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Associations Between Neighborhood Problems and Sexual Behaviors Among Black Men Who Have Sex with Men in the Deep South: The MARI Study

  • Special Section on Social and Behavioral Science with Gay and Bisexual Men in the Era of Biomedical Prevention
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Abstract

There is a disproportionately high HIV incidence among Black men who have sex with men (MSM) despite equal or lower levels of HIV risk behaviors compared to White MSM. Due to high levels of racial segregation in the U.S., Black MSM have an elevated likelihood of living in neighborhoods that contain psychosocial stressors, which, in turn, may increase behaviors promoting HIV infection. We examined associations between perceived neighborhood problems and sexual behaviors among Black MSM in the Deep South, a population at highest risk of HIV. Data came from the MARI Study, which included Black MSM ages 18–66 years recruited from the Jackson, MS, and Atlanta, GA, metropolitan areas (n = 377). Participants completed questions about neighborhood problems (e.g., excessive noise, heavy traffic/speeding cars and trash/litter) and sexual behaviors (e.g., condomless sex and drug use before or during sex). We used Poisson’s regression model with robust standard errors to estimate the adjusted prevalence ratio (aPR; 95% confidence intervals [CI]) of neighborhood problems (coded as tertiles [tertile 1 = low neighborhood problems, tertile 2 = medium neighborhood problems, tertile 3 = high neighborhood problems] as well as continuously) with sexual behaviors, after adjustment for sociodemographic characteristics and other variables. About one-fourth of the sample reported at least one neighborhood problem, with the most common (31.6%) being no/poorly maintained sidewalks, which indicates an infrastructural problem. In multivariable models, compared to those in the lowest tertile, those reporting more neighborhood problems (tertile 2: aPR = 1.49, 95% CI = 1.04, 2.14 and tertile 3: aPR = 1.53, 95% CI = 1.05, 2.24) reported more drug use before or during sex (p for trend = .027). Neighborhood problems may promote behaviors (e.g., drug use before or during sex) conducive to HIV infection. Structural interventions could improve community infrastructure to reduce neighborhood problems (e.g., no/poorly maintained sidewalks and litter). These interventions may help to reduce HIV incidence among Black MSM in the Deep South.

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Acknowledgements

Dr. Hickson received support from R25MH083620, Dr. Timothy Flanigan, Principal Investigator). This project was supported by a Grant from the Centers for Disease Control and Prevention (Grant #U01PS003315, Dr. DeMarc Hickson, Principal Investigator). We thank William Goedel for conducting the initial background research, we thank Yazan Al-Ajlouni for formatting the references, and we thank the participants for engaging in this study.

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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.

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Authors and Affiliations

  1. Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 715, New York, NY, 10032, USA

    Dustin T. Duncan, Su Hyun Park, Denton Callander, Byoungjun Kim & Salem Harry-Hernández

  2. Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Madeline Y. Sutton, William L. Jeffries IV & Kirk D. Henny

  3. Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA

    Sharrelle Barber

  4. Center for Research, Evaluation and Environmental and Policy Change, My Brother’s Keeper, Inc, Jackson, MS, USA

    DeMarc A. Hickson

  5. Us Helping Us, People Into Living, Inc, Washington, DC, USA

    DeMarc A. Hickson

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  1. Dustin T. Duncan
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Duncan, D.T., Sutton, M.Y., Park, S.H. et al. Associations Between Neighborhood Problems and Sexual Behaviors Among Black Men Who Have Sex with Men in the Deep South: The MARI Study. Arch Sex Behav 49, 185–193 (2020). https://doi.org/10.1007/s10508-019-01619-4

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