Individual-Level and Event-Level Associations Between Substance Use and Sexual Risk Behavior Among Gay and Bisexual Men
Methods: We recruited a diverse sample of 375 highly sexually active (≥ 9 partners in 90 days) gay and bisexual men, aged 18-73 (M=36.9), who completed a retrospective timeline follow-back (TLFB) interview followed by 30 days of a prospective, online daily diary. Aggregated substance use frequency (TLFB) was entered it into multilevel models along with day-level substance use to predict daily sexual behavior, adjusting for HIV and relationship status.
Results: In the model predicting having any sexual activity, marijuana (AOR=0.99, p=.001), club drugs (AOR=0.98, p<.001), and heavy drinking (AOR=0.99, p=.056) frequency were associated with decreased odds of engaging in sex, while marijuana (AOR=1.78, p<.001), club drugs (AOR=3.36, p<.001), and heavy drinking (AOR=1.99, p<.001) on a given day increased the odds of sexual activity. In the model predicting unprotected anal intercourse (UAI) on sex days, marijuana (AOR=0.98, p=.001) and heavy drinking (AOR=0.98, p<.05) frequency were associated with decreased odds of UAI, while club drugs (AOR=1.84, p=.009) and heavy drinking (AOR=1.65, p=.003) on a given day increased the odds of UAI.
Conclusions: When examined simultaneously, individual-level patterns of substance use and event-level substance use on a given day have opposite effects on sexual behaviors. These findings suggest that frequency may be suggestive of interference with sexual pursuits, while event-level use may indicate impairment in decision-making.
Learning Areas:Public health or related research
Social and behavioral sciences
Differentiate individual-level and event-level mechanisms for investigating substance use and sexual risk. Explain distinct contributions of individual-level and event-level substance use on sexual risk.
Keyword(s): Sexual Risk Behavior, Drug Abuse
Qualified on the content I am responsible for because: I have been conducting research on substance use and sexual risk among gay and bisexual men for more than 8 years. I have held a National Institute of Mental Health NRSA Predoctoral Fellowship and have more than 15 publications in the area.
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.