title: Activity spaces of men who have sex with men: An initial exploration of geographic variation in locations of routine, potential sexual risk, and prevention behaviors.
abstract: Theory and research on HIV and among men who have sex with men (MSM) have long suggested the importance of non-residential locations in defining structural exposures. Despite this, most studies within these fields define place as a residential context, neglecting the potential influence of non-residential locations on HIV-related outcomes. The concept of activity spaces, defined as a set of locations to which an individual is routinely exposed, represents one theoretical basis for addressing this potential imbalance. Using a one-time online survey to collect demographic, behavioral, and spatial data from MSM, this paper describes activity spaces and examines correlates of this spatial variation. We used latent class analysis to identify categories of activity spaces using spatial data on home, routine, potential sexual risk, and HIV prevention locations. We then assessed individual and area-level covariates for their associations with these categories. Classes were distinguished by the degree of spatial variation in routine and prevention behaviors (which were the same within each class) and in sexual risk behaviors (i.e., sex locations and locations of meeting sex partners). Partner type (e.g. casual or main) represented a key correlate of the activity space. In this early examination of activity spaces in an online sample of MSM, patterns of spatial behavior represent further evidence of significant spatial variation in locations of routine, potential HIV sexual risk, and HIV prevention behaviors among MSM. Although prevention behaviors tend to have similar geographic variation as routine behaviors, locations where men engage in potentially high-risk behaviors may be more spatially focused for some MSM than for others.
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA; Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA. Electronic address: adam.s.vaughan@gmail.com.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Vaughan
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA; Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA. Electronic address: mkram02@emory.edu.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Kramer
authors.affiliation: Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA; Department of Behavioral Sciences and Health Education, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA. Electronic address: hcoope3@emory.edu.
authors.forename: Hannah L F
authors.initials: HL
authors.lastname: Cooper
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA; Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA. Electronic address: esrose2@emory.edu.
authors.forename: Eli S
authors.initials: ES
authors.lastname: Rosenberg
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA; Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA. Electronic address: pssulli@emory.edu.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Sullivan
mesh_terms: D000328:Adult; D005843:Geography; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D000072339:Sexual and Gender Minorities / Q000523:psychology* / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: Activity space; HIV; Latent class analysis; Men who have sex with men; Spatial epidemiology