Differences in Sexual Networks By Patterns of Substance Use in a Sample of African American Men Who Have Sex with Men

Introduction

Drug and alcohol use are contributing factors to HIV risk among men who have sex with men (MSM).   Substance-using MSM are a potential bridge population to non-drug using male sexual partners and heterosexual drug using populations.  There is substantial evidence that social networks influence HIV risk and substance use behaviors among MSM.  Sexual networks is a key factor hypothesized to contribute to HIV risk.  Multiplexity (e.g. overlap in sexual and drug use networks) and density of sex and drug networks  are two understudied but critical features of networks that directly pertain to disease transmission dynamics and improved understanding of the intersection between drug use and HIV risk.  The aim of this study was to examine differences in the sexual networks of a sample African American MSM (AA MSM )by substance use.

Methods

Data for this study came from cross-sectional surveys conducted with two convenience samples of AA MSM.  For both studies, inclusion criteria were: 1) aged 18-55, 2) self-report African American/Black ethnicity/race, and 3) self-report sex with another male in the prior 90 days.  Participants reported drug and alcohol use in the prior 90 days and completed an inventory to characterize size, age and drug use of the social and sexual network.  To assess density of the sexual network participants identified which sex partners knew each other.  To determine multiplexity, participants identified individuals with whom they had sex and used drugs. Latent class analysis was conducted to empirically characterize classes of substance use.  ANOVA was used to examine differences in sexual networks by substance use class. 

Results

The sample was 359 men, 50% classified as problematic alcohol users (alcohol), 33% non-problematic alcohol users (light users) and 18% poly-substance users (poly).  No differences by class in the size (mean=3.07, SD=2.16) or density of the sexual network (mean=0.27, SD=0.38).  Compared to poly (mean=0.75, SD=1.54) and alcohol users (mean=0.69, SD=1.25), light users, reported fewer sex partners whom they had met at a bar (mean=0.37, SD=0.76).  Poly users reported greater dependence on their sex partners and greater multiplexity in their network (mean=1.78, SD=1.90) compared to light (mean=0.56, SD=1.54) and alcohol (mean=1.09, SD=1.81) classes.  No differences in density of drug network was observed. 

Conclusions

Findings indicate that heterogeneity of alcohol and drug use patterns were not associated with differences in the size or density of the sexual network.  Multiplexity was associated with Poly-use class.  Interventions that target both sex and substance use risk behaviors for MSM are warranted.