A Multilevel Network Model of Drug Use and HIV Racial Disparities in Men

Black men who have sex with men (MSM), especially young MSM, are disproportionately affected by HIV, with an annual incidence higher than any other age or race group. Despite this increasing epidemic, few studies have focused on MSM nor accounted for these disparities. The research that has examined disparities in MSM has been focused on understanding individual-level behavior, but this has been inadequate to explain HIV racial disparities. Additionally, network research is increasingly a priority area in HIV research due to the disease’s high transmission dependence on drug and sexual network dynamics. However, network descriptions alone are also inadequate without considering the interplay of individual and contextual factors. Instead, it has been suggested that a broader systems-level perspective may be necessary as several interacting individual, network, and contextual differences may account for the increased epidemic in Black MSM populations. Due to this call for a systems-level perspective in understanding and preventing HIV infection, this grant seeks to advance understandings of HIV racial disparities in MSM by examining individual, network, and contextual factors and the interplay between factors, within a multilevel network model. This model will be tested across two studies. Study 1 is a secondary data analysis of the NIDA-funded Sexual Acquisition and Transmission of HIV Cooperative Agreement Program (SATHCAP), which allows for the examination of individual, network, and structural characteristics associated with HIV. Study 2 collects an original multilevel macronetwork dataset as an extension of the applicant’s R03 Project which is analyzing the social, sexual, and drug networks of YMSM macronetwork. 200 YMSM will complete relational network interviews (social, sexual, and drug) and contextual network interviews (networks of neighborhoods; networks of venues). Additionally, data will be integrated with both a) detailed open-access neighborhood data via Chicago Department of Public Health and b) data from three NIH-funded parent grants. This comprehensive multilevel macronetwork dataset will allow innovative analyses and methods that account for the complex dynamics of HIV transmission and racial disparities. The overall project has two aims: 1) Identify network factors (i.e., relational and contextual network structures) which contribute to racial disparities in HIV (Studies 1 & 2) and 2) Examine interplay of individual, relational network, and contextual network factors (Study 2). Additional sub-aims include: A) Compare the contribution of each level of analysis to racial disparities in HIV using innovative Multiple-Membership Multiple-Classification Models (MMMC) and B) Compare the contribution of individual, relational, and contextual structures and attributes to racial disparities in HIV with ERGMs/p*analysis.