266115 Developmental and Racial Differences in the Association between Substance Use and HIV Risk in Men Who Have Sex with Men Using in a Sexual Diary Study

Tuesday, October 30, 2012 : 1:15 PM - 1:30 PM

Michael E. Newcomb, MA , Department of Psychology, University of Illinois, Chicago, IL
Brian Mustanski, PhD , Department of Medical and Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
     
Background: Men who have sex with men (MSM) account for more than half of all new HIV/AIDS diagnoses in the United States each year, and within MSM there are substantial differences in incidence rates based on race and developmental cohort. Alcohol and substance use increase risk of unprotected sex in MSM, but very few empirical investigations have examined age and racial differences in these effects. Methods: Ethnically-diverse MSM (N=143) ages 16-40 (M=27.53, SD=7.33) completed a diary study of sexual behavior. Weekly diaries of sexual encounters and associated variables were completed for 12 weeks with 83.7% retention. Analyses were conducted using Hierarchical Linear Modeling. Results: Drinking before sex increased the odds of sexual risk (OR = 1.15, p < .01), and this relationship was stronger in younger MSM (OR=0.99, p<.05). Substance use before sex increased across the age span for all drug types. Across all MSM, any drug use (OR=1.24, p<.05), stimulant use (OR=1.40, p<.05), and polysubstance use (OR=1.20, p<.01) increased odds of sexual risk. Neither age nor race moderated these relationships, but there were substantial group differences in rates of substance use before sex. Latino MSM were more likely to use stimulants (OR=2.49, p<.05), club drugs (OR=2.70, p<.05), and multiple substances (ERR=1.96, p<.001), and while Black MSM were less likely to use stimulants (OR=0.27, p<.05). Conclusions: Analyses revealed several novel findings, including the moderating effect of age on drinking and sexual risk and the various group differences in substance use before sex. Implications for intervention will be discussed.

Learning Areas:
Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
1) Describe group differences (i.e., age and race) in the association between substance use and HIV risk in MSM. 2) Examine the incremental influence of multiple substances on HIV risk, including alcohol, stimulants, club drugs, and polysubstance use.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of a federally funded grant focusing on age and race differences in sexual risk behavior among men who have sex with men. I am broadly interested in lesbian, gay, bisexual and transgender (LGBT) health research, as well as the development of interventions to address mental and physical health disparities in this population.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4224.0: Substance Use and HIV Risk in MSM Across the Lifespan