Substance use and sexual risk: A participant- and episode-level analysis among a cohort of men who have sex with men
Substance use and sexual risk: A participant- and episode-level analysis among a cohort of men who have sex with men
复制标题
DOI：
10.1093/aje/kwh135
复制
发表时间：
2004-05-15
影响因子：
5
通讯作者：
Coates, TJ
中科院分区：
文献类型：
--
作者：
Colfax, G;Vittinghoff, E;Coates, TJ
先前的报告将使用物质使用与性风险行为相关联，通常使用了摘要措施，并且没有针对参与者的物质使用水平进行调整。在这项1999 - 2001年的美国研究（探索研究）中，作者确定了在最近的性事件中，性生活中的物质使用是否与性风险独立相关，正如4,295个与男性发生性关系的人类免疫缺陷病毒阴性男性所报道的那样。主要结果指标是血清旁的未受保护的肛交（SDUA）。通过使用重复测量的逻辑模型检查了参与者级特征的影响。在评估情节级预测因子对SDUA的影响时，通过使用条件逻辑回归来消除参与者级特征（包括6个月使用物质）的影响，实际上使每个参与者自己的控制。作者还调整了合作伙伴特征。 11％的参与者报告了大量饮酒，37％的使用者使用了poppers，19％的可卡因和13％的使用苯丙胺。在参与者级别的分析中，使用Poppers，苯丙胺和可卡因的使用以及在前6个月中的大量饮酒与SDUA独立相关。在有条件的分析中，在性别之前或性交期间，大于或等于6含酒精的饮料或使用Poppers，Amphetamine或嗅探可卡因的消费与SDUA独立相关。作者得出的结论是，旨在防止人类免疫缺陷病毒传播的计划应强调性药物在性别中使用对增加风险行为的影响。
Prior reports associating substance use with sexual risk behavior have generally used summary measures and have not adjusted for participants' background levels of substance use. In this 1999-2001 US study (the EXPLORE study), the authors determined whether substance use during sex was independently associated with sexual risk during recent sexual episodes, as reported by 4,295 human immunodeficiency virus-negative men who have sex with men. The main outcome measure was serodiscordant unprotected anal sex (SDUA). The influence of participant-level characteristics was examined by using repeated-measures logistic models. In assessing the influence of episode-level predictors on SDUA, the influence of participant-level characteristics, including 6-month substance use, was removed by using conditional logistic regression, in effect making each participant his own control. The authors also adjusted for partner characteristics. Eleven percent of participants reported heavy alcohol use, 37% used poppers, 19% sniffed cocaine, and 13% used amphetamines. In the participant-level analysis, use of poppers, amphetamines, and sniffed cocaine as well as heavy alcohol use in the prior 6 months were independently associated with SDUA. In the conditional analysis, consumption of greater than or equal to6 alcoholic drinks or use of poppers, amphetamines, or sniffed cocaine just before or during sex was independently associated with SDUA. The authors concluded that programs aimed at preventing human immunodeficiency virus transmission should emphasize the influence of substance use during sex on increased risk behavior.