title: Stimulant use patterns and HIV transmission risk among HIV-serodiscordant male couples.
abstract: BACKGROUND
  Substance use is strongly linked to HIV risk, and members of couples can have a powerful influence on each other's health behaviors. We examined whether couple-level patterns of stimulant use were differentially associated with engaging in condomless anal intercourse with primary partners and outside partners.
  
  
  METHODS
  Members of HIV serodiscordant male couples (N = 117 couples, 232 men) completed surveys, and HIV-positive men had blood drawn for viral load.
  
  
  RESULTS
  Results revealed that stimulant use by only one partner in the couple was associated with a decrease in the odds of engaging in condomless anal sex with one's primary partner (AOR = 0.09, 95% CI: 0.01, 0.89). When both partners reported stimulant use, the HIV-negative partner had an increase in the odds of condomless sex with outside partners (AOR = 6.68, 95% CI: 1.09, 8.01).
  
  
  CONCLUSIONS
  Understanding the role of couples' stimulant use patterns in HIV transmission risk is an important area for future research and intervention.
authors.affiliation: *Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI; Departments of †Medicine; and ‡Nursing, University of California, San Francisco, San Francisco, CA.
authors.forename: Kristi E
authors.initials: KE
authors.lastname: Gamarel
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Woolf-King
authors.forename: Adam W
authors.initials: AW
authors.lastname: Carrico
authors.forename: Torsten B
authors.initials: TB
authors.lastname: Neilands
authors.forename: Mallory O
authors.initials: MO
authors.lastname: Johnson
mesh_terms: D000328:Adult; D003625:Data Collection; D005191:Family Characteristics; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000150:complications*; D019562:Viral Load