Dustin T. Duncan’s research while affiliated with Columbia University and other places

Sexually minoritized men (SMM), transgender women (TW), and particularly Black SMM and Black TW may be disproportionately impacted by alcohol-related problems. Few studies have empirically examined neighborhood factors that may contribute to alcohol use, specifically among these populations. Using data from the N2 longitudinal cohort study in Chicago, IL, survey data from the second wave of longitudinal assessment (n = 126) and GPS mobility data from enrollment were used to evaluate neighborhood alcohol outlet availability, neighborhood disorder, and neighborhood poverty as correlates of individual alcohol use. Neighborhood exposures were measured using 200-m-derived activity space areas, created from GPS data, using publicly accessible geospatial contextual data. Separate multivariable quasi-poison regression models tested for association between neighborhood alcohol outlet density (AOD), measured separately for on-premise (e.g., bars) and off-premise consumption outlets (e.g., liquor stores), neighborhood poverty (defined as the percentage of neighborhood areas at 150% or greater of the US poverty line), exposure to vacant buildings, and neighborhood violent crime density. Separate analytical models found no significant effect between alcohol use and exposure to on-premise consumption venue AOD (risk ratio (RR) = 0.99, p = 0.57), off-premise consumption AOD (RR = 0.94, p = 0.56), neighborhood poverty (RR = 1.04, p = 0.07), or neighborhood violent crime (RR = 1.00, p = 0.94). Exposure to higher levels of vacant buildings (RR = 1.03, p = 0.04) was found to be significantly associated with increased alcohol use. Among this population, opposed to geospatial access, neighborhood measurements indicative of disorder may have a greater influence on shaping alcohol use.

Background Using a theoretically-grounded approach to the epidemiological study of HIV incidence among a national, diverse sample of sexual and gender minority (SGM) men (age 17 -29 years), as well as examining HIV incidence through an innovative geospatial lens, is of considerable public health significance. Our overarching objectives are to assemble a U.S.-based national cohort of diverse SGM men: (1) to estimate HIV incidence in SGM men followed every 6 months for up to 24 months, (2) to assess the association of individual and geospatial factors associated with HIV incidence and (3) to determine the relative efficiency and acceptability of three different, discrete study enrollment approaches (including completion of remote HIV testing). The purpose of this manuscript is to describe the study protocol. Methods The cohort is composed of English- and/or Spanish-speaking SGM men at risk for HIV, age 17–29 years and living in the United States and its territories. We used multiple methods to recruit our sample including social networking apps like GrindrTM. If a participant was eligible for the study, they completed an address intake form so an HIV test could be mailed to their home or chosen address. We assembled three cohorts using different enrollment approaches. Cohort 1 used Zoom video calls with study staff observing participants use of OraQuick test with oral swabs at the baseline visit. Cohort 2 used No Zoom and OraSure oral fluid tests that participants mailed to an external lab. Cohort 3 used No Zoom/self-administration of OraQuick tests and participants uploading test results to an online portal (REDCap). Discussion This study will provide important data on multilevel determinants of HIV incidence among SGM men at the national level, allowing us to examine important differences by local jurisdiction, region and state and to better understand the impact of individual, social and geospatial factors on HIV incidence to help inform future prevention strategies.

Chronic insufficient and poor-quality sleep are linked to hypertension, diabetes, depression, heart attack, and stroke. While studies on substance use and sleep typically focus on people in or entering treatment, there is a lack of research on sleep health among community-recruited people who inject drugs (PWID). To address this literature gap, we examined factors associated with insufficient and poor-quality sleep among community-recruited PWID. We recruited and interviewed 472 active opioid-using PWID (injected within the last 30 days) in Los Angeles, CA and Denver, CO between 2021 and 2022. Participants completed computer-assisted interviews covering demographics, subsistence measures, drug use patterns, injection-related behaviors, health risks, and sleep duration and quality in the last 3 months. Descriptive statistics were used to analyze all variables for subjects with complete responses to sleep items ( n = 464). Bivariate analyses determined factors associated with sleep measures using chi-square and t -tests. Collinear variables were removed, and binomial linear multivariable regression calculated risk ratios (RR) for insufficient and poor-quality sleep in the last 3 months. Participants exhibited low sleep duration (mean = 4.99, standard deviation (SD) = 2.70), with 76% reporting insufficient sleep and 62% poor-quality sleep. Bivariate analyses associated both sleep measures with drug use, high subsistence scores, violent victimization, and poor health outcomes. Multivariable analyses showed a high subsistence score predicting insufficient (RR = 1.31) and poor-quality sleep (RR = 1.69) compared to low subsistence. Poor sleep health is common among structurally vulnerable community-recruited PWID, as measured by subsistence index associated with adverse sleep outcomes. Further research on structural interventions to address sleep and subsequent health outcomes among PWID is imperative.

BACKGROUND Social network data are essential and informative for public health research and implementation as they provide details on individuals and their social context. OBJECTIVE We aimed to generate a more complete sociocentric-like “fuzzy” network by harmonizing alternative sources of egocentric and digital network data to examine relationships between participants in the N2 cohort study. Further, we propose to examine network peer effects of status neutral HIV care continuum cascade. METHODS Data were collected from January 2018 to December 2019 in Chicago, Illinois, US from a community health center and via peer referral sampling as part of the Neighborhoods and Networks (N2) Cohort Study, comprised of Black sexually minoritized men and gender expansive populations. Participants provided sociodemographics, social networks, sexual networks, mobile phone contacts, and Facebook friend list data. Lab-based information about HIV care continuum cascade was also collected. We used an experimental approach to develop and test a fuzzy matching algorithm to construct a more complete network across confidant, sexual, Facebook, and phone networks using R and Excel. We calculated social network centrality measures for each of these networks and then described the HIV care continuum within the context of each network. We then used Spearman’s correlation and a network autocorrelation model to examine social network peer effects with HIV status and care engagement. RESULTS A total of 412 participants resulted in 2,054 network connection (ties) across all confidant, sexual, phone, and Facebook networks - reaching the entire study sample in one fully connected “fuzzy” network. Results from the network autocorrelation model suggest that participants who were proximate to network members who were engaged in care were significantly more likely to be engaged in care (significant at p<0.05). CONCLUSIONS Using alternative sources of network data allowed us to fuzzy match a more complete network: fuzzy matching may identify hidden ties among participants which were missed by examining alternative sources of network data separately. Although sociocentric studies may be complex, more complete sociocentric-like networks may be generated using a fuzzy match approach that leverages peer referral, egocentric networks, and digital networks. Enriching offline networks with digital network data may provide insights into characteristics and norms that traditional egocentric approaches may not be able to capture. INTERNATIONAL REGISTERED REPORT RR2-10.2196/48548