Key Social Network Members Provide HIV Medical Care Social Support for African American Men Who Have Sex with Men

Introduction: The HIV care continuum shows the largest drop-off between people linked to care and retained in care. Furthermore, African Americans are less likely to be in care compared to other racial/ethnic groups. Social networks are a rich source of social support and network members may be able to provide necessary support to address these declines in the continuum and engage difficult to reach populations. The goal of this social network study is to examine who provides HIV medical care social support to African American men who have sex with men (AAMSM).

Methods: Data for the current study are from the baseline survey from Unity iN Diversity, a pilot HIV risk-reduction intervention for AAMSM conducted in Baltimore, MD. Recruitment was through venue-based outreach, print advertisement, referrals from agencies, and websites. Participants described their social networks using a modified inventory based on the Arizona Social Support Inventory. Participants named individuals who could provide social support and with whom they socialized and had sex in the past 3 months. After names were generated, participants described each social network member, including demographics and types of social support provided. HIV medical care social support was received if the network member either helped the participant get medical care for his HIV (e.g., reminders to get care, accompaniment to visits) or with his HIV medication (e.g., reminders to take medication, picking up medication at the pharmacy). Descriptive data analysis and logistic regression with generalized estimating equations were conducted, as network members are nested within each MSM.

Results: In total, 673 social network members were described by 83 HIV seropositive AAMSM. Three-quarters (74.59%) of social network members did not provide any HIV medical care support. Participants were less likely to get HIV medical help from networks with whom they get high. Social support was more likely from people participants entrusted with money, asked for advice about a health problem, would ask to accompany them to STI testing, and had had conversations with about HIV or STI prevention.

Conclusions: There are few, yet key, social network members who provide HIV medical care social support to HIV seropositive AAMSM. Targeting these network members may promote HIV prevention, care, and treatment. These individuals might benefit from interventions that train them in additional strategies to provide HIV medical care social support to AAMSM or in preventing their own burnout. Future research should assess how these members entered into the social network and the stability of the relationship.