Associations of social capital resources and experiences of homophobia with HIV transmission risk behavior and HIV care continuum among men who have sex with men in Los Angeles

ABSTRACT

For men who have sex with men (MSM) in the US, the positive and negative aspects of social capital – access to resources within their social networks and experiences of homophobia – may explain their disproportionate burden of HIV infection. We analyzed data from 379 HIV seronegative and seropositive MSM in Los Angeles, collected between May 2017 and February 2018. Dependent variables were HIV transmission risk behaviors and care continuum outcomes. We used multivariable logistic regression to estimate the association between social capital resources and experiences of homophobia with dependent variables, adjusting for sociodemographics and drug use. Most participants were under age 40 and 41% identified as Black/African American and 36% as Hispanic/Latino. Social capital resources associated with likelihood of new sexually transmitted infections (−5.5% per standard deviation (SD), 95%CI −10.3, 0.7%) and HIV testing (5% per SD, 95%CI 0.8, 9.2%). Experiences of homophobia associated with likelihood of methamphetamine use during sex (10% per SD, 95%CI 7, 14%), receiving (4.3% per SD, 95%CI 1.9, 6.7%) and giving (7.2% per SD, 95%CI 4.5, 9.9%) exchange sex, and missing appointments (7.2% per SD, 95%CI 0.8, 13.6%). Findings that social capital associated with HIV transmission risk behaviors and HIV testing suggest interventions to increase social capital resources would impact the HIV-prevention continuum.

KEYWORDS:

• Men who have sex with men
• social capital
• homophobia
• HIV care continuum
• risk behaviors

Acknowledgements

We would like to thank our study participants and our research assistants and coordinators.

ST designed the project, conducted data analysis, and wrote the manuscript. RB supervised the analysis and interpretation and contributed to the final version of the manuscript. PG and SS supervised the project, provided critical feedback, and helped shape the research, analysis, and manuscript. RB, PG and SS also designed and implemented the parent cohort study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Institute on Drug Abuse grant U01DA036267, the mStudy (PI: Gorbach, Shoptaw). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The authors acknowledge salary support by the VA Office of Academic Affiliations through the National Clinician Scholars Program. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.