The topic for tomorrow's presentation & discussion is: Sources of racial disparities in HIV prevalence among men who have sex with men in Atlanta: a modeling study. This will be presented by Steven M. Goodreau, Ph.D. Dr. Goodreau a professor in the Department of Anthropology at the University of Washington in Seattle, Washington.
The abstract for his presentation & subsequent discussion is as follows:
Black men who have sex men (MSM) in the US have a substantially higher prevalence of infection than White MSM, and many proximal and distal explanations have been offered to account for pieces of this disparity.
We created a simulation model to assess the strength of existing hypotheses and data. We built a dynamic, stochastic, agent-based network model of Black and White MSM aged 18–39 years in Atlanta, that incorporated race-specific individual and dyadic-level prevention and risk behaviors, network attributes, and care patterns. We estimated parameters from two Atlanta-based studies in this population (n=1117), supplemented by other published work. We modeled the ability for racial assortativity to generate or sustain disparities in the prevalence of HIV infection, alone or in conjunction with scenarios of observed racial patterns in behavioral, care, and susceptibility parameters.
Race-assortative mixing alone could not sustain a pre-existing disparity in prevalence of HIV between Black and White MSM. Differences in care cascade, stigma-related behaviors, and CCR5 genotype each contributed substantially to the disparity (explaining 10.0%, 12.7%, and 19.1% of the disparity, respectively), but nearly half (44.5%) could not be explained by the factors investigated. A scenario assessing race-specific reporting differences in risk behavior was the only one to yield a prevalence in black MSM (44.1%) similar to that observed (43.4%). Racial assortativity is an inadequate explanation for observed disparities. Work to close the gap in the care cascade by race is imperative, as are efforts to increase serodiscussion and strengthen relationships among Black MSM particularly. Further work is urgently needed to identify other sources of, and pathways for, this disparity, to integrate concomitant epidemics into models, and to understand reasons for racial differences in behavioral reporting.
Ce-PIM‘s Prevention Science and Methodology Group (PSMG) is a virtual network of more than 480 empirical researchers and methodologists aimed to advance the field of prevention science and support the implementation of evidence-based prevention programs. The PSMG grand rounds are now conducted virtually over the internet, allowing the members to view, question, and comment live from their own computer with leading scientists and methodologists at no cost. Access to live presentations is restricted to PSMG members. However, PSMG presentations are recorded and will be publicly accessible on our website two weeks after the presentation date on the archive page.
The PSMG will host sessions devoted specifically to HIV Prevention (chaired by Nanette Benbow and Gregory Phillips) as well as Implementation Science (chaired by J D Smith), Agent-Based Modeling (chaired by Wouter Vermeer), and Innovations in Research Designs (chaired by Booil Jo).