More recently, I’ve been able to shift my research to an extremely high priority area – using network analysis to understand the social and contextual drivers of HIV – particularly within black YMSM. While these men are disproportionately affected by HIV, most studies which have examined HIV in this population have focused on individual-level behavior, but none have been able to account for the extreme racial disparities that exist. Therefore, I believe a broader systems-level perspective is necessary, as racial differences in several interacting individual and social contextual levels— fueled by individual and systemic racism, homophobia, and poverty— may account for the increased epidemic in Black YMSM populations. My Career Development Award advances this work through my development of a multilevel network model that examines racial differences in social contextual factors and how these factors may indirectly drive HIV. This model is being developed and tested across multiple studies on which I am the PI (K08DA037825, R03DA033906), Co-I (U01DA036939, PI: Mustanski), and Mentor (CFAR Supplement, PI: Phillips; F31DA040524, PI: McConnell).
Already my work in this area has produced some of the most detailed empirical data available on the sexual networks of YMSM, identifying several dyadic-level, network-level, and neighborhood-level factors associated with HIV. Furthermore, as systems science approaches require a shift away from traditional statistical association analyses toward complex modeling approaches – I have sought collaborators at the forefront of these innovative modeling techniques who could benefit from my access to community populations and my in-depth knowledge of health, HIV, and YMSM. For example, one of these collaborations with a student in Industrial Engineering led to a publication in the Journal of Acquired Immune Deficiency Syndromes. In this study, several network-level mechanisms were demonstrated to play a significant role in the spread of HIV and the production of racial disparities in YMSM – particularly differences in partner characteristics across race and age and in differences in the structure of sexual networks. Through my work in this area, I hope to demonstrate how racial stigma and homophobia intersect within black YMSM to influence the dynamics of HIV transmission beyond individual behavior. I hope my work not only sparks new insights into the complex role of stigma on health—but also that these insights expand current intervention frameworks.