“…The use of alcohol and drugs has been implicated in acts of unprotected anal sex among both HIV-negative and HIV-positive MSM (Barta, Tennen, & Kiene, 2010;Forrest et al, 2010;Hirshfield, Remien, Humberstone, Walavalkar, & Chiasson, 2004;Hurt et al, 2010;Shuper, Joharchi, Irving, & Rehm, 2009;Stall & Purcell, 2000). Moreover, some research indicates that young HIV-positive MSM are more likely to use substances during sex when compared with those who are HIV-negative (Harawa et al, 2004;Hein et al, 1995).…”