title: Evidence of social network influence on multiple HIV risk behaviors and normative beliefs among young Tanzanian men.
abstract: Research on network-level influences on HIV risk behaviors among young men in sub-Saharan Africa is severely lacking. One significant gap in the literature that may provide direction for future research with this population is understanding the degree to which various HIV risk behaviors and normative beliefs cluster within men's social networks. Such research may help us understand which HIV-related norms and behaviors have the greatest potential to be changed through social influence. Additionally, few network-based studies have described the structure of social networks of young men in sub-Saharan Africa. Understanding the structure of men's peer networks may motivate future research examining the ways in which network structures shape the spread of information, adoption of norms, and diffusion of behaviors. We contribute to filling these gaps by using social network analysis and multilevel modeling to describe a unique dataset of mostly young men (n = 1249 men and 242 women) nested within 59 urban social networks in Dar es Salaam, Tanzania. We examine the means, ranges, and clustering of men's HIV-related normative beliefs and behaviors. Networks in this urban setting varied substantially in both composition and structure and a large proportion of men engaged in risky behaviors including inconsistent condom use, sexual partner concurrency, and intimate partner violence perpetration. We found significant clustering of normative beliefs and risk behaviors within these men's social networks. Specifically, network membership explained between 5.78 and 7.17% of variance in men's normative beliefs and between 1.93 and 15.79% of variance in risk behaviors. Our results suggest that social networks are important socialization sites for young men and may influence the adoption of norms and behaviors. We conclude by calling for more research on men's social networks in Sub-Saharan Africa and map out several areas of future inquiry.
authors.affiliation: The University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Health Behavior, Rosenau Hall, CB 7440, Chapel Hill, NC 27599, United States. Electronic address: mulawa@unc.edu.
authors.forename: Marta
authors.initials: M
authors.lastname: Mulawa
authors.affiliation: American University, School of International Service, 4400 Massachusetts Avenue, NW, Washington DC 20016, United States. Electronic address: yamanis@american.edu.
authors.forename: Thespina J
authors.initials: TJ
authors.lastname: Yamanis
authors.affiliation: The University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Health Behavior, Rosenau Hall, CB 7440, Chapel Hill, NC 27599, United States. Electronic address: hilllm@live.unc.edu.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Hill
authors.affiliation: The University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Health Behavior, Rosenau Hall, CB 7440, Chapel Hill, NC 27599, United States. Electronic address: balvanz@email.unc.edu.
authors.forename: Peter
authors.initials: P
authors.lastname: Balvanz
authors.affiliation: Muhimbili University of Health and Allied Sciences, Department of Psychiatry and Mental Health, PO Box 65466, Dar es Salaam, Tanzania. Electronic address: sajokm@gmail.com.
authors.forename: Lusajo J
authors.initials: LJ
authors.lastname: Kajula
authors.affiliation: The University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Health Behavior, Rosenau Hall, CB 7440, Chapel Hill, NC 27599, United States. Electronic address: smaman@unc.edu.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Maman
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D015658:HIV Infections / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010379:Peer Group; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners / Q000523:psychology; D012944:Social Support; D013179:Spouse Abuse / Q000706:statistics & numerical data; D013636:Tanzania; D055815:Young Adult
keywords: Clustering; HIV normative beliefs; HIV risk behaviors; Intraclass correlation; Social networks; Tanzania; Young men