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

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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 determine whether 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.

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Acknowledgments

The author was supported as a pre-doctoral fellow in the Behavioral Sciences Training in Drug Abuse Research program sponsored by Public Health Solutions and National Development and Research Institutes with funding from the National Institute on Drug Abuse (5T32 DA007233). Points of view, opinions, and conclusions in this article do not necessarily represent the official position of the U.S. Government, Public Health Solutions or National Development and Research Institutes.

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Authors and Affiliations

  1. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA

    Gary Yu & Melanie M. Wall

  2. Research and Evaluation Unit, Public Health Solutions, 40 Worth Street, 5th Floor, New York, NY, 10013, USA

    Mary Ann Chiasson & Sabina Hirshfield

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  1. Gary Yu
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  2. Melanie M. Wall
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  3. Mary Ann Chiasson
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  4. Sabina Hirshfield
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Correspondence to Sabina Hirshfield.

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Yu, G., Wall, M.M., Chiasson, M.A. et al. Complex Drug Use Patterns and Associated HIV Transmission Risk Behaviors in an Internet Sample of U.S. Men Who Have Sex with Men. Arch Sex Behav 44, 421–428 (2015). https://doi.org/10.1007/s10508-014-0337-8

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  • DOI: https://doi.org/10.1007/s10508-014-0337-8

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