Understanding social context in HIV and drug use via community-informed computational modeling: SILOS study protocol.

Introduction: Racial, ethnic, and sexual and gender minority populations are disproportionately impacted by HIV and other infectious diseases. A rigorous and holistic view of how individual and complex factors interact to produce health disparities among minority populations is urgently necessary. Methods: This project seeks to understand the social and contextual systems around the most marginalized HIV-impacted populations by investigating how differences in access to people and places confer HIV risk. Specifically, we have planned an innovative observational study across five US cities, administering in-depth remote network surveys to 2,700 racially diverse young men who have sex with men and transgender women. The data captured will be used to develop simulation models of city-specific synthetic populations to examine how differences in the people and places populations have access to pools risk within marginalized populations and increases their disparities in HIV. Results: The study was awarded in August 2024 but has paused since March 2025 due to the NIH's termination of the study just prior to the start of participant recruitment. The future of the work is currently unclear as we pursue multiple avenues for reinstatement. Discussion: Drawing upon both our expertise in network modeling and our strong community partnerships, this project remains poised to transform scientific understanding of the structural drivers of health inequity.