Affiliation network model of HIV transmission in MSM

Background: Black men who have sex with men (MSM) in the U.S. are more likely to be HIV-positive than white MSM. Intentional and unintentional segregation of black from non-black MSM in sex partner meeting places may perpetuate this disparity, a fact that is ignored by current HIV risk indices, which mainly focus on individual behaviors and not systemic factors. This paper capitalizes on recent studies in which the venues where MSM meet their sex partners are known. Connecting individuals and sites leads to so-called affiliation networks, and we propose a model for how HIV might spread along these networks, and we also formulate a new risk index based on this model. Results: In simulations based on an affiliation network of 431 African-American MSM in Chicago, a median AUC of 0.7605 is obtained for the new risk index. Conclusions: The new risk index works well when there are two groups of people, one with higher HIV prevalence than the other, with limited overlap in where they meet their sex partners. This model has extensions beyond the realm of HIV.