Sexual risk taking and club drug use across three age cohorts of HIV-positive gay and bisexual men in New York City

Abstract

This study examined club drug use, (i.e., cocaine, ecstasy, ketamine, GHB, and methamphetamine) and unprotected anal intercourse (UAI) in an ethnically and racially diverse sample of 166 New York City-based seropositive, club drug-using, gay and bisexual men, ages 19 to 61, and considered these behaviors in relation to age category (20s, 30s, 40+) and number of years living with HIV. Club drug use was common across all age categories, with differences arising only in the type of club drug used. Multivariate logistic regression modeling indicated older participants (30s, 40+) were more likely to use cocaine and methamphetamine and less likely to use GHB and ketamine than those in their 20s. We examined unprotected anal intercourse (UAI) with casual partners in relation to age category, the number of years living with HIV, and club drug use. The likelihood of engaging in UAI with seronegative casual partners was greater among those in their 20s than those in their 30's or 40+. Further, participants were equally likely to engage in unprotected receptive anal intercourse and unprotected insertive anal intercourse with each casual partner serostatus type. With regard to number of years living with HIV, those living longer with the disease were more likely to report UAI with casual partners with a seropositive status than with a negative or unknown serostatus. Our findings suggest that UAI and club drug use is common among seropositive gay and bisexual men regardless of age category, but that differential patterns of risk emerge in relation to the number of years one has been living with HIV and age. These findings are of significance as both the aging population of seropositive gay and bisexual men and HIV infection rates continue to grow, and demonstrate a need for differentiated and tailored prevention strategies across the age continuum.

Substance Use and Experienced Stigmatization Among Ethnic Minority Men Who Have Sex with Men in the United States

“…We found no significant association between HIV status and stimulant drug use or poly-drug use in bivariate and multivariate analyses. This would seem to be at odds with research that has found such a link (e.g., Gorman et al, 2004; Pappas & Halkitis, 2011; Stall et al, 2001; Vaudrey et al, 2007); it should be noted that our confidence intervals did include the effects noted in the literature. While statistically significant associations have generally been found among MSM samples which include large numbers of white men, it may be that this relationship differs with exclusively ethnic minority MSM samples.…”

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

“…Numerous studies have documented associations between drug and alcohol use and HIV transmission risk (Colfax et al, 2004); (Koblin, Chesney, Husnik, et al, 2003b; Mayer, Wang, Koblin, et al, 2014; Ostrow, Plankey, Cox, et al, 2009; Pappas & Halkitis, 2011; Sander, Cole, Stall, et al, 2013; Skeer, Mimiaga, Mayer, et al, 2012). However, MSM subpopulations are not homogenous and often exhibit different substance-use related risk profiles (Newcomb, Ryan, Greene, et al, 2014).…”

The Pleasure Principle: The Effect of Perceived Pleasure Loss Associated with Condoms on Unprotected Anal Intercourse Among Immigrant Latino Men Who Have Sex with Men

“…HIV status, relationship status, and age were controlled in the analyses predicting UAI given past reports linking these factors to condom use. 7,12,[22][23][24][25][26] We did not formulate a specific hypothesis about the amount of pleasure loss associated with condoms for the insertive position compared to the receptive position, as complaints about condoms inhibiting physical sensation and interfering with emotional connectedness have been voiced from both stances. With regard to our second objective, we hypothesized that greater perceived pleasure loss would be related to a higher likelihood of UAI in both positions.…”