Associations between Sociodemographic Characteristics and Sexual Risk Behaviors among Methamphetamine-using Men who Have Sex with Men |
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| Authors: | Cathy J. Reback Jesse B. Fletcher Dallas Swendeman |
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| Affiliation: | 1. Friends Research Institute, Inc., Los Angeles, California, USA;2. David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA;3. Center for HIV Identification, Prevention and Treatment Services, University of California, Los Angeles, California, USA;4. Center for HIV Identification, Prevention and Treatment Services, University of California, Los Angeles, California, USA |
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| Abstract: | Background: Methamphetamine-using men who have sex with men (MSM) exhibit elevated rates of HIV and STI prevalence, indicating increased engagement in sexual risk behaviors. Objectives: This analysis elucidates associations between participant sociodemographics (i.e., age, racial/ethnic identity, sexual identity, educational attainment, and HIV status) and sexual risk behaviors, particularly substance use before/during sex, and engagement in condomless anal intercourse (CAI) with casual, anonymous, and/or exchange male partners. Methods: From March 2014 through January 2016, 286 methamphetamine-using MSM enrolled in a technology-based study to reduce methamphetamine use and HIV sexual risk behaviors. A robustly estimated generalized structural equation model employing the negative binomial family and log link function (n = 282) tested the simultaneous associations between participant sociodemographics and engagement in HIV sexual risk behaviors. Results: Participants' racial/ethnic identity (χ2(6) = 43.5; p < 0.0001), HIV status (χ2(6) = 22.0; p = 0.0012), educational attainment level (χ2(6) = 13.8; p = 0.0322), and years of age (χ2(6) = 32.4; p < 0.0001) all influenced participants' engagement in substance use before/during sex and engagement in CAI. Methamphetamine (χ2(2) = 7.0; p = 0.0309) and marijuana (χ2(2) = 9.7; p = 0.0079) use before/during sex influenced participants' engagement in CAI with casual, anonymous, and exchange male partners. Conclusion: Results indicate the importance of intervention efforts focused on younger racial/ethnic minority MSM with fewer years of educational attainment, and provides evidence of the specific subpopulations of MSM at greatest risk of detrimental effects of illicit substance use. |
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| Keywords: | Men who have sex with men HIV substance use sexual risks |
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