Substance use as a predictor of sexual risk behavior in ethnic minority HIV positive men who have sex with men in New York City

Background:

Recent research has suggested that methamphetamine use is prevalent among younger MSM, while crack usage among Black men of low socioeconomic status (SES) continues to rise. Few studies aim to understand the relationship between sexual risk behavior and drug use at the situational level. The current study examines whether crack, inhalant, and methamphetamine use predicts unprotected anal intercourse (UAI) during sexual episodes in a sample of MSM.

Methods:

Data were collected from a sample of 150 primarily Black and Latino HIV-positive MSM living in New York City over a six-week period. Participants were asked to specify whether they had used condoms in their last sexual episode. Drug use items evaluated the type and amount of drugs used on a weekly basis and during individual sexual episodes. Logistic regression was conducted to examine the relationship between drug use and sexual risk behavior at the episode level.

Results:

The use of crack and inhalants during sexual episodes predicted UAI among men in the sample. This relationship was mediated by age and race; young and Black men participated in more UAI than older men and men of other races. Methamphetamine use did not predict UAI in this sample.

Conclusion:

The use of crack and inhalants during sex may increase the risk of UAI for MSM, especially young Black men. In contrast to previous studies, methamphetamine use did not predict UAI at the situational level of analysis. Further research into the young black demographic must be implemented to confirm these relationships.