Understanding changing relationships between substance use and sexual risk behavior among MSM in Chicago: 1997 vs. 2003

We compared patterns of potentially high risk sexual behavior and their association with reported patterns of heavy drinking, use of inhalants, ecstasy, and other drugs during the past six months in two household probability samples of men who have sex with men (MSM). Samples were drawn from the City of Chicago for two different studies conducted five years apart: the Urban Men's Health Study (n= 414; UMHS; 1996-1997) and the MSM Supplement (n= 216; 2002-2003). We found that reports of unprotected insertive or receptive anal intercourse were more prevalent in the MSM Supplement. We investigated whether those who reported any encounters that involved unprotected insertive or receptive anal intercourse or those who reported exclusive non-condom use in these encounters were more likely to use substances in the past six months. Adjusted odds ratios and bonferroni corrected significance levels suggested that ecstasy use was significantly associated with increased risk behavior in both samples but that recent “other drug” use (a combined indicator of cocaine methamphetamine, psychedelic, sedative/tranquilizer and opiate use) was associated with increased risk behavior only in the UMHS. The measure of “other drug use” was associated with reduced odds of risk behavior in the MSM Supplement. Neither inhalant use nor heavy drinking were associated with elevated rates of risk behavior in either sample. Findings are discussed in light of substance abuse and HIV risk prevention strategies targeted to urban MSM.