Yale University

HIV Prevention Needs Among MSM in Small Urban Areas

Principle Investigator(s):

Funder: NIMH through CIRA's Pilot Project Program
Project period: 06/09/2014 - 06/30/2015
Grant Type: Pilot Project

Abstract Text:

Gay, bisexual, and other men who have sex with men (MSM) represent the only major risk group for whom new incident cases of HIV are increasing in the U.S.  While several social ecological determinants contribute to HIV infection among MSM, these determinants have typically been identified in large urban areas.  MSM residing in small urban areas are also increasingly at risk of acquiring HIV, although much less attention has been directed toward examining the social ecological determinants of risk in small urban areas. Further, the influence of travel between small urban and major urban areas on HIV risk remains unknown. This proposed pilot study seeks to describe the HIV risk environment surrounding MSM living in three high-risk small urban environments in Connecticut, a state with high HIV prevalence that despite containing no large urban areas is situated in close proximity to New York City-the city with the largest concentration of MSM living with HIV in the U.S. In-depth interviews with 30 MSM will characterize the small urban risk environment in terms of sexual minority stigma, gay community norms, and sex venues, and determinants specific to small urban areas, in addition to the ways in which MSM in small urban areas engage with the risks and resources of large urban areas.  Nine community informants will contribute to t,he design of interview questions, participant recruitment, and translation of findings. Interviews with both MSM and community informants will suggest ways in which the unique features of small urban areas might be optimally situated to take advantage of new prevention technologies (e.g., smartphone interventions, social networking interventions).

Determining the unique features of small urban areas that contribute to MSM's increasing HIV risk represents a critical next step in the local production of effective prevention interventions for this increasingly vulnerable segment of the population.