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.
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.
de Souza
Claudia Teresa Vieira
CT
Research Center, Evandro Chagas Hospital, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. clau@cpqhec.fiocruz.br
Diaz
Theresa
T
Sutmoller
Frits
F
Bastos
Francisco Inácio
FI
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
D016578:Crack Cocaine