Neighborhood Compositional Characteristics on HIV, Sexual Risk Behaviors, and Prevention Activities among Black and White Young Men Who have Sex with Men

This study examined associations between individual and neighborhood compositional characteristics for young black and white men who have sex with men (MSM), ages 15-25 years. Individual baseline data were collected during 1999-2000 as part of a 13-city randomized control trial. Neighborhood composition data at the zip code tabulation area were obtained from the 2000 US Census. Consistent with other studies, individual characteristics--including supportive condom use peer norms--were associated with any unprotected anal sex, HIV testing, having an HIV-positive/unknown test result, recent participation in prevention activities, and knowledge of antiretroviral therapies used to treat HIV. While young black men generally engaged in less risky sexual behaviors, they were more likely to test for HIV than were young white men but were also less likely to have recently participated in prevention programs or have knowledge of drugs used to treat HIV. Associations were also observed for neighborhood compositional variables and HIV risk. Neighborhood percentage of single-parent female-headed households and neighborhood population turnover were associated with reduced HIV risk; while neighborhood composition measures of poverty and socioeconomic status were associated with increased HIV risk. Neighborhood percentage of same-sex couples, also a measure of neighborhood gay presence, was associated both with factors that increase and factors that decrease risk for HIV transmission or acquisition. Young black men were more likely to live in neighborhoods characterized by increased risk while young white men were more likely to live in neighborhoods that were characterized by decreased risk. These findings suggest that HIV risk disparities experienced among black and white young MSM can be partially explained by the neighborhoods in which these men reside. As such, prevention efforts for MSM should focus on both individual characteristics of these men and the neighborhoods in which they reside.