Historically, network-based interventions that aim to combat HIV/AIDS have targeted sexual partners and focused on risk reduction strategies. However, it is equally important to examine aspects central in the lives of individuals at risk for transmitting or contracting HIV including sexual risk behaviors, but also engagement in HIV care, adherence and retention to treatment and disclosure of HIV status and men who have sex with men (MSM) identity. It might be that these individuals are embedded in similar social contexts that place them at risk for HIV. Furthermore, it might be friends, acquaintances and colleagues and not sexual partners who act as sources of influence on individuals'health behaviors. In other words, the mode of HIV transmission might not be the same as the mode of information transmission or behavior influence. As such, network-based interventions might be more effective if they target friendship networks rather than sexual networks and address more social aspects than risk reduction. Hispanic men are disproportionately burdened by the HIV/AIDS epidemic. Hispanic men make up 32% of the reported 51,250 cumulative AIDS cases among men in Los Angeles County as of December 2009. Among Hispanic men, male-to-male sexual contact represents the primary mode of HIV transmission, making up 69% of the cumulative AIDS cases ever reported, as compared to heterosexual contact that makes up 3%. The objective of this research is to investigate social environments and HIV status &MSM identity disclosure across friendship and sexual networks of Hispanic MSM. Specifically, the aims of this research are to 1) identify and describe social contexts including how respondents'social contexts may vary by intrapersonal characteristics;2) identify and describe HIV status and MSM identity disclosure patterns including how such patterns may vary by respondents'social contexts and intrapersonal characteristics;3) investigate the effects of similarities in social contexts on similarities in disclosure of HIV status and MSM identity across friendship and sexual networks. The data for the research came from a cross-sectional study of Hispanic MSM in Los Angeles County as part of the Brothers Y Hermanos project. Respondents were recruited to the project via respondent driven sampling (RDS) and the final sample size is composed of 564 men. This research will utilize traditional quantitative analyses such as linear and logistic regressions to examine the associations between disclosure behaviors, social environmental factors and intrapersonal characteristics. Furthermore, it will use social network analyses, specifically, one-to-many dyadic analyses to examine similarities across RDS referral pairs in terms of intrapersonal characteristics, social environmental factors and disclosure behaviors of HIV status and MSM identity, and whether similarities in social environmental factors are associated with similar disclosure behaviors across friendship and sexual networks.

Public Health Relevance

Disclosure behaviors of HIV status and men who have sex men (MSM) identity have public health significance in preventing further HIV transmission, and individual health benefits such as greater adherence to treatment, greater social support, higher self-esteem and lower levels of depression. This research will identify similarities in social environmental factors and disclosure behaviors across friendship and sexual networks and in so doing;it will help to inform which networks HIV interventions should target to promote disclosure behaviors.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Dissertation Award (R36)
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HSR Health Care Research Training SS (HCRT)
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Harding, Brenda
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Rand Corporation
Santa Monica
United States
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