GENDER, SEXUALITY, AND ETHNICITY AS FACTORS OF CLUB DRUG USE AMONG ASIAN AMERICANS

Racial/Ethnic Disparities in Club Drug Use, Situational Club Drug Use during Sex, and Sexual Risk Behaviors among Alcohol-Using Men Who Have Sex with Men (MSM) in San Francisco

BACKGROUND

Club drug use-including 3,4-Methylenedioxymethamphetamine, ketamine, crack/cocaine, hallucinogens, gamma hydroxybutyrate, volatile nitrites, and methamphetamine-has been linked to sexual risk behaviors among MSM. Few studies examine how the use of club drugs and the association between club drug use during sex and sexual risk may differ by race/ethnicity.

METHODS

Using data from a cross-sectional study among alcohol-using MSM in San Francisco (n = 252), we examined the associations between the interaction of race/ethnicity and club drug use during sex, and the following behavioral outcomes: any condomless anal intercourse (CAI), insertive CAI, receptive CAI, and any serodiscordant sex in the past six months. All models controlled for income, HIV status, relationship status, age, and current use of a biomedical HIV prevention tool (i.e., Pre-Exposure Prophylaxis [PrEP] or antiretroviral therapy).

RESULTS

There were significant racial differences in club drug use (p < 0.001) and club drug use during sex (p = 0.01). Asian/Pacific Islander (API) and Latino participants reported using club drugs the most at 78.8% and 79%, respectively. Among users of club drugs, club drug use during sex was most common among Black (100%), and Latino MSM (93%). Significant interactions between race/ethnicity and club drug use during sex were observed for CAI (p = 0.02), insertive CAI (p = 0.01), and receptive CAI (p = 0.01). API participants who used club drug during sex had higher odds of reporting CAI (aOR = 15.27, CI = 1.50-155.34), insertive CAI (aOR = 21.11, CI = 2.04-218.10), and receptive CAI (aOR = 21.11, CI = 2.04-218.10).

CONCLUSIONS

Given the differing rates of club drug use during sex by race/ethnicity and the role race/ethnicity plays in modifying the relationships between club drug use during sex and sexual risk behaviors, culturally-tailored interventions may be needed to address the needs of ethnically-diverse, club drug-using MSM.

A narrative review of the biopsychosocial and health characteristics of Asian Indians in the United States: Clinical and research implications for neuropsychological functioning

Objective: The prevailing scientific literature aggregates Asians living in America into one omnibus category and thus can problematically result in a subpar and at times inaccurate understanding of health, social and cultural factors necessary for competent and informed medical care. Method: A literature search was conducted by cultural experts familiar with Asian Indian culture with a focus on immigrants from this community living in the US. Database using search engines was sought in the following domains: immigration patterns, prevalence for key medical and neurological conditions commonly associated with cognitive dysfunction, psychiatric/psychological needs in the community, some preliminary neuropsychological testing considerations while working with this community, and treatment considerations that could affect adherence and efficacy of outcomes. Articles were selected from 2000 to the most recent date, with emphasis on compiling information from review papers and meta-analysis from the past decade. Conclusions: Asian Indians living in the US are distinct from the larger Asian American community. Immigration trends underscore that Asian Indians have a bimodal distribution of wealth. Regarding medical conditions, a key and highly concerning finding is the higher prevalence of cardiovascular risk factors, especially in young males. The lack of non-existent cognitive data in this community is glaring and should serve as an impetus for conducting high-priority research in this community. Preliminary neuropsychological testing considerations are discussed from a practical perspective with emphasis on multilingualism and region of origin. Finally, treatment considerations include understanding attitudes and beliefs regarding traditional medicine.

Uso de club drugs entre estudantes de graduação: prevalência, características associadas e a influência dos pares

RESUMO Objetivo Medir a prevalência do uso na vida, no último ano e no último mês de duas club drugs – o ecstasy e o LSD –, bem como as características associadas ao uso dessas substâncias, no último mês, entre estudantes de graduação de uma universidade no Sul do Brasil. Métodos Trata-se de um estudo transversal conduzido no ano de 2015 com amostragem aleatória sistemática por conglomerados. Participaram 1.423 estudantes de graduação. Foi utilizado um modelo de análise multivariável em três níveis hierárquicos por meio da regressão de Poisson com ajuste robusto da variância. Resultados As prevalências de uso na vida, no último ano e no último mês de club drugs foram de 12,7%, 7,8% e 3,8%, respectivamente. Indivíduos do sexo masculino, com orientação sexual homossexual ou bissexual, mais jovens, que moravam com seus pares, solteiros, e que relataram uso no último mês de tabaco e maconha apresentaram maior probabilidade de ter feito uso no último mês de alguma club drug. Entretanto, a variável mais fortemente associada a esse desfecho foi ter algum amigo que já fez uso de alguma droga ilícita na vida (RP = 19,54). Conclusões O ambiente universitário parece ser um terreno fértil para a difusão do uso de club drugs. O fortalecimento de uma rede de apoio institucional da universidade, capaz de propor atividades de prevenção, bem como de identificar, acolher e encaminhar casos em que haja abuso e dependência dessas substâncias, pode ser uma estratégia importante para lidar com essa problemática.

Substance use, gender, and generation status among Asian Indians in the United States

This study examined substance use (cigarette, alcohol, and illicit drug) among first- and second-generation Asian Indian women and men (n = 1,209; ages 18-34) living in the United States. Participants reported low rates of substance use compared to national averages. First-generation participants reported lower rates of substance use. Men were more likely to have used alcohol and tried cigarettes. Within the first generation, gender differences were only significant for alcohol, but within the second generation, gender differences were significant for all three substances. The findings support the resiliency of immigrants and highlight gender differences that occur among second-generation participants.

A Synthesis of 20 Years of Research on Sexual Risk Taking Among Asian/Pacific Islander Men Who Have Sex With Men in Western Countries

Over the past two decades, there has emerged a body of literature documenting a number of risk factors associated with Asian/Pacific Islander men who have sex with men's unsafe sexual behaviors. This study aims to systematically review existing empirical studies and synthesize research results into a social-ecological framework using a mixed research synthesis. Empirical research articles published in peer-reviewed journals between January 1990 and June 2013 were identified in six databases, including PubMed, Ovid MEDLINE, PsycINFO, Social Work Abstract, CINAL, and Web of Knowledge. Both quantitative and qualitative studies were included. Two analysts independently reviewed the articles, and findings were organized on a social-ecological framework. Twenty-two articles were included in the analysis; among these 13 were quantitative, 8 were qualitative, and 1 was mixed-methods research. Results indicated that demographic characteristics, psychological resources, behavioral patterns, relationships with family and friends, dynamics with romantic or sexual partners, community involvement, culture, discrimination, and institutional factors were related to unprotected anal intercourse. This article presents a critique of this literature and discusses implications for future research with this population. It concludes with prevention/intervention initiatives based on review findings.

"A cool little buzz": alcohol intoxication in the dance club scene

In recent years, there has been increasing concern about youthful "binge" drinking and intoxication. Yet the meaning of intoxication remains under-theorized. This paper examines intoxication in a young adult nightlife scene, using data from a 2005-2008 National Institute on Drug Abuse-funded project on Asian American youth and nightlife. Analyzing in-depth qualitative interview data with 250 Asian American young adults in the San Francisco area, we examine their narratives about alcohol intoxication with respect to sociability, stress, and fun, and their navigation of the fine line between being "buzzed" and being "wasted." Finally, limitations of the study and directions for future research are noted.

Consumption, drugs and style: Constructing intra-ethnic boundaries in Asian American youth cultures

Based on 250 qualitative interviews with Asian American young men and women in the dance/club scenes in the San Francisco area, we examine the interplay between consumption, style and taste cultures with issues of ethnic identity, gender and acculturation. We explore the ways that consumption and taste markers (e.g. fashion, cars, music and drugs) are used to establish or negotiate symbolic boundaries between groups in this youth culture. The picture they paint of the dance scene is one less about cohesiveness and unity and more about divisions and boundaries, not only between but also significantly within ethnic groupings. The choice of drugs and ways of exhibiting intoxication are among the types of consumption that the young people drew upon to mark symbolic boundaries and establish identities. The young men and women in this study discuss a number of key boundaries in the scene, e.g. between FOBs and twinkies, between pretty boys and thugs, as they attempt to establish the cultural legitimacy of their own styles of Asian American identities.

Embarking on large-scale qualitative research: reaping the benefits of mixed methods in studying youth, clubs and drugs

Qualitative research is often conceptualized as inherently small-scale research, primarily conducted by a lone researcher enmeshed in extensive and long-term fieldwork or involving in-depth interviews with a small sample of 20 to 30 participants. In the study of illicit drugs, traditionally this has often been in the form of ethnographies of drug-using subcultures. Such small-scale projects have produced important interpretive scholarship that focuses on the culture and meaning of drug use in situated, embodied contexts. Larger-scale projects are often assumed to be solely the domain of quantitative researchers, using formalistic survey methods and descriptive or explanatory models.In this paper, however, we will discuss qualitative research done on a comparatively larger scale-with in-depth qualitative interviews with hundreds of young drug users. Although this work incorporates some quantitative elements into the design, data collection, and analysis, the qualitative dimension and approach has nevertheless remained central. Larger-scale qualitative research shares some of the challenges and promises of smaller-scale qualitative work including understanding drug consumption from an emic perspective, locating hard-to-reach populations, developing rapport with respondents, generating thick descriptions and a rich analysis, and examining the wider socio-cultural context as a central feature. However, there are additional challenges specific to the scale of qualitative research, which include data management, data overload and problems of handling large-scale data sets, time constraints in coding and analyzing data, and personnel issues including training, organizing and mentoring large research teams. Yet large samples can prove to be essential for enabling researchers to conduct comparative research, whether that be cross-national research within a wider European perspective undertaken by different teams or cross-cultural research looking at internal divisions and differences within diverse communities and cultures.