Comparison of substance use and risky sexual behavior among a diverse sample of urban, HIV-positive men who have sex with men.
Comparison of substance use and risky sexual behavior among a diverse sample of urban, HIV-positive men who have sex with men.
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DOI：
10.1080/10550880903014726
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发表时间：
2009-07
影响因子：
2.3
通讯作者：
Simon Rosser BR
中科院分区：
文献类型：
--
作者：
Hatfield LA;Horvath KJ;Jacoby SM;Simon Rosser BR
测量艾滋病毒阳性男男性行为者（MSM）各种族和族裔亚组的物质使用情况，模拟药物使用与不安全性行为之间的关联，并描述与危险性行为最密切相关的物质使用者的特征。积极联系行为干预试验干预前时间点横断面调查。生活在美国六个城市的与男性发生性行为的有色人种hiv阳性男性。675名试验参与者。自我报告的药物和酒精使用以及性行为。我们发现，在这个样本中，药物使用的患病率很高，而且在种族和民族群体中存在差异。与西班牙裔、非裔美国人和其他或混合种族/民族的男性相比，白人男性最有可能在肛交中使用兴奋剂（30%）、甲基苯丙胺（27%）和亚硝酸盐戊酯吸入剂（“poppers”，46%）。非裔美国男性吸食快克/可卡因的比例在四组中最高（38%）。虽然许多药物单独与血清不一致无保护肛交（SDUAI）相关，但在多变量模型中只保留了酒精量和与性行为相关的popers。更频繁地使用罂粟花与更多报告的SDUAI实例相关，并根据增加的肛交进行调整。使用罂粟花的男性更有可能是白人，受教育程度更高，收入略高于不使用罂粟花的男性。Poppers使用者还报告说，使用避孕套的同伴规范和自我效能较低。在包含这些心理社会因素的多元逻辑回归模型中，只有避孕套使用（与未使用相比OR = 2.46, CI: 1.55, 3.94）和避孕套自我效能（在量表上OR = 0.58， CI: 1 sd增加）。46岁。73)与SDUAI显著相关。这些结果来自大量艾滋病毒阳性的有色男男性行为者样本，强调了与性行为一起使用的药物对艾滋病毒传播的重要性。
To measure substance use across racial and ethnic subgroups of HIV-positive men who have sex with men (MSM), model associations between drug use and unsafe sex, and characterize users of the substances most strongly associated with risky sexual behavior. Cross-sectional survey at the pre-intervention time point of the Positive Connections behavioral intervention trial. HIV-positive men of color who have sex with men living in six US cities. 675 trial participants. Self-reported drug and alcohol use and sexual behaviors. We found high prevalence of substance use in this sample, with differences across racial and ethnic groups. Compared to Hispanic, African America, and men of other or mixed races/ethnicities, Caucasian men were most likely to report use of stimulants (30%), methamphetamines (27%), and amyl nitrite inhalants (“poppers”, 46%) with anal sex. African American men reported crack/cocaine use in the highest proportion (38%) among the four groups. While many drugs were individually associated with serodiscordant unprotected anal intercourse (SDUAI), only alcohol quantity and poppers with sex were retained in a multivariate model. More frequent poppers use was associated with more reported instances of SDUAI, adjusted for increased anal sex. Men who used poppers were more likely to be white, have completed more education, and have slightly higher income than non-users. Poppers users also reported lower peer norms and self-efficacy for condom use. In a multiple logistic regression model including these psychosocial factors, only poppers use (vs non-use OR = 2.46, CI: 1.55, 3.94) and condom self-efficacy (1 sd increase on scale OR = .58, CI: .46, .73) were significantly associated with SDUAI. These results, from a large sample of HIV-positive MSM of color, highlight the HIV transmission importance of drugs used specifically in conjunction with sex.