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HIV Risk Among Substance-Using Men Who Have Sex with Men and Women (MSMW): Findings from South Florida

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Abstract

Compared with men who have sex with men only (MSMO), men who have sex with men and women (MSMW) consistently report higher rates of two HIV risk behaviors: transactional sex (TS) and concurrent substance use and sex (CSS). Within MSMW, little is known about how synergistic epidemics (“syndemics”) affect TS and CSS. Using a sample of substance-using MSM (n = 515) in South Florida, we compared TS and CSS among MSMO and MSMW; examined whether, within MSMW (n = 86), TS and CSS predict unprotected anal intercourse with partners of serodiscordant/unknown HIV status (SU-UAI); and tested whether syndemics predict TS and CSS. MSMW reported higher rates of engaging in both TS and CSS (AOR = 1.7; 95 % CI 1.0–3.0). Within MSMW, engagement in both TS and CSS predicted SU-UAI (AOR = 3.3; 95 % CI 1.2–9.6); and syndemics predicted TS and CSS involvement (p < 0.01). Substance-using MSMW may benefit from interventions targeting TS, CSS, and background syndemics.

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Acknowledgments

This research was supported by Department of Health and Human Services (Grant Number 5 R01 DA024579) from the National Institute on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health.

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Authors and Affiliations

  1. Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, P.O. Box 7319, Pittsburgh, PA, 15213, USA

    M. Reuel Friedman & Anthony J. Silvestre

  2. Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    M. Reuel Friedman, Anthony J. Silvestre & Ron Stall

  3. Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Coral Gables, FL, USA

    Steven P. Kurtz & Mance E. Buttram

  4. Department of Epidemiology & Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Chongyi Wei

  5. Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    Ron Stall

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  1. M. Reuel Friedman
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  2. Steven P. Kurtz
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  3. Mance E. Buttram
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  4. Chongyi Wei
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  6. Ron Stall
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Correspondence to M. Reuel Friedman.

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Friedman, M.R., Kurtz, S.P., Buttram, M.E. et al. HIV Risk Among Substance-Using Men Who Have Sex with Men and Women (MSMW): Findings from South Florida. AIDS Behav 18, 111–119 (2014). https://doi.org/10.1007/s10461-013-0495-z

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  • DOI: https://doi.org/10.1007/s10461-013-0495-z

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