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Try out PMC Labs and tell us what you think. Learn More. Network analysis is useful for understanding sexual transmission of HIV and other sexually transmitted infections. We conducted egocentric and affiliation network analysis among HIV-infected young black men who have sex with men MSM in the Jackson, Mississippi, area to understand networks and connectedness of this population. Participants provided demographic and geographic information about each sex partner during the 12 months before diagnosis and identified venues where they met these partners.
We created affiliation network diagrams to understand connectedness of this population and identify venues that linked participants. The median of partners reported was four range 1—16 ; a total of 97 partners 88 of whom were male were reported.
All but one participant were connected through a network of venues where they had met partners during the 12 months before diagnosis. Three venues were named as places for meeting partners by 13 of 22 participants. Participants reported having partners from all regions of Mississippi and five other states. These venues should be targeted for testing and prevention interventions. The pattern of meeting sex partners in a small of venues suggests densely connected networks that propagate infection. This pattern, in combination with sexual partnerships with persons from outside Jackson, may contribute to spread of HIV and other STIs into or out of the Jackson area.
A network study of HIV-infected young black MSM in Jackson, Mississippi, found all were linked by few Jackson venues but that partners were from locations that were widely distributed geographically. Individual risk behaviors do not adequately explain racial disparities in HIV infection, as black MSM are not more likely than other MSM to report sexual risk behavior or substance use.
However, differences in social and sexual networks likely have a substantial impact on racial disparities in HIV infection. Network analyses assessing connections between people can inform our understanding of transmission of HIV and other STIs. Sociometric network analysis consists of interviewing all members of a network and describing both direct and indirect linkages among persons at risk in the network. Egocentric analysis requires that respondents provide descriptive data about their social and sexual contacts; 13 this type of analysis does not allow direct observation of complete population-level structures of networks, but allows assessment of age-mixing, spatial bridging, and concurrency.
During February-AprilCDC and MSDH conducted a multi-method investigation that included a case-control study, 1718 a qualitative study, 19 a phylogenetic analysis, 20 and an egocentric and affiliation network analysis study.
Formative interviews with community members and stakeholders indicated that the Internet was playing a large role in finding sex partners and that travel was prominent in social and sexual networks; therefore, these issues were explored in the network analysis. We analyzed data from the egocentric and affiliation network component of this investigation to identify the sexual networks of young black MSM with new HIV diagnoses and to describe their social and sexual mixing patterns and risk behaviors.
Because a substantial of persons meeting these criteria did not have complete information regarding transmission category, we did not limit recruitment to persons who were believed to have a transmission category of male-male sex. However, we later excluded from analysis those persons who did not report any male anal sex partners during the 12 months before HIV diagnosis. Those who agreed to participate in the investigation were invited to participate in the case-control study, 1718 and those who participated in the case-control study after the network analysis study had begun were also invited to participate in the network analysis study.
Trained interviewers conducted a standardized interview. The questionnaire, deed using input from formative interviews, focused on partners and venues from the 12 months before HIV diagnosis. Although participants were assured that partners would not be contacted and were asked to provide the full name of each partner, nearly all were willing or able to provide only a partial name, a nickname, or initials. Sample sizes are small and this is intended as a descriptive analysis; therefore, no statistical tests were performed.
We created egocentric network diagrams showing links between participants and their partners. These diagrams depict the type of partnership main or casualgender of partner, and HIV status of partner, all as reported by the participant. We also created affiliation network diagrams showing links between participants and Jackson-area public venues gay bars and clubs, shopping malls, cruising areas, and colleges where they met sex partners or socialized. We did not include locations that were reported by only one person unless the location was a gay bar or cruising area.
Network diagrams were created using NetDraw version 2. Forty of these men participated in the investigation, of whom 30 had male-male sex during the 12 months before diagnosis. Of these, 22 completed the network analysis interview. Those not included were not ificantly different from those included with respect to age, year of diagnosis, reported risk category, or residency or HIV diagnosis in the Jackson area versus elsewhere in Mississippi.
Among the 22 men interviewed, median age was 22 years range: 18— Fifteen identified as gay or homosexual, 4 as bisexual, 2 as heterosexual, and 1 as questioning. The median of sex partners named was 4 range: 1—16and 20 men reported having only male partners in the 12 months prior to HIV diagnosis. Two participants reported buying or selling sex. Full names were provided for only 2 male partners. Table 1 presents characteristics of the 88 male sex partners stratified by type of partner. However, the duration of more than one-third of main partnerships Looking for black man to fuck Jackson Mississippi wife less than 6 months.
Characteristics of male sex partners of HIV-infected young black men who have sex with men, Jackson, Mississippi. Over half of main partners and three-quarters of casual partners resided in the Jackson area. Participants reported greater risk with casual than main partners. Figure 1 shows the egocentric sexual networks of the 22 participants during the 12 months before HIV diagnosis. There is large variation in the of sex partners reported. Thirteen of the 15 men who reported more than one sex partner in the month period had both main and casual partners.
Additionally, 12 men reported more than one main partnership in the month period; we do not have data to indicate whether these main partnerships were serial or concurrent. Seventeen participants had at least one sex partner of unknown HIV status. Only 2 participants had female or transgender sex partners; both reported having multiple male and female partners. Few connections between cases were identified—only one sex partner was reported by more than one participant, and one participant was reported by another participant.
Figure includes participants and sex partners they reported from the 12 months before HIV diagnosis. The affiliation network diagram Figure 2 connects participants to venues where they socialized and met sex partners solid black linesmet sex partners only dashed blue linesor socialized but did not meet sex partners dashed red lines.
This diagram is densely connected; all participants were connected through a network of where they had met sex partners or socialized, and all but one participant were connected through a network of where they had met sex partners during the 12 months prior to diagnosis.
Three venues two gay bars and one college were named as places for meeting sex partners by 13 of the 22 participants. In contrast, less than half of participants reported meeting sex partners online. Of the 17 partners who were met online, 7 were first met in person at a physical venue included in Figure 2 3 at a gay bar, 3 at a college, and 1 at a mall. Affiliation network diagram showing links between HIV-infected young black MSM in the Jackson, MS, area and public venues where they met sex partners and where they socialized.
Although the largest proportion of partners resided in Jackson, partners resided in all regions of Mississippi and 5 other states, and there are numerous partners from the Mississippi Delta region, which has the highest HIV prevalence rates in the state outside of the Jackson area. Mississippi counties are shaded according to the rate of persons living with HIV.
Affiliation network analysis demonstrated that the HIV-infected young black MSM interviewed were linked by a small of venues. The pattern of meeting sex partners in a limited of venues suggests densely connected networks that propagate infection.
This, in combination with sexual partnerships with persons from outside of Jackson, many from large urban areas, may contribute to spread of HIV and other STIs into or out of the Jackson area. The fact that there were few venues frequented may be a result of homophobia and stigma which is widely present, particularly in the black community 23 and the South. While many young Looking for black man to fuck Jackson Mississippi wife MSM interviewed reported frequenting Internet websites, our suggest that public venues played a more prominent role in meeting sex partners, especially casual partners.
Egocentric network analysis revealed important information regarding relationship dynamics and concurrency. We found that concurrency was prevalent in both main and casual partnerships and that relationship duration was less than 6 months for most casual partnerships and over one-third of main partnerships. These findings may have important implications for transmission of HIV and other STIs, especially at the network level.
Our egocentric and affiliation network analysis identified several network factors that may promote HIV transmission. These factors are potential behavioral targets for prevention campaigns. The men interviewed identified a small of venues; these venues, especially those with many patrons, should be targeted for testing and prevention interventions. research has demonstrated the importance of understanding venues where people meet sex partners for prevention efforts for HIV and other STIs.
All data are limited by recall bias and social desirability bias, which may affect reliability and accuracy of the analysis. We had data for less than half of eligible cases, limiting generalizability. The fact that we had full names for only 2 of 88 male partners severely limited our ability to determine when more than one participant had a common partner; therefore, we likely overestimated the total of unique partners and underestimated the of connections in the network.
Egocentric network analysis is also limited by the fact that partners are not interviewed.
Interviewing the partners may have identified additional links among network members. Thus, Figure 1 may under-represent the connectedness of the sexual network. A prominent limitation of affiliation networks is that they measure opportunities for social connection, but not direct social connections.
The true level of connectedness likely lies somewhere between that displayed in Figure 1 and Figure 2. Using egocentric and affiliation network analysis, we identified networks that were densely connected by a small of venues within the Jackson, Mississippi, area but bridged to other communities both inside and outside of Mississippi. These data are relatively easy and inexpensive to collect, and they provided insights and targets for intervention not obtained from other investigation methods.
When used in public health investigations, egocentric network analysis can be a valuable tool to understand sexual network structure and partner-level risk behavior, and affiliation network analysis can help identify targets for interventions for HIV and other STIs. Moreover, data from network analysis can be triangulated with other surveillance and behavioral data from public health investigations; in doing so, multi-method investigations such as this one provide a more complete picture of acquisition and transmission dynamics within a community.
Finally, we are indebted to the participants. Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Conflicts of Interest and Source of Funding: The authors declare no conflicts of interest. National Center for Biotechnology InformationU. Sex Transm Dis. Author manuscript; available in PMC Jul Alexandra M. Leandro A. James D. Author information Copyright and information Disclaimer. Correspondence: Alexandra M. Copyright notice. The publisher's final edited version of this article is available at Sex Transm Dis. See other articles in PMC that cite the published article. Abstract Background Network analysis is useful for understanding sexual transmission of HIV and other sexually transmitted infections.
Key Words: HIV, sexual networks, young black men who have sex with men. Short summary A network study of HIV-infected young black MSM in Jackson, Mississippi, found all were linked by few Jackson venues but that partners were from locations that were widely distributed geographically. Measures Trained interviewers conducted a standardized interview. Table 1 Characteristics of male sex partners of HIV-infected young black men who have sex with men, Jackson, Mississippi.
Open in a separate window. Figure 1. Figure 2. Figure 3. Discussion Affiliation network analysis demonstrated that the HIV-infected young black MSM interviewed were linked by a small of venues. Limitations All data are limited by recall bias and social desirability bias, which may affect reliability and accuracy of the analysis. Conclusion Using egocentric and affiliation network analysis, we identified networks that were densely connected by a small of venues within the Jackson, Mississippi, area but bridged to other communities both inside and outside of Mississippi.
Footnotes Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. References 1. Centers for Disease Control and Prevention. Prevalence and awareness of HIV infection among men who have sex with men 21 cities, United States, PLoS One.
Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. Greater risk for HIV infection of black men who have sex with men: a critical literature review. Am J Public Health. Perceived condom norms and HIV risks among social and sexual networks of young African American men who have sex with men.
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Social context, sexual networks, and racial disparities in rates of sexually transmitted infections. J Infect Dis. Wohlfeiler D, Potterat JJ.Looking for black man to fuck Jackson Mississippi wife
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HIV Infection Among Young Black Men Who Have Sex with Men—Jackson, Mississippi, , Centers for Disease Control and Prevention, 58 MMWR 77 ()