Abstract
A subgroup most impacted by HIV in the US and in Miami-Dade County, Florida, are Latino men who have sex with men (LMSM). The most effective primary prevention measure for HIV is pre-exposure prophylaxis (PrEP), a daily pill to prevent HIV. However, LMSM in Miami are not sufficiently accessing PrEP services and PrEP information. Social networks, immigration stress, and PrEP availability may play an important role in LMSM’s access to PrEP and PrEP information. This Dissertation addressed the following two Specific Aims through three research studies: 1) determine if immigration stress is a barrier to PrEP information access within the sociocentric friendship networks of LMSM; and 2) determine if zip code levels of immigration stress are associated with LMSM accessibility to PrEP services in South Florida. This cross-sectional study utilized secondary data from 130 LMSM grouped into 10 sociocentric networks. Data were collected from August 2019 to October 2019 in South Florida. Analyses included linear regression examining out-degree centrality, the social network multiple regression quadratic assignment procedure to assess the effects of homophily, and multilevel geospatial logistic regressions exploring geographic accessibility to PrEP services. Visualizations include sociograms and maps. Findings from this Dissertation suggest that 1a) foreign-born LMSM experienced higher immigration stress relative to US-born LMSM, and immigration stress was associated with fewer friendship ties, 1b) there was no association between immigration stress homophily and tie presence, 1c) out-degree centrality was not associated with access to PrEP information within networks but higher levels of emotional closeness was associated with more frequent PrEP communication, and 2) higher zip code levels of immigration stress was not associated with geographic accessibility to PrEP services. Social network factors and geographic location may be important determinants for LMSM access to PrEP and PrEP-related information. Recommendations for further study and interventions are enclosed.