Spatial Patterns of Migration among Men Who have Sex with Men in the United States

• Main Author: Reid, Sean Casey
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2021
• Subjects: Demography; Geography; Health sciences
• ISBN: 9798790634468

The spatial distribution and movement of men who have sex with men (MSM) in the United States has received limited research attention due to a lack of comprehensive data for this underserved demographic. Understanding the dynamics and drivers of spatial distribution, mobility, and migration are key to implement culturally and geographically appropriate health interventions to limit the spread of infectious disease like HIV and allocate resources to better serve the healthcare needs of MSM. To address the gap in comprehensive quantitative literature on MSM mobility and migration, this paper outlines a novel approach. A uniform baseline population is created and compared to a county level MSM population estimate derived using a combination of American Community Survey (ACS), National Center for Health Statistics (NCHS), and National Health and Nutrition Examination Survey (NHANES) data. The assessment of these two data sets allows for the identification of sending and receiving counties of MSM population based on over- and under-representation of MSM in the estimated distribution compared to the baseline distribution. Sending and receiving counties are further examined using clustering analysis and a geographically weighted regression (GWR) model. The results show urban counties serve as primary receiving counties of MSM population based on their over-representation compared to the baseline distribution. As county urbanicity levels decrease, there is more abundant under-representation of MSM population as many rural counties are primarily sending counties of MSM population. The clustering results indicate strong regional patterns of receiving counties with high over-representation of MSM that are surrounded by sending counties with under-representation of MSM. Notable clustering occurs in traditional MSM destinations like the San Francisco, Miami, and Phoenix but additional, less known, regional hubs emerge as well. Lastly, the results from the GWR model indicate attributes like population density and income are key factors associated with MSM over-representation but vary regionally and in some cases are associated with MSM under-representation for portions of the country. Social attributes were also shown to be largely non-significant factors driving distribution of MSM population.