Racial Mixing and HIV Risk Among Men Who Have Sex With Men

In the United States, HIV disproportionately affects black residents. In the current study, the authors from the San Francisco Department of Public Health conducted a cross-sectional survey of men who have sex with men (MSM) in San Francisco through time-location-sampling, analyzing the dynamics of racial mixing and HIV risk. Through computer-assisted interviews, MSM were asked about their selection of sexual partners, partner preferences, HIV-risk perceptions and social mixing in terms of race/ethnicity.

Among 1,142 MSM, 56 percent were white; 22 percent Latino; 14 percent Asian; and 9 percent black. Altogether, participants reported 3,532 sexual partnerships in the previous six months.

Black MSM had a significant, three-fold higher level of same-race partnering than would be expected through chance alone; that is, in the absence of selective forces regarding race among partnerships. Among participants, black MSM were reported to be the least preferred as sexual partners; at a higher risk for HIV; counted less frequently among friends; considered hardest to meet; and perceived as less welcome by other MSM in San Francisco venues where MSM congregate.

"Our findings support the hypothesis that sexual networks of black MSM, constrained by the preferences and attitudes of non-blacks and the social environment, are pushed to be more highly interconnected than other groups with the potential consequences of more rapid spread of HIV and a higher sustained prevalence of infection," the authors suggested. "The racial disparity in HIV observed for more than a decade will not disappear until the challenges posed by a legacy of racism towards blacks in the U.S. are addressed."

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