Dr. Dustin Duncan Awarded $2 Million for Geospatial Research into Neighborhood and Social Network Risk Factors for Drug Use and HIV

Studies in Deep South & NYC Could Inform Prevention and Treatment among Men who Have Sex with Men

Thursday, July 07 2016

 

Dustin Duncan, ScD
Dustin Duncan, ScD

Dustin T. Duncan, ScD, assistant professor in the Department of Population Health at NYU Langone Medical Center, has been awarded $2 million by the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health’s National Institute for Mental Health (NIMH) and National Institute on Drug Abuse (NIDA) to study neighborhoods, social and sexual networks, drug and alcohol use, and the risk of contracting HIV among black gay, bisexual, and other men who have sex with men (MSM) who live in Jackson, Mississippi, and in New York City.

Using innovative geo-spatial technology and methods, the studies will aim to identify the risk profiles of different neighborhoods and inform geographically targeted public health interventions, including reducing the burden of HIV in these and similar communities.

In the United States, black MSM, especially those who are younger, are disproportionately affected by HIV. Currently, few health interventions, including those for HIV prevention and treatment, are based on data from geospatial research.

Using GPS, Twitter, and Other Methods to Map Neighborhood and Network Risk Factors

The following grants will fund Dr. Duncan’s research:

  • A CDC grant of $1.2 million to enroll 300 black MSM in the Jackson metropolitan area from an existing CDC-funded study of MSM who are both HIV-positive and negative. In this longitudinal study, participants will wear GPS (global positioning system) technology devices for two-weeks every three-months during a one-year period—for a total of five times. By mapping their travel patterns, the study will seek to better capture the breadth of the participants’ exposure to neighborhood-level factors, such as poverty, HIV prevalence, access to healthcare services, and interactions with social and sexual networks.
  • An NIMH grant of $463,000 to randomly enroll from an existing NIH-funded cohort study 250 racially diverse young men in the New York metropolitan area who have had sex with another male in the past six months and are HIV-seronegative. The investigators will use GPS methods and purposive sampling of public, geo-located Twitter posts to investigate relationships between novel neighborhood factors including HIV-related stigma, racism, and homophobia and behaviors that increase the risk of contracting HIV such as condomless anal sex.
  • A NIDA grant of $299,000 to determine the feasibility of implementing different advanced GPS protocols among a sample of 150 young black MSM not infected with HIV in Jackson recruited through community-based methods, and investigate how characteristics of their neighborhoods may relate to alcohol and other drug use, including the use of these substances immediately before or during sexual activity.

Dr. Duncan, who is also a faculty affiliate at the NYU College of Global Public Health and the NYU Center for Drug Use and HIV Research (CDUHR), has previously tested and validated the feasibility of using GPS devices in small samples of MSM and low-income housing residents in New York.

Spatial Research Could Inform New, Dynamic Interventions

Jackson, MS
Some of Dr. Duncan’s research will involve men living in Jackson, Mississippi.

The findings from Dr. Duncan’s research will be used to understand whether the drug use and sexual health risks of particular neighborhood spaces change or remain constant over time. If these risk environments change, prevention strategies may need to be dynamic, fluid, and mobile to provide ready access to services.

Additionally, findings from these studies will help to identify optimal locations to provide HIV testing and other prevention and risk reduction strategies based on the geographic patterns of the men studied, and raise awareness of new biomedical prevention strategies—including pre-exposure prophylaxis (PrEP). Findings from the CDC study will help better reach men living with HIV, by improving retention in HIV care, adherence to antiretroviral treatment (ART), and reducing viral load so that the virus is not further transmitted.

The findings may also inform specific neighborhood-level policy interventions such as community efforts to combat lesbian, gay, bisexual and transgender (LGBT) hate crimes through increased local police attention in high-crime locations, since stress resulting from hate crimes and other forms of stigma has been associated with risky substance use and sex behaviors. Furthermore, understanding social networks could help with prevention and treatment of HIV, such as using early adopters as peer educators for promotion of PreP.

Enhancing Social Epidemiology with Spatial Methods

Dr. Duncan, who directs NYU’s Spatial Epidemiology Lab, is a social and spatial epidemiologist who uses a geospatial lens to study how neighborhood characteristics, such as the built environment—parks, tobacco retailers, and access to healthcare services—and the social environment—including crime, violence, and spatial stigma—influence population health.

With a special emphasis on minority health and health disparities, Dr. Duncan focuses on socio-demographic disparities in neighborhood environmental features and how these disparities relate to population health and community wellbeing. In his research, he uses methods such as computer-based geographic information systems (GIS), web-based geospatial technologies, real-time geospatial technologies, and geospatial modeling techniques.

The grants are entitled “Impact of Neighborhoods and Networks on HIV Prevention and Care Behaviors Among Black MSM in the Deep South,” funded by the CDC National Center for HIV, Viral Hepatitis, STDs and TB Prevention (1U01PS005122-01); “Neighborhoods, Mobility and HIV Among Young MSM,” funded by the NIH National Institute on Mental Health” (1R21MH110190-01); and “Activity Space Neighborhoods, Drug Use and HIV Among Black MSM in the Jackson Mississippi MSA” funded by the NIH National Institute on Drug Abuse (1R03DA039748-01A1).