Network Modeling of PrEP Uptake on Referral Networks and Health Venue Utilization Among Young Men Who Have Sex with Men
The objective of this study is to identify individual-level factors and health venue utilization patterns associated with uptake of pre-exposure prophylaxis (PrEP) and to evaluate whether PrEP uptake behavior is further diffused among young men who have sex with men (YMSM) through health venue referral networks. A sample of 543 HIV-seronegative YMSM aged 16–29 were recruited in 2014–2016 in Chicago, IL, and Houston, TX. Stochastic social network models were estimated to model PrEP uptake. PrEP uptake was associated with more utilization of health venues in Houston and higher levels of sexual risk behavior in Chicago. In Houston, both Hispanic and Black YMSM compared to White YMSM were less likely to take PrEP. No evidence was found to support the spread of PrEP uptake via referral networks, which highlights the need for more effective PrEP referral network systems to scale up PrEP implementation among at-risk YMSM.
KeywordsSocial network analysis PrEP Health care delivery system Young men who have sex with men Systems science methodology Exponential random graph models Auto-logistic actor attribute models
This work was supported by the National Institutes of Health (1R01MH100021, 1R01DA039934, K23-MH109358-02), by Gilead Sciences, Inc. (IN-US-276-D120), and by UTHealth Innovation for Cancer Prevention Research Training Program (Cancer Prevention and Research Institute of Texas grant # RP160015). We acknowledge the contributions to this study of Angela Di Paola, Ju-Yeong Kim, and the YMAP staff in both Houston and Chicago.
Compliance with Ethical Standards
Conflicts of interest
K. Fujimoto, L. Kuhns, and J. Schneider have received research grants from Gilead Sciences, Inc. C. Flash serves on the scientific advisory board of Gilead Sciences, Inc.
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