Community Connectedness and Its Association with Stigma and Viral Suppression Among MSM with HIV: Findings from HPTN 078.

Gay, bisexual, and other men who have sex with men (MSM) continue to be disproportionately affected by HIV in the United States, with viral suppression rates among MSM across varied racial and ethnic groups remaining below national targets. Stigma is a major barrier to viral suppression, while community connectedness may serve as a protective factor. However, few studies have examined whether different forms of community connectedness are associated with viral suppression or moderate the negative effects of stigma. Data were drawn from 490 MSM with HIV enrolled in the HIV Prevention Trials Network (HPTN) 078 study (2016-2017). Multivariable logistic regression estimated adjusted odds ratios with 95% confidence intervals. Exploratory moderation analyses tested interactions between stigma and community connectedness, and significant interactions were further examined using stratified models. Viral suppression was documented in 78% (n = 383) of participants. Having a medium-sized MSM network (6-25 vs. low [0-5 MSM known personally]) was associated with lower odds of viral suppression, whereas medium (2-5) and high (> 5) levels of recent peer interactions (vs. low [0-1]) were associated with higher odds of viral suppression. Perceived connectedness to the broader lesbian, gay, among MSM across varied racial and ethnic groups bisexual(LGB) community was not significantly associated with viral suppression. Exploratory analyses suggested that the association between provider-related MSM stigma and viral suppression may vary by levels of network size and peer interactions, with associations observed only at medium levels of connectedness. These findings suggest that fostering active peer interactions may improve viral suppression among MSM.