title: Community Sexual Bridging Among Heterosexuals at High-Risk of HIV in New York City.
abstract: Community sexual bridging may influence the socio-geographic distribution of heterosexually transmitted HIV. In a cross-sectional study, heterosexual adults at high-risk of HIV were recruited in New York City (NYC) in 2010 for the Centers for Disease Control and Prevention-sponsored National HIV Behavioral Surveillance system. Eligible participants were interviewed about their HIV risk behaviors and sexual partnerships and tested for HIV. Social network analysis of the geographic location of participants' recent sexual partnerships was used to calculate three sexual bridging measures (non-redundant ties, flow-betweenness and walk-betweenness) for NYC communities (defined as United Hospital Fund neighborhoods), which were plotted against HIV prevalence in each community. The analysis sample comprised 494 participants and 1534 sexual partnerships. Participants were 60.1 % male, 79.6 % non-Hispanic black and 19.6 % Hispanic race/ethnicity; the median age was 40 years (IQR 24-50); 37.7 % had ever been homeless (past 12 months); 16.6 % had ever injected drugs; in the past 12 months 76.7 % used non-injection drugs and 90.1 % engaged in condomless vaginal or anal sex; 9.6 % tested HIV positive (of 481 with positive/negative results). Sexual partnerships were located in 33 (78.6 %) of 42 NYC communities, including 13 "high HIV-spread communities", 7 "hidden bridging communities", 0 "contained high HIV prevalence communities", and 13 "latent HIV bridging communities". Compared with latent HIV bridging communities, the population racial/ethnic composition was more likely (p < 0.0001) to be black or Hispanic in high HIV-spread communities and to be black in hidden bridging communities. High HIV-spread and hidden bridging communities may facilitate the maintenance and spread of heterosexually transmitted HIV in black and Hispanic populations in NYC.
authors.affiliation: HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, New York City, NY, USA. an2118@columbia.edu.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY, USA. an2118@columbia.edu.
authors.forename: Alan
authors.initials: A
authors.lastname: Neaigus
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, WA, USA.
authors.forename: Samuel M
authors.initials: SM
authors.lastname: Jenness
authors.affiliation: HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, New York City, NY, USA.
authors.forename: Kathleen H
authors.initials: KH
authors.lastname: Reilly
authors.affiliation: Department of Sociology, Yonsei University, Seoul, Korea.
authors.forename: Yoosik
authors.initials: Y
authors.lastname: Youm
authors.affiliation: College of Nursing, New York University, New York City, NY, USA.
authors.forename: Holly
authors.initials: H
authors.lastname: Hagan
authors.affiliation: St. Ann's Corner of Harm Reduction, New York City, NY, USA.
authors.forename: Travis
authors.initials: T
authors.lastname: Wendel
authors.affiliation: National Development and Research Institutes, New York City, NY, USA.
authors.forename: Camila
authors.initials: C
authors.lastname: Gelpi-Acosta
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006296:Health Services; D020010:Heterosexuality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D044469:Racial Groups; D012111:Residence Characteristics; D012725:Sexual Behavior; D012747:Sexual Partners; D014505:Urban Population
keywords: Bridging; Communities; HIV; Heterosexual; New York City; Sexual networks