Accepted for/Published in: JMIR Research Protocols
Date Submitted: Mar 12, 2025
Date Accepted: Dec 30, 2025
A novel social network approach to measure intersectional stigma among Latino men who have sex with men in San Diego California (NEXUS): Protocol for a longitudinal cohort study
ABSTRACT
Background:
Latino men who have sex with men (LMSM) account for a disproportionate and growing number of HIV diagnoses in the United States. Intersectional stigma remains a key driver of HIV inequities; however, most quantitative intersectional stigma measures are limited and do not consider the larger social context.
Objective:
NEXUS is a longitudinal cohort study that will utilize social network methods and theory to more rigorously measure intersectional stigma among LMSM and quantify the longitudinal association between intersectional stigma and HIV prevention outcomes.
Methods:
We will prospectively enroll 500 HIV-negative LMSM in San Diego, California and follow participants over one year. At baseline and every 6 months thereafter (at Month 0, Month 6, and Month 12), participants will complete an interviewer-administered social network inventory and a self-administered survey to collect information on their social network (members (i.e., alters), size, characteristics) and HIV prevention engagement (HIV testing and PrEP use), respectively. Information on HIV prevention engagement will also be abstracted from medical records. We will operationalize intersectional stigma as a multilevel latent variable comprised of observed measures of anticipated and enacted stigma experienced by a participant from an alter towards the participant’s Latino, masculine, and sexual identities. We will use multilevel structural equation modeling to estimate the longitudinal association between intersectional stigma and HIV testing and PrEP use, considering potential mediators and moderators.
Results:
NEXUS recruitment began in June 2021, and as of November 11, 2024, 482 participants had been enrolled. Enrollment is planned to end by February 2025, with results expected later that year.
Conclusions:
NEXUS will advance quantitative intersectional stigma measurement by employing a novel social network approach. In doing so, we will identify intervention targets to reduce HIV inequities among LMSM and mitigate the harms of intersectional stigma in this population. Clinical Trial: N/A
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