Longitudinal patterns of methamphetamine, popper (amyl nitrite), and cocaine use and high-risk sexual behavior among a cohort of san francisco men who have sex with men.
Most prior studies examining drug use among men who have sex with men (MSM) have been cross-sectional or retrospective and have not determined whether periods of increased drug use are associated with high-risk sexual behavior at the individual level. In this article, we describe patterns of use of methamphetamines, poppers, and sniffed cocaine and sexual risk behavior among 736 San Francisco MSM enrolled in the EXPLORE study and followed for up to 48 months. In longitudinal analysis, use of methamphetamines, poppers, and sniffed cocaine declined during follow-up. However, compared with older participants, younger participants were more likely to increase their drug use over time. Results of conditional logistic regression demonstrated that high-risk sexual behavior was more common during reporting periods characterized by increased methamphetamine, poppers, or sniffed cocaine use. This within-person analysis found that compared with periods of no drug use, periods of both light drug use (less than weekly use of drugs) and heavier drug use (at least weekly use of at least one drug) were significantly associated with increased risk of engaging in unprotected anal sex with an HIV-positive or unknown-status partner. These results suggest that even intermittent, recreational use of these drugs may lead to high-risk sexual behavior, and that, to reduce and prevent risks of HIV, no level of use of these drugs should be considered "safe." HIV prevention interventions should target MSM who report either light or heavy use of methamphetamines, poppers, and sniffed cocaine.
Colfax
Grant
G
San Francisco Department of Public Health, HIV Research Branch, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102-6033, USA. grant_colfax@sfdph.org
Coates
Thomas J
TJ
Husnik
Marla J
MJ
Huang
Yijian
Y
Buchbinder
Susan
S
Koblin
Beryl
B
Chesney
Margaret
M
Vittinghoff
Eric
E
D000293:Adolescent; D000328:Adult; D000680:Amyl Nitrite; D019970:Cocaine-Related Disorders / Q000150:complications; D003863:Depression / Q000150:complications; D005006:Ethnicity; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology*; D015497:HIV-1; D018451:Homosexuality, Male; D006801:Humans; D013287:Illicit Drugs; D008137:Longitudinal Studies; D008297:Male; D008694:Methamphetamine; D008875:Middle Aged; D012306:Risk; D012309:Risk-Taking; D012495:San Francisco / Q000453:epidemiology; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000150:complications*
D013287:Illicit Drugs; D008694:Methamphetamine; D000680:Amyl Nitrite
AIDS Educ Prev. 2000 Feb;12(1):38-48
10749385
JAMA. 2000 Jul 12;284(2):198-204
10889593
Am J Epidemiol. 2000 Jul 15;152(2):99-106
10909945
J Sch Health. 2000 Sep;70(7):271-85
10981282
Drug Alcohol Depend. 2001 Jan 1;61(2):105-12
11137274
Am J Public Health. 2001 Jun;91(6):907-14
11392933
Health Psychol. 2001 Jul;20(4):291-9
11515741
J Subst Abuse. 2001;13(1-2):185-200
11547619
Addiction. 2001 Nov;96(11):1589-601
11784456
Am J Public Health. 2002 Mar;92(3):388-94
11867317
J Subst Abuse. 1993;5(4):311-25
7910500
AIDS Educ Prev. 1996 Oct;8(5):415-29
8911569
J Subst Abuse Treat. 1996 Nov-Dec;13(6):483-6
9219145
Am J Epidemiol. 1997 Oct 1;146(7):531-42
9326430
Med Anthropol Q. 1997 Dec;11(4):505-15
9408904
Drug Alcohol Depend. 1999 Feb 1;53(3):197-205
10080045
Am J Epidemiol. 1999 Aug 1;150(3):306-11
10430236
Am J Public Health. 2003 Jun;93(6):926-32
12773357
Am J Public Health. 2003 Nov;93(11):1915-21
14600066
Am J Epidemiol. 2004 May 15;159(10):1002-12
15128613
Lancet. 2004 Jul 3-9;364(9428):41-50
15234855
J Acquir Immune Defic Syndr. 2004 Oct 1;37 Suppl 2:S68-77
15385902
Am J Epidemiol. 1984 Jun;119(6):997-1004
6731436
J Acquir Immune Defic Syndr. 1990;3(12):1181-7
2243318