Episodic Analysis of Illicit Drug Use and Sexual Risk Taking in YMSM Ages 13-29 in NYC

Background: HIV rates continue to rise for young men who have sex with men (YMSM) in NYC. An episodic analysis of unprotected sexual behaviors during the last two sexual encounters offers an opportunity to explore the role of illicit substance use in the HIV epidemic. Methods: Cross-sectional data were collected from 558 13-29 year old YMSM in NYC, utilizing hand held palm devices. Results: 558 participants, 40.1% (n = 224) had used marijuana, 14.2% (n = 79) had used powder cocaine, 12.4% (n = 69) had used nitrite inhalants, and 7.5% (n = 42) reported having used ecstasy in the previous 3-months. Tetrachoric correlations were computed for sexual behaviors in each episode with a casual partner and use of illicit drugs. In episode 1 unproteced receptive anal intercourse was related to nitrite inhalant use (φ = .16, p < .01) and party drug (cocaine and ecstasy) use (φ = .16, p < .01). Multivariate analyses suggest a greater likelihood of engagement in receptive anal intercourse among Black and API YMSM as compared to White men. Conclusions: Overall rates of illicit substance use appear low in YMSM, however, there is a significant association between use of cocaine, ecstasy and inhalant nitrates, and sexual risk taking. The analysis indicates that while a contributing factor to the rising HIV rates, substance use may not in fact be a primary reason for the increased rates of HIV infection.