Sullivan, Patrick S et al. (2014) Understanding the HIV disparities between black and white men who have sex with men in the USA using the HIV care continuum: a modeling study. Lancet HIV 1:e112-e118