Influence of Social Networks on HIV Testing and PrEP Care among Young Latin American Gay, Bisexual, and Other Men Who Have Sex with Men

HIV continues to be a major, “invisible” public health crisis among young Latin American gay, bisexual and other men who have sex with men (GBMSM) in the U.S. Latin American GBMSM are rarely the focus of funded research despite their susceptibility to HIV acquisition. Relevant GBMSM represented 70% of new HIV diagnoses among Latin American GBMSM in 2022; young people (13-29 years old) accounted for 43%. Latin American GBMSM have better health profiles than other populations yet receive delayed HIV diagnoses despite high levels of HIV testing and similar sexual behaviors. Concerningly, young Latin American men report significantly lower HIV testing rates, and PrEP uptake remains exceptionally low among young Latin American GBMSM overall. Social networks can shape susceptibility to HIV acquisition by promoting and inhibiting HIV prevention behaviors (e.g., PrEP use), including among young Latin American GBMSM. However, research on the impact of social networks on HIV testing and PrEP care among young Latin American GBMSM remains limited. For Latin American people, the characteristics and structures of their local and long-distance networks can uniquely shape how social capital (e.g., actual or potential resources), social bonding (e.g., support, cohesion, and perceptions of belongingness), and network stress (e.g., negative social interactions) each work to affect their health and healthcare utilization, including PrEP care. This study will focus on both positive and negative network factors, understanding that social ties can be both supportive and harmful, with the overarching goal of identifying network-based points of intervention for developing and enhancing social network-based interventions to increase HIV testing and PrEP uptake, adherence, and retention in care. To address the knowledge gap regarding the influence of social networks for young (16-29 years old) Latin American GBMSM on HIV testing and PrEP care, and to inform future social network-based HIV prevention interventions for this population, the Specific Aims for this exploratory R21 proposal are: Aim 1: To characterize and map the social networks of 60 young Latin American GBMSM in New York City (NYC), not living with HIV, through in-depth interviews and mapping of four social network health areas (general/sexual health, alcohol/drug use, HIV testing, and PrEP use) using concentric circles methodology. Aim 2: To determine how social network-level factors influence HIV testing (at baseline) and PrEP care outcomes (PrEP initiation, adherence, and retention) among 60 young Latin American GBMSM over 6 months, focusing on the role of social capital, social bonding, and network stress. We will ensure a range of young Latin American GBMSM experiences are included, by purposive sampling by on and not on PrEP.