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Substance Use, Substance Choice, and Unprotected Sex among Young AsianPacific Islander API Men Who H

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Methylenedioxymethamphetamine ('ecstasy') 19. Marijuana 14. Inhalant nitrites ... Use of ecstasy and poppers during sex was related to having unprotected anal ... – PowerPoint PPT presentation

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Title: Substance Use, Substance Choice, and Unprotected Sex among Young AsianPacific Islander API Men Who H


1
Substance Use, Substance Choice, and Unprotected
Sex among Young Asian/Pacific Islander (API)Men
Who Have Sex with Men (MSM)
  • Kyung-Hee Choi,1 Don Operario,2 Steven
    Gregorich,1 Willi McFarland 3
  • 1Center for AIDS Prevention Studies, University
    of California, San Francisco
  • 2Oxford University, UK
  • 3San Francisco Department of Public Health, San
    Francisco

UC
SF
University of California San Francisco
2
  • Background
  • Substance use is highly prevalent among young API
    MSM.
  • Sex under the influence of one or more substances
    has been shown to be the most powerful predictor
    of having unprotected anal intercourse (UAI)
    among API MSM.
  • However, little is known about which substances
    are used in conjunction with sexual activity and
    whether having UAI varies by substance choice in
    this population.

3
  • Research Questions
  • What substances are used during sex?
  • What substances used during sex are associated
    with having UAI?

4
  • Research Methods
  • From January 2000 to September 2001, we sampled
    API MSM aged 18 to 29 years from 30 randomly
    selected MSM-identified venues in San Francisco.
  • We interviewed 496 participants face-to-face
    using a standardized questionnaire.

5
Sample Characteristics ()
  • Ethnicity Sexual orientation
  • Chinese 27 Gay
    82
  • Filipino 28 Bisexual
    13
  • Vietnamese 16 Other
    5
  • Other 29
  • Frequency of bar/club attendance, 6
    months Once a month or less 26
  • Age (mean, 24) 2-3 times a month
    26
  • 18-24 years 49 Once a week 29
  • 25-29 years 51 More than once a week
    19
  • US born 30 Circuit party attendance,
    lifetime 20
  • Education
  • no college 17
  • some college 33
  • college graduate 50

6
Sexual Behaviors, 6 months
  • Median number of male sex partners 2 (range 0 -
    100)
  • Had a steady partner 72
  • Had a non-steady partner 61
  • Had an exchange partner 4
  • Had unprotected anal intercourse 47

7
Substances Used during Sex, Six Months
() Alcohol 32 Any drug
34 Methylenedioxymethamphetamine
(ecstasy) 19 Marijuana

14 Inhalant nitrites ("poppers")
11 Crystal
methamphetamine (crystal)
10 Gamma-hydroxybutyrate (GHB)
9 Ketamine (Special K)
5
Powder or crack cocaine
3 Methamphetamine other than
crystal or cocaine 1 Lysergic acid
diethylamide (LSD) 1
Downers or other barbiturates

0
8
Correlates of Unprotected Anal Sex, Six
MonthsResults of Multivariate Analysis
  • Adjusted Odds Ratio (95 CI)
  • High or buzzed on alcohol during sex 1.40
    (0.89, 2.22)
  • High or buzzed on marijuana during sex 0.81
    (0.43, 1.53)
  • High or buzzed on ecstasy during sex 2.62
    (1.37, 5.02)
  • High or buzzed on GHB during sex 0.90 (0.37,
    2.22)
  • High or buzzed on poppers during sex 3.29
    (1.50, 7.25)
  • High or buzzed on crystal during sex 1.68
    (0.73, 3.83)
  • Controlled for age, ethnicity, education, birth
    place, sexual orientation, frequency of bar/club
    attendance, circuit party attendance, and number
    and types of sexual partners.
  • A reference group is those who did not report
    using the specified drug.
  • p

9
Conclusions
  • One third of young API MSM in San Francisco use
    drugs or alcohol during sex.
  • Use of ecstasy and poppers during sex was related
    to having unprotected anal intercourse among
    these API men.
  • This result underscores the need to develop HIV
    prevention programs focusing on particular drugs
    associated with sex for young API MSM.

10
Limitations
  • Because this study used a cross-sectional design,
    we cannot make any inferences about temporal
    order between substance use and sex, nor can we
    assert any causal claims between substance use
    and sex.
  • The venue-based sampling method favored
    recruitment of men who frequent MSM venues more
    often, which may have biased our findings by
    overestimating the frequency of alcohol and drug
    use.

11
Directions for Future Research
  • Qualitative research should explore individual
    motivations and social contexts with the use of
    specific substances and high risk sex among young
    API MSM who use alcohol and drugs.
  • Research should inquire about discrete HIV risk
    episodes to examine for the presence, sequence,
    and possible pathways linking substance use and
    sexual behavior.
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