title: The association of socioeconomic status and use of crack/cocaine with unprotected anal sex in a cohort of men who have sex with men in Rio de Janeiro, Brazil.
abstract: To evaluate the relation between illicit drug use, sexual practices, and socioeconomic status, we analyzed data from the baseline interview of a cohort of 675 men who have sex with men conducted from 1994 to 1999 in Rio de Janeiro, Brazil. Bivariate analyses of factors associated with crack/cocaine use with sex revealed that men who reported crack/cocaine use were significantly ( p <.05) more likely than men who did not report drug use to be unemployed (42.7% vs. 29.1%), to have an income of <$250 per month (70.7% vs. 60.9%), to have <8 years of education (69.5% vs. 50.9%), to report bisexual activity (81.7% vs. 41.7%), and to engage in commercial sex (72.0% vs. 37.9%). Multivariate analysis of factors associated with unprotected anal sex with casual male partners in the last 6 months demonstrated that the following variables were associated with this outcome: an income <$250 per month (adjusted odds ratio [AOR] = 1.73, 95% confidence interval [CI]: 1.04-2.87), less than 8 years of education (AOR = 2.21, CI: 1.38-3.53), a greater sense of vulnerability (AOR = 2.58, CI: 1.54-4.33), a willingness to participate in vaccine trials (AOR = 1.91, CI: 1.20-3.05), and use of crack/cocaine (AOR = 1.91, CI: 1.05-3.46). Our findings suggest that HIV prevention programs for these men need to address drug use and how drug use may influence sexual behaviors.
authors.affiliation: Research Center, Evandro Chagas Hospital, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. clau@cpqhec.fiocruz.br
authors.forename: Claudia Teresa Vieira
authors.initials: CT
authors.lastname: de Souza
authors.forename: Theresa
authors.initials: T
authors.lastname: Diaz
authors.forename: Frits
authors.initials: F
authors.lastname: Sutmoller
authors.forename: Francisco Inácio
authors.initials: FI
authors.lastname: Bastos
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D016578:Crack Cocaine; D018023:HIV Seronegativity; D006306:Health Surveys; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012309:Risk-Taking; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D011795:Surveys and Questionnaires
chemical_list: D016578:Crack Cocaine