Examining Diversity Across MSM Alcohol Use Outlets to Inform HIV Prevention

Introduction: HIV is a significant problem among men who have sex with men (MSM) in the U.S., including Baltimore. Alcohol use venues are frequently used locations for sampling high risk MSM, but multi-level interventions within MSM alcohol use outlets are rare. HIV prevalence and sexual risk behavior tends to be higher among those who attend alcohol use venues, but little is known about differences across venues. There has been a dearth of research on the diversity that exists across venues and among venue attendees, which limits the ability to design appropriate and acceptable interventions in these settings.

Methods: This study is a secondary analysis of data collected from Baltimore MSM recruited in 2011 using venue-based time location sampling, including socio-behavioral data and HIV test results. We identified a set of indicators to examine diversity of venues based on HIV and STI prevalence, demographic and behavioral characteristics, socioeconomic vulnerability, and service utilization.

Results: A total of 387 MSM were recruited from 18 alcohol use venues. There was substantial venue variation in all domains: HIV prevalence ranged from 22-59% and report of recent STI ranged from 7-21%. Demographic differences included proportion African-American (6-100%) and proportion under 25 (16-89%). Behavioral differences include mean number of past year partners (2-8), UAI with casual partners (12-71%), monthly binge drinking (38-85%), and heroin/cocaine/crack use (20-70%). Socioeconomic vulnerability and service utilization also differed across venues, with notable patterns across indicators.

Conclusions: MSM alcohol use outlets are heterogeneous. Characterizing venues based on demographic and behavioral clustering provides insight into both the characteristics and needs of attendees as well as the descriptive norms of each setting and holds substantial promise for design of venue-based intervention strategies.