Black men who have sex with men (BMSM) have the highest rates of HIV in the United States. Despite increased attention to social and sexual networks as a framework for biomedical intervention, the role of family in these networks and their relationship to HIV prevention has received limited attention.
A network sample (N=380) of BMSM (n=204) and their family members (n=176) was generated through respondent driven sampling of BMSM and elicitation of their personal networks. The proportion of personal networks that were family was calculated and weighted logistic regression was used to assess the relationship between this proportion and unprotected anal intercourse (UAI), sex-drug use (SDU) and group sex (GS); as well as intravention efforts to discourage these risk behaviors among their MSM social networks.
45.3% of respondents listed at least one family member in their close personal network. Greater family network proportion (having 2 or more family members in the close network) was associated with less SDU [adjusted odds ratio (AOR 0.38(0.17-0.87))] and participation in GS (AOR 0.25(0.10-0.67)). For intravention, BMSM with greater family proportion were more likely to discourage GS (AOR 3.83(1.56-9.43) and SDU (AOR 2.18(1.35-3.54)) among their MSM friend network. Moreover, increased male family network proportion was associated with lower HIV-risk and greater intravention than increased female network proportion.
Nearly half of BMSM have a close family member with whom they share personal information. Combination prevention interventions might be made more potent if this often overlooked component of personal networks were incorporated.