142nd APHA Annual Meeting and Exposition

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Substance Use Patterns and Sexual Agreements among Same-Sex Male HIV Serodiscordant Couples

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014

Kristi Gamarel, PhD , Department of Medicine, Brown University, Providence, RI
Sarah Woolf-King, PhD , Center for AIDS Prevention Studies, University of California at San Francisco, San Francisco, CA
Torsten Neilands, PhD , Center for AIDS Prevention Studies, University of California at San Francisco, San Francisco, CA
Mallory Johnson, Ph.D. , Center for AIDS Prevention Studies, University of California at San Francisco, San Francisco, CA
Background: Agreements about sex with outside partners are common and can be protective among male couples, and discrepancies in these agreements can be indicative of HIV risk. Substance use has been associated with sexual risk behavior. Also, differences in substance use between partners have been linked with poor health outcomes. This study examined how substance use patterns were associated with being in a monogamous, open, or discrepant sexual agreement among serodiscordant male couples.

Methods: HIV-positive men and their HIV-negative partners (N= 117 couples, 234 men) were surveyed. A multinomial logistic regression model examined associations between each partner’s AUDIT alcohol screening, stimulant use, and couple's substance use difference scores with the couple's sexual agreement type, adjusting for depressive symptoms, communication, relationship duration, and time since HIV diagnosis.

Results: Participants' mean age was 46.70; 38.4% were racial/ethnic minority; and 40% earned less than $20,000 annually. In total, 31.6% of couples reported a monogamous agreement, 26.5% open, and 41.0 % discrepant agreements. HIV-positive partners’ stimulant use and higher alcohol use scores were associated with reporting a discrepant, compared to an open agreement (p<0.05). Higher couple alcohol use difference scores were associated with being in a discrepant, compared to open agreement (p<0.05).  

Discussion: Substance use is associated with a discrepant sexual agreement for gay couples. Differences in alcohol use between partners are associated with a discrepant sexual agreement. Examining how alcohol and use of other substances impacts sexual communication and agreements represent an important area for future research and intervention with male couples.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Assess how stimulant use and alcohol use is associated with sexual agreement within same-sex male couples in serodiscordant relationships. Identify and examine the associations of couples' differences in substance use are associated with sexual agreements within serodiscordant same-sex male couples, and to consider their unique roles in couples-based HIV prevention.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceptualized the project and conducted all analyses.
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: 5057.0: Substance Use and HIV/AIDS