Principal Investigator: B.R. Simon Rosser, PhD, MPH, Professor and Director Center
for HIV/STI Intervention and Prevention Studies, Division of
Epidemiology and Community Health
Co-Investigators: J. Michael Oakes, PhD, Associate Professor, McKnight Presidential Fellow, Division of
Epidemiology and Community Health
In the US, HIV prevention targeting Men who have Sex with Men (MSM) appears to be failing, while a syndemic of high alcohol/drug use and unsafe sex is increasing. The Office of AIDS Research at the NIH (FY 2006) has prioritized research that aims to "develop and evaluate methods ... to reduce HIV acquisition ... associated with drug and alcohol use" while CDC has described finding "new approaches to reduce HIV risk among MSM" as of the "highest" priority. In response, our broad long-term objective is to study the impact of structural interventions likely to reduce Alcohol-Related HIV Risk (ARHR) among MSM. Legislation on homosexuality and the growth of gay e-infrastructure are two such structural factors which have become prominent national issues, yet little is known about how either impacts MSM's health and HIV risk behavior.
We theorize that gay bars are the environmental structure most driving heavy alcohol use and ARHR, and thus contribute to male-male transmission of HIV, syphilis and gonorrhea. If so, the growing utilization of gay e-environments should lower risk. Similarly, legislation on homosexuality, by mainstreaming or marginalizing MSM, is predicted to have significant health impact on this population. This project has 2 aims:
To study, at the community level, how public policy and gay e-infrastructure may be changing the centrality and popularity of gay bars;
To study, at the individual level, how public policy and gay e-infrastructure modifies alcohol use and ARHR among Men who use the Internet to seek Sex with Men (MISM).
To implement these aims, we have assembled an interdisciplinary team of researchers in HIV prevention, alcohol, law, computer science, demography, Internet research, and homosexuality. This team will conduct a prospective, case-comparison, natural experiment study in 16 cities with different legislation on homosexuality (8=pro, 8=anti) and different levels of gay e-infrastructure (8=strong, 8=weak). How these factors impact risk will be tracked at two levels, annually, over 4 years:
the city level, by taking a city-wide census of gay bars/clubs, bar attendance, gay e-infrastructure, and HIV/STI rates;
the individual level, by comparing MISM's (n=250 per city; 4000 per period) alcohol use and ARHR behavior with men first met (a) in gay bars, (b) online, and (c) in neither environment (with participants acting as their own control).
PUBLIC HEALTH RELEVANCE:
This study:
advances methods for online behavioral surveillance;
examines how alcohol use impacts HIV risk; and
studies how virtual environments and public policy impact a community's structure, alcohol use, and HIV risk behavior.
As the first study to examine how legislation and e-infrastructure impacts health of high risk communities, this study will inform key stakeholders and the public, nationally and internationally, on how law and the e-environment impact health and HIV risk.
Rick Weinmeyer, M.Phil. (project coordinator, SILAS) completed his B.A. in Political Science at the University of Washington, writing his senior thesis on gay political representation in the U.S. Congress. He then went on to receive his M.Phil. in Social and Political Sciences from Cambridge University, England where he investigated obstacles in conducting health outreach in commercial sex environments. His previous experiences include: working for the Center for American Politics and Public Policy, conducting HIV/STI prevention outreach in Seattle-area gay bathhouses, and undertaking legal research for the Committee for International Human Rights Inquiry. Rick hopes to ultimately pursue a career in medical and public health law.
Gabriel Anderson, B.A. (research assistant, SILAS) is an MPH graduate student in the Division of Epidemiology and Community Health. Prior to matriculation, Gabriel worked as a health educator/program planner for a health education department in southern California. Among his research/professional interests are: Health Curricula Development, Health & Strategic Communications, HIV/STI Prevention, and Public Policy as a prevention strategy.
Lindsey Niswanger, B.A. (research assistant, SILAS) is an MPH student in the Division of Epidemiology and Community Health. Prior to starting her graduate studies, she spent a year as an AmeriCorps volunteer at the Nebraska AIDS Project performing HIV testing and counseling and managing their AIDS hotline. Her public health interests include infectious disease prevention, health disparities, health and human rights, and public policy.
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