HIV RISK AND CLUB DRUGS AMONG MSM--A TWO CITY COMPARISON

吸毒的男男性行为者（MSM）属于高危人群。 主要的危险行为包括无保护的性活动和使用注射和非注射药物。这些危险的做法令人关切，因为它们占现有艾滋病毒感染病例的如此之多，最近的流行病学证据表明，吸毒是男男性行为者艾滋病毒血清转化的原因。 特别令人关切的是，越来越多的报告称，在男男性行为者的社交场所，注射和非注射使用“俱乐部毒品”。 俱乐部毒品包括一些以前研究过的物质，如甲基苯丙胺和吸入性亚硝酸盐，以及一些相对较新的、尚未研究过的物质，如氯胺酮和摇头丸。 这四种药物在同性恋酒吧、性俱乐部和浴室都很容易买到，并且与注射和性风险行为有关。然而，对这些药物中的任何一种的研究都非常有限，并且没有研究检查它们之间的相互关系，它们的使用方式和频率，以及它们与MSM中高风险性活动的特定关系。 了解的社会，生态和心理因素，定位MSM在潜在的风险充满毒品和性交易是至关重要的，既获得流行病学的了解MSM人群和制定可操作的预防和服务建议的MSM。 使用对比的MSM人群和环境在波士顿和纽约，本研究将描述人口的男性与男性发生性关系和使用俱乐部药物，包括人口特征，流行的药物和性风险行为，并参与高风险设置和社交网络。 研究将分三个阶段进行。 在第一阶段，社区评估过程将确定这两个城市的场地，并提供MSM参与的环境和社会群体的基础。 在第二阶段，为期一年的民族志研究的150男男性接触者将采用参与观察和深入的半结构化访谈，以文件的模式开始进入毒品和性风险行为，参与高风险的性和毒品社交网络，以及与艾滋病和毒品和性风险行为相关的悲伤和损失的经验之间的关系。 最后，在第三阶段，使用基于场地的概率抽样策略，调查工具将管理900男男性接触者（450在每个城市），以制定估计流行的俱乐部药物使用的男性参加抽样场地，并记录相关的药物使用和药物之间的关系和性风险行为的男男性接触者人群。

Men who have sex with men (MSM) who use drugs are a high-risk population. Major risk behaviors include unprotected sexual activity and the use of both injected and non-injected drugs. These risk practices are of concern because they account for so many of the existing cases of HIV infection and recent epidemiological evidence implicates drug abuse in HIV seroconversion among MSM. Of particular concern are increasing reports of both injected and non-injected use of "club drugs" in MSM social venues. Club drugs include a number of previously studied substances such as methamphetamine and inhaled nitrites, as well as a number of relatively new and as yet unexamined substances such as ketamine and MDMA. All four drugs are widely available in gay bars, sex clubs, and bathhouses, and have been associated with both injection and sexual risk practices. However, research on any one of these drugs is quite limited and there have been no studies which examine the interrelationship between them, the mode and frequency of their use, and their specific relationship to high risk sexual activity among MSM. An understanding of the social, ecological and psychological factors that position MSM in potentially risk-laden drug and sexual transactions is essential to both acquiring an epidemiological understanding of the MSM population and the formulation of actionable prevention and service recommendation for MSMs. Using the contrasting MSM populations and environments in Boston and New York, this study will describe the population of men who have sex with men and use club drugs, including demographic characteristics, prevalence of drug and sexual risk behaviors, and involvement in high risk settings and social networks. The study will be conducted in three phases. In Phase I, a Community Assessment Process will identify venues in both cities and provide grounding in the environments and social groups in which MSM participate. In Phase II, a year-long ethnographic study of 150 MSM will employ participant-observation and in-depth semi-structured interviews in order to document patterns of initiation into drug and sex risk behavior, involvement in high risk sex and drug social networks, and the relationship between experiences of grief and loss associated with AIDS and drug and sex risk behaviors. Finally, in Phase III, using a venue-based probability sampling strategy, a survey instrument will be administered to 900 MSM (450 in each city) in order to develop estimates of prevalence of club drug use among men attending the sampled venues, and document correlates of drug use and the relationship between drug and sexual risk behaviors in the MSM population.