In the US, HIV prevention targeting Men who have Sex with Men (MSM) appears to be failing, while a syndemic of high alcohol/drug use and unsafe sex is increasing. The Office of AIDS Research at the NIH (FY 2006) has prioritized research that aims to """"""""develop and evaluate methods ... to reduce HIV acquisition .... associated with drug and alcohol use"""""""" while CDC has described finding """"""""new approaches to reduce HIV risk among MSM"""""""" as of the """"""""highest"""""""" priority. In response, our broad long-term objective is to study the impact of structural interventions likely to reduce Alcohol-Related HIV Risk (ARHR) among MSM. Legislation on homosexuality and the growth of gay e-infrastructure are two such structural factors which have become prominent national issues, yet little is known about how either impacts MSM's health and HIV risk behavior. We theorize that gay bars are the environmental structure most driving heavy alcohol use and ARHR, and thus contribute to male-male transmission of HIV, syphilis and gonorrhea. If so, the growing utilization of gay e-environments should lower risk. Similarly, legislation on homosexuality, by mainstreaming or marginalizing MSM, is predicted to have significant health impact on this population. This project has 2 aims: (1) To study, at the community level, how public policy and gay e-infrastructure may be changing the centrality and popularity of gay bars; (2) To study, at the individual level, how public policy and gay e-infrastructure modifies alcohol use and ARHR among Men who use the Internet to seek Sex with Men (MISM). To implement these aims, we have assembled an interdisciplinary team of researchers in HIV prevention, alcohol, law, computer science, demography, Internet research, and homosexuality. This team will conduct a prospective, case-comparison, natural experiment study in 16 cities with different legislation on homosexuality (8=pro, 8=anti) and different levels of gay e-infrastructure (8=strong, 8=weak). How these factors impact risk will be tracked at two levels, annually, over 4 years: (1) the city level, by taking a city-wide census of gay bars/clubs, bar attendance, gay e-infrastructure, and HIV/STI rates; (2) the individual level, by comparing MISM's (n=250 per city; 4000 per period) alcohol use and ARHR behavior with men first met (a) in gay bars, (b) online, and (c) in neither environment (with participants acting as their own control). ? ?

Public Health Relevance

This study (1) advances methods for online behavioral surveillance; (2) examines how alcohol use impacts HIV risk; and (S)studies how virtual environments and public policy impact a community's structure, alcohol use, and HIV risk behavior. As the first study to examine how legislation and e-infrastructure impacts health of high risk communities, this study will inform key stakeholders and the public, nationally and internationally, on how law and the e-environment impact health and HIV risk. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA016270-02
Application #
7294287
Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Freeman, Robert
Project Start
2006-09-30
Project End
2011-08-31
Budget Start
2007-09-01
Budget End
2008-08-31
Support Year
2
Fiscal Year
2007
Total Cost
$640,795
Indirect Cost
Name
University of Minnesota Twin Cities
Department
Family Medicine
Type
Schools of Medicine
DUNS #
555917996
City
Minneapolis
State
MN
Country
United States
Zip Code
55455
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Wilkerson, J Michael; Noor, Syed W; Galos, Dylan L et al. (2016) Correlates of a Single-Item Indicator Versus a Multi-Item Scale of Outness About Same-Sex Attraction. Arch Sex Behav 45:1269-77
Noor, Syed W B; Rampalli, Krystal; Rosser, B R Simon (2014) Factors influencing HIV serodisclosure among men who have sex with men in the US: an examination of online versus offline meeting environments and risk behaviors. AIDS Behav 18:1638-50
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Noor, Syed W; Rosser, B R Simon (2014) Enema use among men who have sex with men: a behavioral epidemiologic study with implications for HIV/STI prevention. Arch Sex Behav 43:755-69
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O'Leary, Ann; Horvath, Keith J; Simon Rosser, B R (2013) Associations between partner-venue specific personal responsibility beliefs and transmission risk behavior by HIV-positive men who have sex with men (MSM). AIDS Behav 17:1855-61
Jones-Webb, Rhonda; Smolenski, Derek; Brady, Sonya et al. (2013) Drinking settings, alcohol consumption, and sexual risk behavior among gay men. Addict Behav 38:1824-30
Brady, Sonya S; Iantaffi, Alex; Galos, Dylan L et al. (2013) Open, closed, or in between: relationship configuration and condom use among men who use the internet to seek sex with men. AIDS Behav 17:1499-514
Wilkerson, J Michael; Smolensk, Derek J; Brady, Sonya S et al. (2013) Performance of the Duke Religion Index and the spiritual well-being scale in online samples of men who have sex with men. J Relig Health 52:610-21

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