| Walking the line: stimulant use during sex and HIV risk behavior among Black urban MSM. | |
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MedLine Citation:
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PMID: 20334986 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Although the association of stimulant use to sexual risk taking and HIV transmission has been well documented among white gay men, stimulant use during sex continues to be under-explored among Black men who have sex with men (MSM). METHODS: Black MSM (n=197) recruited via modified respondent-driven sampling between January and July 2008 completed an interviewer-administered quantitative assessment and optional HIV counseling and testing. Bivariate logistic regression procedures were employed to examine the association of demographics, sexual risk, and other psychosocial factors with stimulant use (at least monthly during sex in the past 12 months). Variable elimination using the backward selection process was used to fit two separate final multivariable logistic regression models examining stimulant use as the outcome and HIV sexual risk in the past 12 months by gender as the primary predictor: (1) Model 1: HIV sexual risk behavior with a casual male sex partner as a primary, forced predictor; (2) Model 2: HIV sexual risk behavior with a female sex partner as primary, forced predictor. RESULTS: One-third (34%) of Black MSM reported using stimulants monthly or more frequently during sex in the past 12 months. The following factors were independently associated with stimulant use during sex: (1) Model 1: unprotected anal sex with a casual male sex partner in the past 12 months (AOR=2.61; 95% CI=1.06-6.42; p=0.01), older age (AOR=1.09; 95% CI=1.05-1.15; p<0.001), erectile dysfunction (ED) medication use monthly or more during sex in the past 12 months (AOR=7.81; 95% CI=1.46-41.68; p=0.02), problematic alcohol use (AOR=3.31; 95% CI=1.312-8.38; p=0.005), and higher HIV treatment optimism (AOR=0.86; 95% CI=0.76-0.97; p=0.01). (2) Model 2: unprotected vaginal or anal sex with a female partner in the past 12 months (AOR=3.54; 95% CI=1.66-7.56; p=0.001), older age (AOR=1.10; 95% CI=1.05-1.14; p<0.001), ED use monthly or more during sex in the past 12 months (AOR=3.70; 95% CI=1.13-12.13; p=0.03), clinically significant depressive symptoms (CES-D) at the time of study enrollment (AOR=3.11; 95% CI=1.45-6.66; p=0.004), and supportive condom use norms (AOR=0.69; 95% CI=0.49-0.97; p=0.03). CONCLUSION: Frequent stimulant use is an important factor in HIV and STD sexual risk among Black MSM, particularly for older men and those with co-occurring psychosocial morbidities. HIV and STD prevention interventions in this population may benefit from addressing the precipitants of stimulant use and sexual risk taking. |
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Authors:
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Matthew J Mimiaga; Sari L Reisner; Yves-Michel Fontaine; Sean E Bland; Maura A Driscoll; Deborah Isenberg; Kevin Cranston; Margie R Skeer; Kenneth H Mayer |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-03-23 |
Journal Detail:
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Title: Drug and alcohol dependence Volume: 110 ISSN: 1879-0046 ISO Abbreviation: Drug Alcohol Depend Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-14 Completed Date: 2010-09-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7513587 Medline TA: Drug Alcohol Depend Country: Ireland |
Other Details:
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Languages: eng Pagination: 30-7 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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The Fenway Institute, Fenway Community Health, Boston, MA 02215, United States. mmimiaga@fenwayhealth.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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AIDS Serodiagnosis Adult African Continental Ancestry Group Amphetamine-Related Disorders / epidemiology, psychology Central Nervous System Stimulants* Cocaine-Related Disorders / epidemiology, psychology Condoms Crack Cocaine Depression / epidemiology, psychology Female HIV Infections / epidemiology* Homosexuality / psychology*, statistics & numerical data* Humans Logistic Models Male Methamphetamine Middle Aged Risk-Taking* Sexually Transmitted Diseases / epidemiology, prevention & control, psychology Socioeconomic Factors Substance-Related Disorders / epidemiology* Unsafe Sex / statistics & numerical data* Urban Population |
| Grant Support | |
ID/Acronym/Agency:
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R03DA023393/DA/NIDA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Central Nervous System Stimulants; 0/Crack Cocaine; 537-46-2/Methamphetamine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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