Complex Drug Use Patterns and Associated HIV Transmission Risk Behaviors in an Internet Sample of U.S. Men Who Have Sex with Men

Abstract

Although the relationship between drug use and HIV risk among men who have sex with men (MSM) is well described, relatively few studies have employed empirical methods to assess underlying classes of drug use that may better predict the risk of HIV or sexually transmitted infections (STIs) among MSM. The aim of this study was to determinewhether latent class analysis (LCA) would identify underlying drug classes reported prior to sex, as well as predict unprotected anal intercourse (UAI) in the last sexual encounter among MSM. From 2004 to 2005, an anonymous online survey was conducted among 8,717 sexually active MSM recruited from gay-affiliated U.S. websites. LCA clustered participants into six distinct drug use classes based on the specific types and number of drugs used: (1) low/no drug use, (2) recreational drug use, (3) poppers with prescription erectile dysfunction (ED) drug use, (4) poppers with both prescription and non-prescription ED drug use, (5) recreational, club, and ED drug use, and (6) high polydrug use. Compared with men in Class 1, men in the highest drug use class were 4.84 times more likely to report UAI in their last sexual encounter and 3.78 times more likely to report an STI in the past year (both ps<.001). Younger MSM aged 18–29 were significantly more likely to report an STI than men aged 50 and above (p<.001). There is a need to better understand the complex relationship between a diverse set of drugs used among MSM and how polydrug use impacts sexual negotiation over time.

Alcohol and cocaine use among Latino and African American MSM in 6 US cities

“…Our group has previously reported elevated co-occurrence of psychiatric distress and substance-use disorders among sexual minority men (Yu, Wall, Chiasson, & Hirshfield, 2015). Thus, our data suggest the need to develop specifically tailored interventions that can address not only substance-use but mental health, especially psychological distress, among minority MSM populations.…”

Poppers use and risky sexual behaviors among men who have sex with men in Beijing, China

“…Alcohol and recreational drug use may lead to sexual risk-taking behaviors (Jia et al, 2010; Li et al, 2012; Santos et al, 2013). There are two types of illicit drugs in Chinese market, which are associated with HIV infection in different mechanisms: (1) use of the traditional drugs of heroin and opium is associated with HIV risk mainly among injection drug users; and (2) use of recreational drugs or club drugs, which are commonly used for the purpose of increasing euphoria at social venues such as clubs, “raves”, and dance parties (Mansergh et al, 2001; Mattison et al, 2001), may increase HIV risk through increasing unprotected sex and/or number of sexual partners (Bao et al, 2015; Jerome et al, 2009; Yu et al, 2015). …”

Sexual Initiation and Complex Recent Polydrug Use Patterns Among Male Sex Workers in Vietnam: A Preliminary Epidemiological Trajectory

“…The 11 dichotomous drug use indicators, and an overall count of the number of different drugs used, were analyzed using LCA with varying number of classes, ranging from 1 to 7 (Yu et al, 2015a, Cheung et al, 2015). The optimal number of classes was determined using Bayesian information criterion (BIC), which balances model fit and parsimony (Fraley & Raftery, 1998, McLachlan & Peel, 2004).…”

“…Relatively little is known about the relationship between age of onset of sexual and drug use risks and current patterns of combined complex drug use among MSW in Vietnam, as most research has focused on the use of specific individual drugs or classes of drugs (Yu et al, 2015a, Yu et al, 2015b). Based on data collected in a controlled comparison, epidemiological study of young MSW in Vietnam, this paper describes the prevalence of current use for a wide range of drugs.…”