The Potential Role of Latino MSM’s Social and Sexual Networks in Extending PrEP Protection to Women and Non-Latino Men

Introduction: Latinos who have sex with other men (LMSM) account for 92% of new HIV diagnoses among Latino men living in Miami, which is the highest HIV incidence and third highest HIV prevalence of all metropolitan cities in the US. This presentation describes LMSM’s social and sexual networks, and the association of these networks with LMSM’s PrEP use and the exposure of HIV to other segments of the population.

Methods: This is a cross-sectional study of 39 LMSM grouped in three socio-centric social networks and 39 egocentric sexual networks. Participants are HIV negative, LMSM, age 20–39, and meet CDC criteria for PrEP use. Respondent-driven sampling was the primary recruitment strategy. Each participant (the seed) referred three friends who met eligibility criteria. Each of these friends recruited three additional friends. Seeds were randomly recruited among clients from Latinos Salud, a community health center in Miami Beach. Network visualization analyses were performed using UCINET and NetDraw.

Results: One in four LMSM is using PrEP. More US-born than foreign-born LMSM are using PrEP. Social networks: PrEP user seed typically only discusses PrEP with PrEP user friends. Non-PrEP user friends are influential in all networks. PrEP users are not necessarily influential in their networks. Networks with non-PrEP user seeds discuss PrEP more frequently than the PrEP user network. There is no homogeneity between seed’s and friend’s country of origin. PrEP conversations occur between close friends regardless of network structure. Sexual networks: LMSM are not using condoms regardless of whether or not they are using prep. PrEP users may have PrEP conversations with non-PrEP users but are unlikely to convince them to use PrEP. Non-PrEP users have PrEP conversations and report being able to encourage friends to use PrEP. Regardless of PrEP use, LMSM have sex with HIV-positive people, women and bisexual people. LMSM sexual networks include non-Latino MSM and women.

Discussion: PrEP strategies should incorporate Latino and non-Latino MSM social networks. PrEP programs incorporating LMSM networks will reach bisexual men, reducing the HIV risk of their female sexual partners. Condom use should be emphasized as a part of PrEP programs. Social network-based PrEP programs should promote interactions with close friends to reach potential PrEP users. Networks of non-PrEP users have the right structure and dynamics needed for promoting PrEP messages as well as identifying PrEP candidates. PrEP recruitment strategies incorporating LMSM’s social and sexual networks can reach bisexual men. The study of socio-centric and egocentric networks provides a better understanding of LMSM’s HIV risk.