Stimulant Use and HIV Risk in Older Men Who Have Sex with Men: A Longitudinal Analysis of Risk and Resiliency Factors

Background: The negative consequences of stimulant use on mental and physical well being among men who have sex with me has been well established. However, there is a paucity of evidence in the extant scientific literature regarding the relationship of stimulant use and sexual risk taking behaviors among men who have sex with men (MSM) 50+ years of age particularly using individual longitudinal data.

Methods: This session will provide a systematic review of the scientific evidence regarding: 1) stimulant use among older adults in the general US population; and 2) stimulant use and sexual risk taking behaviors among MSM using data from the EXPLORE study and the Multicenter AIDS Cohort Study.

Results: Group-based trajectory analyses of data from these men over the study period yielded a four groups solution: consistent users (9.8%), men whose use increased (5.4%), men whose use declined (6.9%), and abstinent or rarely-using men (77.9%). There were significant differences between groups in terms of demographic, behavioral risk and HIV serostatus. Men who increased or decreased stimulant drug use over time reported congruent changes in sexual risk taking. The fact that sexual risk levels parallel stimulant drug use over time suggests that finding ways to lower rates of stimulant drug use among MSM could be a tool in HIV prevention.

Conclusions: Implications for intervention will be discussed, and consideration of deficit and resilient co-factors associated with substance use among this aging population of MSM will be explored.