title: HIV risk among substance-using men who have sex with men and women (MSMW): findings from South Florida.
abstract: Compared with men who have sex with men only (MSMO), men who have sex with men and women (MSMW) consistently report higher rates of two HIV risk behaviors: transactional sex (TS) and concurrent substance use and sex (CSS). Within MSMW, little is known about how synergistic epidemics ("syndemics") affect TS and CSS. Using a sample of substance-using MSM (n = 515) in South Florida, we compared TS and CSS among MSMO and MSMW; examined whether, within MSMW (n = 86), TS and CSS predict unprotected anal intercourse with partners of serodiscordant/unknown HIV status (SU-UAI); and tested whether syndemics predict TS and CSS. MSMW reported higher rates of engaging in both TS and CSS (AOR = 1.7; 95 % CI 1.0-3.0). Within MSMW, engagement in both TS and CSS predicted SU-UAI (AOR = 3.3; 95 % CI 1.2-9.6); and syndemics predicted TS and CSS involvement (p < 0.01). Substance-using MSMW may benefit from interventions targeting TS, CSS, and background syndemics.
authors: Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, P.O. Box 7319, Pittsburgh, PA, 15213, USA, mrf9@pitt.edu.
authors: M Reuel
authors: MR
authors: Friedman
authors: Steven P
authors: SP
authors: Kurtz
authors: Mance E
authors: ME
authors: Buttram
authors: Chongyi
authors: C
authors: Wei
authors: Anthony J
authors: AJ
authors: Silvestre
authors: Ron
authors: R
authors: Stall
mesh_terms: D000328:Adult; D001727:Bisexuality; D005260:Female; D005431:Florida / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D006301:Health Services Needs and Demand; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*
references: J Pers Assess. 1994 Jun;62(3):385-97
references: 8027907
references: MMWR Morb Mortal Wkly Rep. 2010 Sep 24;59(37):1201-7
references: 20864920
references: Am J Public Health. 2009 Jun;99(6):1072-8
references: 19372509
references: Sex Transm Dis. 2006 Oct;33(10):585-93
references: 16641826
references: J Community Health. 2013 Feb;38(1):62-9
references: 22752575
references: Am J Community Psychol. 2003 Jun;31(3-4):281-91
references: 12866685
references: Am J Public Health. 2011 Aug;101(8):1481-94
references: 21680921
references: Pediatrics. 2010 Nov;126(5):879-86
references: 20974791
references: AIDS Behav. 2011 Apr;15(3):576-83
references: 19572194
references: Med Anthropol Q. 2000 Sep;14(3):374-93
references: 11036584
references: AIDS Care. 1999 Dec;11(6):629-48
references: 10716005
references: J Urban Health. 2009 Jul;86 Suppl 1:63-76
references: 19543837
references: Am J Public Health. 2003 Jun;93(6):939-42
references: 12773359
references: Psychol Bull. 2003 Sep;129(5):674-697
references: 12956539
references: J Acquir Immune Defic Syndr. 2007 Nov 1;46 Suppl 2:S80-7
references: 18089988
references: Arch Sex Behav. 2008 Oct;37(5):748-62
references: 18546069
references: J Sex Res. 2007 Aug;44(3):278-89
references: 17879171
references: Arch Sex Behav. 2008 Oct;37(5):697-707
references: 18509753
references: Arch Sex Behav. 2011 Aug;40(4):793-801
references: 21203813
references: Med Anthropol Q. 2003 Dec;17(4):423-41
references: 14716917
references: Am J Public Health. 2013 Jan;103(1):79-85
references: 23153154
references: Am J Public Health. 2002 Feb;92(2):203-10
references: 11818292
references: Am J Public Health. 2010 Mar;100(3):496-502
references: 20075326
references: Am J Public Health. 2012 Jan;102(1):156-62
references: 22095358
references: J Acquir Immune Defic Syndr. 2009 Jul 1;51(3):349-55
references: 19387357
references: Sex Transm Dis. 2006 Jul;33(7 Suppl):S11-6
references: 16614589
references: AIDS Educ Prev. 2012 Jun;24(3):193-205
references: 22676460
references: J Urban Health. 2012 Aug;89(4):697-708
references: 22383094
references: Cult Health Sex. 2012 Oct;14(9):1095-110
references: 22978551
references: Am J Public Health. 2002 Feb;92(2):198-202
references: 11818291
references: J Natl Med Assoc. 2005 Jul;97(7 Suppl):52S-59S
references: 16080458
references: J Urban Health. 2009 Jul;86 Suppl 1:77-92
references: 19526346
references: J Urban Health. 2009 Jul;86 Suppl 1:48-62
references: 19513854