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Venue-Based Affiliation Networks and HIV Risk-Taking Behavior Among Male Sex Workers

Fujimoto, Kayo PhD*; Williams, Mark L. PhD; Ross, Michael W. PhD, MD*

Sexually Transmitted Diseases: June 2013 - Volume 40 - Issue 6 - p 453–458
doi: 10.1097/OLQ.0b013e31829186e5
Original Study

Background This study examined venue-based networks constituted by affiliation with gay bars and street intersections where male sex workers (MSWs) congregate to find their sexual/drug-sharing partners and network influence on risky sexual behavior (e.g., unprotected anal intercourse [UAI]) and HIV infection.

Methods Data collected in 2003 to 2004 in Houston, Texas, consists of 208 MSWs affiliated with 15 gay bars and 51 street intersections. Two-mode network analysis was conducted to examine structural characteristics in affiliation networks, as well as venue-based network influence on UAI and HIV infection.

Results Centralized affiliation patterns were found where only a few venues were popular among MSWs, and these were highly interdependent. Distinctive structural patterns of venue-based clustering were associated with UAI and infection. Individuals who shared venue affiliation with MSWs who engage in UAI were less likely to have UAI themselves. This suggests a downhill effect; that is, individuals compensate for their risk of infection by adjusting their own risk-taking behavior, based on their perceptions of their venue affiliates.

Conclusions Venue-based HIV/AIDs interventions could be tailored to specific venues so as to target specific clusters that are more likely to engage in risky sexual behavior.

A network study of male sex workers found centralized affiliation structures of venue-based clustering associated with unprotected anal intercourse and HIV infection. Supplemental Digital Content is available in the article.

From the *Division of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX; and †Robert Stempel College of Public Health and Social Work Florida International University, Miami, FL

The authors acknowledge Erik H. Lindsley for technical supports, and John Atkinson for managing the data.

Supported by the National Institutes of Health/National Institute on Drug Abuse (NIDA) 10205, National Institute on Alcohol Abuse and Alcoholism (NIAAA) 4ROOAA019699, and National Institute of Mental Health (NIMH) 1RO1MH100021.

Conflicts of interest: No conflict of interest exists in this article.

Correspondence: Kayo Fujimoto, PhD, 7000 Fannin Street, Suite 2514, Houston, TX 77030. E-mail:

Received for publication October 11, 2012, and accepted January 30, 2013.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (

© Copyright 2013 American Sexually Transmitted Diseases Association