Ian W. Holloway, MSW, MPH, PhD Department of Social Welfare Luskin School of Public Affairs

1. Associations between Gay Community Venue Network Position and HIV Risk and Protective Factors Among Young Men Who Have Sex With Men in Los Angeles County Ian W. Holloway, MSW, MPH, PhD Department of Social Welfare Luskin School of Public Affairs University of California, Los Angeles Michele D. Kipke, PhD Children’s Hospital Los Angeles Keck School of Medicine University of Southern California

2. Overview • 1,913 new HIV diagnoses in Los Angeles County (LAC) in 2011; 84% among MSM; 64% among 20 – 39 year olds (LACDPH, 2012) • Substance use among young MSM (YMSM) is a major driver of HIV infection (Colfax et al., 2004; Drumright et al., 2006; Semple, Patterson, & Grant, 2002) • Social venues (e.g., bars and clubs) may facilitate substance use and risky sexual behavior (Grov & Crow, 2012; Halkitiset al., 2005; Kubicek et al., 2007; Shoptaw et al., 2005)

3. Gay Social Venues

4. Study Objective Document the network of popular gay community social venues among YMSM in Los Angeles County (LAC). Examine the relationship between attendance at gay community social venues and HIV risk and protective behaviors among YMSM in LAC using venue-based network analysis.

5. Methods • Healthy Young Men’s (HYM) Study (PI: Kipke) • Venue-based recruitment from 2005 – 2006 • Participant eligibility • 18-24 years old • Gay, bisexual, uncertain, or had sex with a man • Caucasian, African American, or Latino of Mexican descent • Resident of Los Angeles County • “Please tell me the names of the three favorite gay places that you go to”

6. Outcomes • Recent substance use (i.e., past 3 months) • Marijuana • Illicit drugs • Club drugs (i.e., cocaine, crystal/methamphetamine, ecstasy, poppers, GHB, Ketamine, and other forms of speed) • Sexual risk behavior • Number of recent sexual partners (past 6 months) • Recent STI infection (past 6 months) • Recent HIV testing (past year) • K-Core analysis, bivariate statistical analysis – χ2(categorical) t-test (continuous)

7. Demographic Characteristics

8. Types of Venues (N=110)

9. Venue Network

10. K-Core Analysis

11. Substance Use

12. Sexual Risk Behaviors

13. Discussion • YMSM social spaces are highly interconnected • Results may be consistent with Theory of Syndemic Production (Stall et al., 2008) • YMSM desire HIV prevention that is quick, convenient and delivered in social contexts they’re already attending (Holloway et al., 2012) • Interventions in venues have had mixed success (Kelly et al., 1992; Elford et al., 2002) • Innovative, venue-based strategies for engaging YMSM should be revisited

14. Limitations • Data is from 2005 • New venues open, old venues close • Popularity of venues changes rapidly • Does not include popular virtual venues • Venue-based recruitment • May overestimate the popularity of venues YMSM are attending • Misses YMSM who do not attend gay social venues

15. Conclusion • YMSM who use substances and engage in sexual risk behavior are integrated into gay communities • Tailoring prevention to capitalize on the socialization patterns of YMSM may be an effective way to reach YMSM “where they’re at” • Strategies that engage consortia of gay social venues to promote health and well-being of YMSM may be especially effective. • More research on the acceptability of venue owner, staff engagement in public health efforts is needed

16. Questions?