title: Risk behaviors among HIV-positive gay and bisexual men at party-oriented vacations.
abstract: OBJECTIVE
  This study examined substance use (intended and actual), unprotected sex, and HIV disclosure practices (disclosure and questioning) among HIV-positive men who have sex with men (MSM) at two party-oriented vacations, where substance use and sexual risk may be heightened.
  
  
  METHODS
  A random sample of 489 MSM attending one of two party-oriented vacations participated in PartyIntents, a short-term longitudinal survey. Nearly half (47%) completed a follow-up assessment at the event or online for up to 2 weeks after the event. We examined rates of baseline intentions to use substances, actual substance use, and unprotected intercourse among HIV-positive men in attendance.Rates among HIV-negative men were estimated for comparison. Multiple logistic regression was used to assess the impact of illegal drug use and HIV status on unprotected anal intercourse (UAI).
  
  
  RESULTS
  HIV-positive attendees (17%) were significantly more likely than HIV-negative attendees to use nitrite inhalants (or "poppers") (24.3% vs. 10.7%). HIV-positive attendees were also significantly more likely to have insertive UAI (64.3% vs. 34.1%) and receptive UAI (68.8% vs. 22.2%). Multivariate models showed associations between HIV status and illegal drug use with UAI (for HIV status, odds ratio [OR] = 4.5, p = .001; for any illegal drug use, OR = 16.4, p < .001). There was no evidence that the influence of drug use moderated risk by HIV status. Rates of HIV disclosure and questioning did not differ by HIV status.
  
  
  CONCLUSIONS
  HIV-positive men attending these events engaged in higher rates of illegal drug use and sexual risk than HIV-negative men. Prevention campaigns targeting MSM at high-risk events should include messages geared toward HIV-positive men.
authors.affiliation: RAND Corporation, Arlington, VA 22202, USA. mfisher@rand.org
authors.forename: Michael P
authors.initials: MP
authors.lastname: Fisher
authors.forename: Rajeev
authors.initials: R
authors.lastname: Ramchand
authors.forename: Sarah
authors.initials: S
authors.lastname: Bana
authors.forename: Martin Y
authors.initials: MY
authors.lastname: Iguchi
mesh_terms: D000328:Adult; D001727:Bisexuality; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000453:epidemiology*; D006693:Holidays; D018451:Homosexuality, Male; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012309:Risk-Taking; D012650:Self Disclosure; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014342:Truth Disclosure; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult