Patterns of sexual minority men's lifestyle and healthcare related activity spaces in Los Angeles

For gay, bisexual, and other sexual minority men (SMM), geo-social exposures in residential and non-residential places are important to consider for health, as home, social, sexual, substance use, and healthcare-related locations may be different. We use survey data from a sample of 219 Black and Hispanic SMM within Los Angeles County to examine the places that individuals visit for eight specific activities, categorized as either lifestyle or healthcare-related. Spatial clustering techniques are used to identify hotspots, or places where individual's activities are clustered in space, for each activity. We then use descriptive statistics to characterize each hotspot based on the socio-demographic characteristics of individuals who engaged in activities within the hotspot, and then assess whether activity-based hotspots overlap in space. We find unique spatial patterns of hotspots, distinct by activity. Additionally, lifestyle activity space hotspots are spatially patterned by socio-demographic characteristics, primarily along race and ethnic categories, whereas healthcare-related hotspots are not. The overlap, or spatial congruence of hotspots, is higher than we hypothesized, as hotspots of residential locations contained the majority of sex hotspots and substance use hotspots. Our work ultimately identifies four distinct areas of Los Angeles County in which activities are clustered among men in the sample, and health interventions can be tailored to the individuals and their activities in those places. Our findings demonstrate the importance of geographically and demographically targeted interventions, at a fine spatial scale, for health promotion among SMM, as interventions and policy to provide equitable care to reduce racial disparities in health among SMM are sorely needed.