*Department of Medicine, Center for AIDS Prevention Studies, University of California-San Francisco, San Francisco, CA; and †The Global Forum on MSM and HIV, Oakland, CA.
J Acquir Immune Defic Syndr. 2013 Dec 15;64(5):496-501. doi: 10.1097/QAI.0b013e3182a7ee52.
To examine how social networks influence HIV risk among US racial/ethnic minority men who have sex with men (MSM) and whether the associations of social network characteristics with risk vary by race/ethnicity.
A chain-referral sample of 403 African American, 393 Asian/Pacific Islander, and 400 Latino MSM recruited in Los Angeles County, California, completed a questionnaire, which asked about their egocentric social networks, safer sex peer norms, and male anal intercourse partners. HIV-nonconcordant partnerships were those reported by respondents as serodisconcordant or where self and/or partner serostatus was unknown.
Overall, 26% of the sample reported HIV-nonconcordant unprotected anal intercourse (UAI) with a nonprimary male partner in the previous 6 months. In a generalized estimating equation (GEE) logistic model that controlled for race/ethnicity, age, nativity, incarceration history, and HIV status, being in a more dense network was associated with less HIV-nonconcordant UAI [adjusted odds ratio (AOR) = 0.92, 95% confidence interval (CI): 0.86 to 0.99, P = 0.0467]. In addition, the effect of safer sex peer norms on HIV-nonconcordant UAI was moderated by ego-alter closeness (P = 0.0021). Safer sex peer norms were protective among those reporting "medium" or "high" ego-alter closeness (AOR = 0.70, 95% CI: 0.52 to 0.95, P = 0.0213 and AOR = 0.48, 95% CI: 0.35 to 0.66, P < 0.0001, respectively), but not among those reporting "low" ego-alter closeness (AOR = 0.96, 95% CI: 0.63 to 1.46, P = 0.8333). The effects of density, closeness, and norms on HIV-nonconcordant UAI did not differ by race/ethnicity.
The significant association of social network characteristics with UAI point to network-level factors as important loci for both ongoing research and HIV prevention interventions among US MSM of color.
探讨美国不同种族/族裔男男性行为者（MSM）的社会网络如何影响 HIV 风险，以及社会网络特征与风险的关联是否因种族/族裔而异。
在加利福尼亚州洛杉矶县招募了 403 名非裔美国人、393 名亚裔/太平洋岛民和 400 名拉丁裔 MSM，他们完成了一份问卷，其中包括他们的自我中心社会网络、安全性行为同伴规范以及男性肛交伴侣。HIV 不一致的伴侣关系是指受访者报告的血清不一致或自我和/或伴侣的血清状态未知的伴侣关系。
总体而言，在过去 6 个月内，样本中 26%的人报告与非主要男性伴侣发生了 HIV 不一致的无保护肛交（UAI）。在控制了种族/族裔、年龄、原籍国、监禁史和 HIV 状态的广义估计方程（GEE）逻辑模型中，处于更密集的网络中与较少的 HIV 不一致的 UAI 相关[调整后的优势比（AOR）=0.92，95%置信区间（CI）：0.86 至 0.99，P=0.0467]。此外，安全性行为同伴规范对 HIV 不一致的 UAI 的影响受到自我-改变亲密程度的调节（P=0.0021）。在报告“中等”或“高”自我-改变亲密程度的人群中，安全性行为同伴规范具有保护作用（AOR=0.70，95%CI：0.52 至 0.95，P=0.0213 和 AOR=0.48，95%CI：0.35 至 0.66，P<0.0001），但在报告“低”自我-改变亲密程度的人群中则没有（AOR=0.96，95%CI：0.63 至 1.46，P=0.8333）。网络密度、亲密程度和规范对 HIV 不一致的 UAI 的影响不因种族/族裔而异。
社会网络特征与 UAI 的显著关联表明，网络层面的因素是美国有色人种 MSM 持续研究和 HIV 预防干预的重要场所。
