Network Mixing and Network Influences Most Linked to HIV Infection and Risk Behavior in the HIV Epidemic Among Black Men Who Have Sex With Men

John A. Schneider is with the Department of Medicine and Department of Health Studies, University of Chicago, Chicago, IL. Phil Schumm is with the Department of Health Studies, University of Chicago. Benjamin Cornwell is with the Department of Sociology, Cornell University, Ithaca, NY. David Ostrow is with Ostrow and Associates, Chicago. Stuart Michaels, and Edward O. Laumann are with the National Opinion Research Center at the University of Chicago. Edward O. Laumann is also with the Department of Sociology, University of Chicago. Samuel Friedman is with the National Development and Research Institutes Inc, New York, NY.
American Journal of Public Health (Impact Factor: 4.55). 11/2012; DOI: 10.2105/AJPH.2012.301003
Source: PubMed


We evaluated network mixing and influences by network members upon Black men who have sex with men.

We conducted separate social and sexual network mixing analyses to determine the degree of mixing on risk behaviors (e.g., unprotected anal intercourse [UAI]). We used logistic regression to assess the association between a network "enabler" (would not disapprove of the respondent's behavior) and respondent behavior.

Across the sample (n = 1187) network mixing on risk behaviors was more assortative (like with like) in the sexual network (r(sex), 0.37-0.54) than in the social network (r(social), 0.21-0.24). Minimal assortativity (heterogeneous mixing) among HIV-infected men on UAI was evident. Black men who have sex with men reporting a social network enabler were more likely to practice UAI (adjusted odds ratio = 4.06; 95% confidence interval = 1.64, 10.05) a finding not observed in the sexual network (adjusted odds ratio = 1.31; 95% confidence interval = 0.44, 3.91).

Different mixing on risk behavior was evident with more disassortativity among social than sexual networks. Enabling effects of social network members may affect risky behavior. Attention to of high-risk populations' social networks is needed for effective and sustained HIV prevention.

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    • "A variety of social influence and learning perspectives contend that individuals' behaviors depend on how their primary social contacts define them (e.g., favorably or not), whether they have learned how to successfully engage in those behaviors, whether their role models engage in those behaviors, and via socialization and peer pressure [5] [49] [54] [97] [135] [146]. Indeed , the influence of network members on others' behavior has been documented with respect to a wide range of consequential issues, including academic performance [90], substance use [110], risky sexual practices [131], delinquency and crime [155], and obesity [29], to name a few. These findings have sparked substantial interest in network members' attitudes and behaviors, and have led to debates about whether these findings reflect actual social influence or homophily – individuals' tendencies to select into relationships with people who are similar to them [30] [99] [134] [150]. "
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    ABSTRACT: This paper highlights the importance of the social networks perspective in social science research and describes the main approaches to measuring social networks and closely related phenomena - including social capital and kin networks - in existing household panel surveys. It then identifies cutting-edge techniques for collecting new data on social networks within the context of a household panel survey design. We focus in particular on possible extensions to traditional egocentric network data collection, the proper enumeration of kin networks and social support in unstable and complex families, measurement of communication via information and communication technology, and identification of the social network properties of social media participation.
    No preview · Article · Aug 2015 · Journal of economic and social measurement
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    • "It has also been established that social norms within a network affect health outcomes by influencing health behaviors [5] [6]. Peer norms have been associated with HIV risk behaviors among drug users and men who have sex with men (MSM) [5] [7]. Network influences pertain to diseases other than HIV as well. "
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    ABSTRACT: Purpose Much attention has been given to the potential non-response bias that occurs in epidemiologic studies that attempt to enroll a representative sample. Most analyses surrounding non-respondents focus on individual-level attributes and how they vary across respondents and non-respondents. While these attributes are of interest, analysis of the social network position of non-respondents as defined by traditional sociometric measures (i.e. centrality, bridging) has not been conducted, and could provide further insights into the validity of the sample. Methods We utilized data from the Secunderabadi Mens’ Study, a whole network of Indian men who have sex with men (MSM) generated using cell phone contact lists of men approached using Time Location Cluster Sampling. Multivariable logistic regression was used to determine whether demographic and behavioral attributes and in-degree (the frequency that a MSM was listed across all cell phone contact lists) were associated with being a respondent. Results 239 respondents were interviewed and 81 were approached but did not consent to the interview (“non-respondents”). Conclusions Respondents were more likely to have higher in-degree than non-respondents, adjusting for attribute differences (OR 1.19; 95% CI 1.07, 1.34). This analysis suggests that the network position of non-respondents may be important when considering the potential impact of non-response bias.
    Full-text · Article · Jul 2014 · Annals of Epidemiology
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    • "Project nGage was developed to capitalize on the empircally documented benefits of social supports [20,21] within the naturally organic networks in the lives of YBMSMT [24]. Unlike prior interventions, we identify, engage and intervene with a support confidant (SC), whose close relationship with index YBMSMT may promote adherence to HIV primary care. "
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    ABSTRACT: Young Black men who have sex with men and transgender persons (YBMSMT) aged 13-29 carry the nation's highest burden of new HIV infections. Studies indicate that YBMSMT have poor retention in care, which is associated with reduced medication adherence and increased virologic failure. Project nGage is a randomized controlled (RCT) trial evaluating the feasibility and preliminary efficacy of a brief, dyadic intervention designed to promote adherence to HIV primary care in safety-net clinics. Network visualization is used to identify and engage a support confidant (SC) from participants' social networks. A social work interventionist then meets with the SC and SC-participant dyad to activate and maintain HIV-specific social support. Project nGage is operating in two phases. In Phase I, the Team refined study protocols based on pilot testing. In Phase II, 94 HIV infected YBMSMT ages 16-29 will be recruited, enrolled and randomly assigned to receive Project nGage or treatment as usual (TAU). The primary outcome is appointment attendance; the secondary outcomes are medication adherence and viral load. Implementation challenges include coordinating sites, managing dyadic intervention logistics, and recruiting non-adherent patients or those who have fallen out of care. The team continues to address implementation issues as the study progresses. Project nGage is addressing a gap in HIV care-related research by focusing on supportive relationships as a mechanism through which to promote retention in care. Pending study results, a larger RCT would compare the relative effectiveness of the Project nGage intervention versus TAU over 18 to 24 months.
    Full-text · Article · Aug 2013 · Journal of AIDS & Clinical Research
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