TY - JOUR
T1 - Neighborhood social cohesion, religious participation and sexual risk behaviors among cisgender black sexual minority men in the southern United States
AU - Duncan, Dustin T.
AU - Ransome, Yusuf
AU - Park, Su Hyun
AU - Jackson, Skyler D.
AU - Kawachi, Ichiro
AU - Branas, Charles C.
AU - Knox, Justin
AU - Al-Ajlouni, Yazan A.
AU - Mountcastle, Hayden
AU - Miles, Caleb H.
AU - Hickson, De Marc A.
N1 - Funding Information:
At the time of analysis and writing, Dr. Dustin Duncan was supported in part by grants from the National Institute on Minority Health and Health Disparities (Grant Numbers R01MD013554 and 3R01MD013554-02S1 ), National Institute on Mental Health (Grant Number R01MH112406 ), and the Centers for Disease Control and Prevention (Grant Number U01PS005122 ). Dr. Yusuf Ransome was supported in part by grant 5K01MH111374-04 . Dr. Skyler Jackson was supported by the Yale Center for Interdisciplinary Research on AIDS training program, funded by the National Institute of Mental Health under award number T32MH020031 . Dr. Ichiro Kawachi was supported in part by grant 5R01AG042463-07 . Dr. Charles Branas was supported in part by grants 1R49CE003094-01 , 5R01AA024941-04 and 5R01HD095609-02 . Dr. Justin Knox was supported by the Substance Abuse Epidemiology Training Program at Columbia University (Grant Number: 5T32DA031099-08 , Dr. Deborah Hasin, Principal Investigator). This project was supported by a grant from the Centers for Disease Control and Prevention (Grant Number U01PS003315 , Dr. DeMarc Hickson, Principal Investigator). Dr. Hickson received support from R25MH083620, Dr. Timothy Flanigan, Principal Investigator. We thank Andrew Trinidad for conducting a literature review and reviewing an early iteration of the manuscript. We also thank Byoungjun Kim formatting the manuscript and the participants to engaging in this study.
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/6
Y1 - 2021/6
N2 - Background: Few studies have examined associations between neighborhood social cohesion and sexual risk behaviors among gay, bisexual, and other sexual minority men (SMM), and none have among Black SMM in the southern U.S. The purpose of the current study is to examine associations between neighborhood social cohesion and sexual risk behaviors among Black SMM in the southern U.S., a population heavily impacted by HIV. We also examined whether these relationships are modified by religious participation for Black SMM in the southern U.S. Methods: Data was obtained from the MARI Study, a sample of Black SMM ages 18–66 years, recruited from the Jackson, MS and Atlanta, GA metropolitan areas (n = 354). Neighborhood social cohesion was assessed with a validated 5-item scale. We conducted multivariable regression analyses to examine the association between neighborhood social cohesion with each of the sexual risk behaviors (e.g., condomless sex and drug use before or during sex), controlling for key confounders. We then performed moderation analysis by religious participation (religious attendance and private religiosity). Results: Compared to Black SMM with higher perceived neighborhood social cohesion, Black SMM with lower neighborhood social cohesion had increased odds of alcohol use before or during sex (aPR = 1.56; 95% CI = 1.16–2.11) and condomless anal sex with casual partners (aPR = 1.55; 1.03–2.32). However, the magnitude of these associations varied by religious attendance and private religiosity. Black SMM with low religious service attendance had higher risk of alcohol use in the context of sex when perceived neighborhood social cohesion was low; those with high private religiosity had elevated alcohol use in the context of sex when perceived neighborhood social cohesion was low. Discussion: Interventions that target connectedness among neighborhood members through community education or mobilization efforts, including the involvement of religious organizations, should be considered for HIV prevention focused on alcohol and condomless sex among Black SMM.
AB - Background: Few studies have examined associations between neighborhood social cohesion and sexual risk behaviors among gay, bisexual, and other sexual minority men (SMM), and none have among Black SMM in the southern U.S. The purpose of the current study is to examine associations between neighborhood social cohesion and sexual risk behaviors among Black SMM in the southern U.S., a population heavily impacted by HIV. We also examined whether these relationships are modified by religious participation for Black SMM in the southern U.S. Methods: Data was obtained from the MARI Study, a sample of Black SMM ages 18–66 years, recruited from the Jackson, MS and Atlanta, GA metropolitan areas (n = 354). Neighborhood social cohesion was assessed with a validated 5-item scale. We conducted multivariable regression analyses to examine the association between neighborhood social cohesion with each of the sexual risk behaviors (e.g., condomless sex and drug use before or during sex), controlling for key confounders. We then performed moderation analysis by religious participation (religious attendance and private religiosity). Results: Compared to Black SMM with higher perceived neighborhood social cohesion, Black SMM with lower neighborhood social cohesion had increased odds of alcohol use before or during sex (aPR = 1.56; 95% CI = 1.16–2.11) and condomless anal sex with casual partners (aPR = 1.55; 1.03–2.32). However, the magnitude of these associations varied by religious attendance and private religiosity. Black SMM with low religious service attendance had higher risk of alcohol use in the context of sex when perceived neighborhood social cohesion was low; those with high private religiosity had elevated alcohol use in the context of sex when perceived neighborhood social cohesion was low. Discussion: Interventions that target connectedness among neighborhood members through community education or mobilization efforts, including the involvement of religious organizations, should be considered for HIV prevention focused on alcohol and condomless sex among Black SMM.
KW - Black sexual minority men
KW - HIV
KW - Neighborhoods
KW - Religious participation
KW - Sexual health
KW - Social cohesion
KW - Southern United States
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U2 - 10.1016/j.socscimed.2021.113913
DO - 10.1016/j.socscimed.2021.113913
M3 - Article
C2 - 33991789
AN - SCOPUS:85105850060
VL - 279
JO - Ethics in Science and Medicine
JF - Ethics in Science and Medicine
SN - 0277-9536
M1 - 113913
ER -