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Orjiakor CT, Eze J, Chinweoke M, Ezenwa M, Orjiakor I, Onwujekwe O, Palamar J. A systematic review of actors, actions, and outcomes of community-based efforts to prevent or reduce methamphetamine use. ADDICTION RESEARCH & THEORY 2023; 31:335-344. [PMID: 37990720 PMCID: PMC10659144 DOI: 10.1080/16066359.2023.2167982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 01/09/2023] [Indexed: 11/23/2023]
Abstract
Background There has been an increase in methamphetamine use across the globe, despite widespread control of the drug, prevention, and treatment. Community-based approaches have proven effective in tackling diverse health-related challenges including substance use; however, little is known regarding community programs targeting methamphetamine use. We conducted a systematic literature review on community programs aimed at tackling the use of methamphetamine across the globe. Method Relevant literature from peer-reviewed and gray literature sources were systematically identified. A grid template was used to extract and synthesize findings from retrieved literature regarding themes of actors, actions, and outcomes related to identified programs. Results A total of 19 documents met our inclusion criteria. Some of the dominant actors in efforts to reduce methamphetamine use in communities were local councils, drug enforcement units, influential persons in the community, people who use or had used methamphetamine, business corporations, and already-existing health promoting platforms. Actions taken were typically education/awareness/information campaigns. Drug enforcement agencies appeared to make little gains when acting alone, and appeared to drive dealers and users underground. Many of the efforts made at the community level were alluded to be beneficial; however, it was difficult to quantify the impact of programs. Community-level efforts also tended to cascade to other drugs. Conclusion Community-based actors and actions are diverse and critical to the prevention of methamphetamine use. There is a need to better coordinate and integrate different actors and interventions so that outcomes can be better monitored and evaluated for greater effectiveness in reducing methamphetamine use.
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Affiliation(s)
- Charles T. Orjiakor
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu-Campus, Enugu, Nigeria
| | - John Eze
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
| | - Methodius Chinweoke
- Department of Health Administration and Management, University of Nigeria, Enugu-Campus, Enugu, Nigeria
| | - Michael Ezenwa
- Department of Psychology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Ijeoma Orjiakor
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu-Campus, Enugu, Nigeria
- Department of Social Work, University of Nigeria, Nsukka, Nigeria
| | - Joseph Palamar
- Department of Population Health, New York University Langone Medical Center, New York, NY, USA
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Neffa-Creech D, Plant A, Montoya JA, Oruga R, Kilgore EA, Fraser R, Tesema L. Development and evaluation of a social marketing campaign to address methamphetamine use in Los Angeles County. BMC Public Health 2022; 22:1796. [PMID: 36138397 PMCID: PMC9493153 DOI: 10.1186/s12889-022-14180-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/13/2022] [Indexed: 12/03/2022] Open
Abstract
Background This study describes the development and impact of a social marketing campaign in early 2020 intended to prevent and reduce methamphetamine use in Los Angeles County (LAC). We used social marketing principles and the transtheoretical model to design the campaign, which was intended to avoid stigmatization of methamphetamine users and communicate compassion, empathy, and support. Methods To evaluate its impact, we collected cross-sectional online survey data post-campaign (n = 1,873) from LAC residents in population segments considered higher risk for methamphetamine use. We examine associations between campaign exposure and outcomes using bivariate analyses and binary logistic regression models, which control for the impact of the COVID-19 pandemic on methamphetamine use or likelihood of use. Results The analyses revealed that campaign exposure was associated with having more negative attitudes toward methamphetamine, calling LAC’s substance abuse service helpline, using methamphetamine fewer days, and considering abstaining. Frequency of exposure to campaign advertisements was positively associated with calling the helpline, suggesting a campaign dose effect. COVID-19-related factors were associated with using methamphetamine in the past 30 days. Conclusions Social marketing campaigns hold promise for impacting methamphetamine prevention and cessation behaviors. This study adds to the limited literature on mass marketing interventions to address this major health issue. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14180-y.
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Affiliation(s)
| | - Aaron Plant
- Sentient Research, 231 North Walnuthaven Drive, West Covina, CA, 91790, USA
| | - Jorge A Montoya
- Sentient Research, 231 North Walnuthaven Drive, West Covina, CA, 91790, USA
| | - Rangell Oruga
- Division of Substance Abuse Prevention and Control, Los Angeles County Department of Public Health, 1000 South Fremont Avenue, Bldg A-9 East, 3rd Floor, Alhambra, CA, 91803, USA
| | | | - Renee Fraser
- Fraser Communications, 1631 Pontius Avenue, Los Angeles, CA, 90025, USA
| | - Lello Tesema
- Division of Substance Abuse Prevention and Control, Los Angeles County Department of Public Health, 1000 South Fremont Avenue, Bldg A-9 East, 3rd Floor, Alhambra, CA, 91803, USA
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Does Treatment Readiness Shape Service-Design Preferences of Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Crystal Methamphetamine? A Cross Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063458. [PMID: 35329146 PMCID: PMC8951578 DOI: 10.3390/ijerph19063458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 12/17/2022]
Abstract
Crystal methamphetamine (CM) disproportionately impacts gay, bisexual, and other men who have sex with men (gbMSM). However, not all gbMSM are interested in changing their substance use. The present study aimed to examine whether participant-preferred service characteristics were associated with their readiness to change. We surveyed gbMSM who used CM in the past six months, aged 18 plus years, on dating platforms. Participants rated service-design characteristics from “very unimportant” to “very important”. Multivariable regression tested service preference ratings across levels of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES-8D). Among 291 participants, 38.7% reported their CM use was not problematic, 19.5% were not ready to take any action to reduce or stop using CM, and 41.7% were ready to take action. On average, participants rated inclusive, culturally-appropriate, out-patient counselling-based interventions as most important. Participants with greater readiness-to-change scores rated characteristics higher than gbMSM with lesser readiness. Contingency management and non-abstinence programming were identified as characteristics that might engage those with lesser readiness. Services should account for differences in readiness-to-change. Programs that provide incentives and employ harm reduction principles are needed for individuals who may not be seeking to reduce or change their CM use.
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Rivera AV, Harriman G, Carrillo SA, Braunstein SL. Trends in Methamphetamine Use Among Men Who Have Sex with Men in New York City, 2004-2017. AIDS Behav 2021; 25:1210-1218. [PMID: 33185774 DOI: 10.1007/s10461-020-03097-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2020] [Indexed: 10/23/2022]
Abstract
Methamphetamine (meth) use among men who have sex with men (MSM) has been documented to be associated with HIV transmission among those who are HIV-negative and worsening HIV outcomes among those who are HIV-positive. Recent media reports have suggested recent increases in meth use in New York City (NYC), particularly among Hispanic/Latino and Black MSM. Using serial cross-sectional data from 2004 to 2017, we aim to describe trends in meth use and describe racial/ethnic patterns among MSM in NYC. Overall, we observed a decrease in meth use among MSM from 2004 to 2011 and an increase from 2011 to 2017. When stratified by race/ethnicity, use among White MSM decreased. Beginning in 2008, use among both Hispanic/Latino and Black MSM increased over time. These data provide more evidence that meth use may be increasing in Hispanic/Latino and Black MSM. Culturally-tailored and status-neutral interventions should be explored.
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Carrico AW, Horvath KJ, Grov C, Moskowitz JT, Pahwa S, Pallikkuth S, Hirshfield S. Double Jeopardy: Methamphetamine Use and HIV as Risk Factors for COVID-19. AIDS Behav 2020; 24:3020-3023. [PMID: 32266501 PMCID: PMC7137401 DOI: 10.1007/s10461-020-02854-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Adam W Carrico
- University of Miami School of Medicine, Miami, FL, USA.
- University of Miami Department of Public Health Sciences, 1120 NW 14th St., Office 1005, Miami, FL, 33136, USA.
| | - Keith J Horvath
- San Diego State University Department of Psychology, San Diego, CA, USA
| | - Christian Grov
- City University of New York Graduate School of Public Health, New York, NY, USA
| | | | - Savita Pahwa
- University of Miami School of Medicine, Miami, FL, USA
| | | | - Sabina Hirshfield
- State University of New York - Downstate Health Sciences University, New York, NY, USA
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6
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Brief Report: Hazardous Cannabis Use and Monocyte Activation Among Methamphetamine Users With Treated HIV Infection. J Acquir Immune Defic Syndr 2020; 81:361-364. [PMID: 30958388 DOI: 10.1097/qai.0000000000002046] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The use of stimulants, such as methamphetamine, has been associated with greater immune activation in treated HIV infection. However, relatively little is known about whether concomitant cannabis use is associated with lower immune activation among HIV-positive stimulant users. SETTING HIV-positive, sexual minority men with biologically confirmed, recent methamphetamine use were enrolled in San Francisco, CA. METHODS In total, 78 methamphetamine-using sexual minority men with an undetectable HIV viral load (<40 copies/mL) completed self-report measures of cannabis use and substance use disorder severity. Plasma biomarkers of monocyte activation (ie, sCD14 and sCD163) and intestinal barrier integrity (iFABP) were measured. The associations of hazardous cannabis use with these measurements were examined after adjusting for substance use disorder severity, age, antiretroviral therapy regimen, CD4 T-cell count, and interleukin-6. RESULTS Hazardous cannabis users had the highest mean sCD14 levels (2181 ng/mL) compared with nonhazardous users (1991 ng/mL) and nonusers (1859 ng/mL; P = 0.05). In adjusted analyses, greater cannabis use severity was associated with higher sCD14 compared with nonusers (unstandardized beta = 133.6 ng/mL, P = 0.03). Cannabis use severity was not significantly associated with sCD163 or iFABP. CONCLUSIONS Hazardous cannabis use is independently associated with elevations in a clinically relevant marker of immune activation in methamphetamine users with treated HIV.
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7
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Naar S, Parsons JT, Stanton BF. Adolescent Trials Network for HIV-AIDS Scale It Up Program: Protocol for a Rational and Overview. JMIR Res Protoc 2019; 8:e11204. [PMID: 30707102 PMCID: PMC6376339 DOI: 10.2196/11204] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/02/2018] [Accepted: 10/04/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The past 30 years have witnessed such significant progress in the prevention and treatment of HIV/AIDS that an AIDS-free generation and the end to the global AIDS epidemic are ambitious, but achievable, national and global goals. Despite growing optimism, globally, youth living with HIV are markedly less likely to receive antiretroviral therapy than adults (23% vs 38%). Furthermore, marked health disparities exist regarding HIV infection risk, with young men of color who have sex with men disproportionately affected. A large body of research has identified highly impactful facilitators of and barriers to behavior change. Several efficacious interventions have been created that decrease the rate of new HIV infections among youth and reduce morbidity among youth living with HIV. However, full benefits that should be possible based on the tools and interventions currently available are yet to be realized in youth, in large part, because efficacious interventions have not been implemented in real-world settings. Scale It Up (SIU) primarily aims to assemble research teams that will ultimately bring to practice evidence-based interventions that positively impact the youth HIV prevention and care cascades, and in turn, advance the fields of implementation science and self-management science. OBJECTIVE This paper aims to describe the structure of the U19-SIU and the effectiveness-implementation hybrid trials, as well as other center-wide protocols and initiatives, implemented within SIU. METHODS SIU will achieve its aims through 4 individual primary protocols, 2 center-wide protocols, and 3 cross-project initiatives. RESULTS SIU was funded by National Institute for Child Health and Human Development (U19HD089875) and began in October 2016. As of November 2018, 6 SIU protocols have launched at least the first phase of work (ATN 144 SMART: Sequential Multiple Assignment Randomized Trial; ATN 145 YMHP: Young Men's Health Project; ATN 146 TMI: Tailored Motivational Interviewing Intervention; ATN 153 EPIS: Exploration, Preparation, Implementation, Sustainment model; ATN 154 CM: Cascade Monitoring; ATN 156 We Test: Couples' Communication and HIV Testing). Further details can be found in the individual protocol papers. CONCLUSIONS To date, the youth HIV research portfolio has not adequately advanced the important care area of self-management. SIU protocols and initiatives address this broad issue by focusing on evaluating the effectiveness and implementation of self-management interventions. SIU is highly innovative for 5 primary reasons: (1) our research framework expands the application of "self-management"; (2) the 4 primary protocols utilize innovative hybrid designs; (3) our Analytic Core will conduct cost-effectiveness analyses of each intervention; (4) across all 4 primary protocols, our Implementation Science Core will apply implementation scales designed to assess inner and outer context factors; and (5) we shall advance understanding of the dynamics between provider and patient through analysis of recorded interactions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/11204.
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Affiliation(s)
- Sylvie Naar
- College of Medicine, Florida State University, Tallahassee, FL, United States
| | - Jeffrey T Parsons
- Center for HIV Educational Studies and Training, Hunter College of the City University of New York, New York, NY, United States
- Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York, New York, NY, United States
| | - Bonita F Stanton
- Hackensack Meridian School of Medicine, Seton Hall University, South Orange, NJ, United States
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Optimizing Contingency Management with Methamphetamine-Using Men who Have Sex with Men. COGNITIVE AND BEHAVIORAL PRACTICE 2017; 25:286-295. [PMID: 32461714 DOI: 10.1016/j.cbpra.2017.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Among men who have sex with men (MSM), methamphetamine use is associated with multiple, overlapping syndemic conditions including increased risk for HIV seroconversion and onward HIV transmission. Contingency management (CM) is an evidence-based, behavioral intervention implemented to curb methamphetamine use and optimize HIV/AIDS prevention among MSM in San Francisco since 2003. We conducted a program evaluation to document the evolution of this 12-week CM program to include delivery of brief, individual counseling incorporating motivational interviewing and behavioral skills. A drop-in group delivered concurrently with CM urine-screening visits also provides peer support as well as referrals for other social and medical services. From December 2011-October 2013, a total of 131 clients enrolled in the CM program and provided a median of 22 urine samples (Interquartile Range = 10-34) that were non-reactive for methamphetamine. Findings support the feasibility and acceptability of integrating individual and group counseling with community-based CM for methamphetamine-using MSM.
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9
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Abstract
In recent decades, methamphetamine developed a peculiar geographic distribution in the United States, with limited diffusion in the Northeast. While use within gay clubs received attention, methamphetamine in club subcultures more broadly remains less clear. Using quantitative and qualitative data, we provide a descriptive assessment of methamphetamine use in club subcultures. Methamphetamine use in club subcultures often has instrumental purposes. The context of initiation into methamphetamine use and its close connection to cocaine shape later patterns of use. Viewing meth solely as a gay party drug misses a significant part of the population and may misguide public health strategies to reduce methamphetamine use in the Northeast.
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Affiliation(s)
- Brian C Kelly
- 1Department of Sociology, Purdue University , West Lafayette, Indiana , USA
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10
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Grov C, Crow T. Attitudes about and HIV risk related to the "most common place" MSM meet their sex partners: comparing men from bathhouses, bars/clubs, and Craigslist.org. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2012; 24:102-16. [PMID: 22468972 PMCID: PMC5824633 DOI: 10.1521/aeap.2012.24.2.102] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This study examined attitudes toward the most common place where men who have sex with men (MSM) met their recent male sex partners. In 2009-2010, MSM were surveyed in bars/clubs, bathhouses, and on Craigslist.org . We found strong but differential overlap between venue of recruitment and participants' most common place: 81% of men from Craigslist indicated their most common place was the Internet, 65% of men from bathhouses indicated their most common place was bathhouses, and 47% of men from bars/clubs indicated their most common place was bars/clubs. In general, interest in seeing more information on drugs/alcohol and HIV and interacting with a health outreach worker in participants' most common place ranged from "agree" to "strongly agree." However, men whose most common place was bars/clubs rated these items lowest on average. Rates of unprotected anal intercourse (UAI) were high (43%), thus targeted efforts in bars/clubs, bathhouses, and on the Internet may be ideal venues for reaching high-risk MSM. Although most common place was unrelated to UAI, it was related to factors that contextualize men's encounters (e.g., attitudes toward HIV status disclosure, and perceptions about barebacking, anonymous sex, and alcohol use). Outreach providers should consider these contextualizing aspects as they continue to retool their efforts.
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Affiliation(s)
- Christian Grov
- Department of Health and Nutrition Sciences at Brooklyn College of the City University of New York (CUNY), 2900 Bedford Avenue, Brooklyn, NY 11210, USA.
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11
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Goodrich KM. Methamphetamine Treatment Issues and Considerations Among Men Who Have Sex With Men. JOURNAL OF ADDICTIONS & OFFENDER COUNSELING 2011. [DOI: 10.1002/j.2161-1874.2011.tb00206.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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12
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Fazio A, Hunt G, Moloney M. "It's one of the better drugs to use": perceptions of cocaine use among gay and bisexual Asian American men. QUALITATIVE HEALTH RESEARCH 2011; 21:625-641. [PMID: 20952603 PMCID: PMC3024451 DOI: 10.1177/1049732310385825] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Research on drug use among gay and bisexual men has primarily focused on examining the link between drug use- most notably, methamphetamine-sexual practices, and risk of HIV transmission. Drawing on in-depth qualitative data from 40 interviews with gay and bisexual Asian American men, we examine perceptions and meanings associated with cocaine use in the San Francisco Bay Area gay community. We found that the participants, in contrast to their negative perceptions of methamphetamine use, believed that cocaine enhanced sociability and was acceptable for use in most social situations. Furthermore, participants perceived little connection between cocaine use and risky sexual practices, emphasizing the drug's safety relative to other illicit substances. Based on these findings, we suggest that an increase in the favorability of cocaine use might be an unintended consequence of methamphetamine prevention campaigns targeting the gay community, with their emphasis on the harmful effects of drug use, unsafe sex, and HIV risk.
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Affiliation(s)
- Adam Fazio
- Institute for Scientific Analysis, Alameda, California, USA
| | - Geoffrey Hunt
- Institute for Scientific Analysis, Alameda, California, USA
| | - Molly Moloney
- Institute for Scientific Analysis, Alameda, California, USA
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Carpiano RM, Kelly BC, Easterbrook A, Parsons JT. Community and drug use among gay men: the role of neighborhoods and networks. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2011; 52:74-90. [PMID: 21362613 DOI: 10.1177/0022146510395026] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Gay neighborhoods serve as vital places for gay men's socializing, yet few studies have examined their contributions to gay men's health-either directly or indirectly via residents' social networks. Drawing from theoretical perspectives on community and networks, we test hypotheses concerning whether gay neighborhoods and social network factors are associated with patterns of recent illicit drug use among a sample of 740 urban gay men from New York City. Higher odds of drug use were observed among individuals who resided in gay neighborhoods, had networks composed predominantly of other gay men, and had increased socialization with gay men. Network factors did not mediate associations between gay neighborhoods and drug use. These findings highlight the need to better contextualize the health risks faced by gay men by accounting for both neighborhood and network structures.
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Affiliation(s)
- Richard M Carpiano
- Department of Sociology, University of British Columbia, Vancouver, British Columbia.
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14
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Mustanski BS, Newcomb ME, Du Bois SN, Garcia SC, Grov C. HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions. JOURNAL OF SEX RESEARCH 2011; 48:218-53. [PMID: 21409715 PMCID: PMC3351087 DOI: 10.1080/00224499.2011.558645] [Citation(s) in RCA: 208] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Epidemiological studies have found that young men who have sex with men (YMSM) represent the majority of young people infected with HIV annually in the United States. Further, they are one of the few risk groups to show an increase in the rate of infections in recent years. In addition to these disparities in prevalence and infection rates, there is an inequity in prevention and intervention research on this population. The purpose of this article is to review the existing YMSM literature on HIV epidemiology, correlates of risk, and intervention research. The article concludes that promising future directions for basic research include a focus on multiple clustering health issues, processes that promote resiliency, the role of family influences, and the development of parsimonious models of risk. In terms of intervention research, the article suggests that promising future directions include Internet-based intervention delivery, integration of biomedical and behavioral approaches, and interventions that go beyond the individual level to address partnership, structural, community, and network factors.
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Affiliation(s)
- Brian S Mustanski
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60608, USA.
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15
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Abstract
Amphetamine-group substances are used worldwide and are more prevalent than either cocaine or opioids. We reviewed published reports about amphetamine-group substances and did a meta-analysis of randomised controlled trials of behavioural interventions for their use. Most research was done in developed countries. Many, but not all, studies show an association between amphetamine-group substance use and risk of HIV infection. Much use of amphetamine-group substances is non-injection and is associated with increased HIV risk, particularly in men who have sex with men. The structural, social, interpersonal, and personal factors that link to amphetamine-group substance use and HIV risk are poorly understood. 13 studies, with a cumulative sample size of 1997 individuals, qualified for the meta-analysis. Overall, high-intensity behavioural interventions were moderately effective in reducing use of amphetamine-group substances (effect size 0.28, 95% CI 0.13-0.44). We did not find conclusive evidence that behavioural interventions as a group are more effective than are passive or minium treatment for reduction of amphetamine-group substance use or sexual risk behaviours. The search for effective, scalable, and sustainable interventions for amphetamine-group substance use, including pharmacotherapies, should be supported and encouraged.
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Affiliation(s)
- Grant Colfax
- HIV Prevention Section, San Francisco Department of Public Health, San Francisco, CA 94102, USA.
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16
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Dew BJ. Toward a Better Understanding of Non-Addicted, Methamphetamine-Using, Men who Have Sex with Men (MSM) in Atlanta. Open AIDS J 2010; 4:141-7. [PMID: 20657718 PMCID: PMC2908926 DOI: 10.2174/1874613601004030141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Revised: 11/15/2009] [Accepted: 11/25/2009] [Indexed: 11/22/2022] Open
Abstract
Methamphetamine use has increasingly become linked with sexual risk behaviors among men have sex with men (MSM). Yet, the majority of research has been done with methamphetamine dependent MSM or with samples in which addiction to the substance was not evaluated. Furthermore, research with methamphetamine-using MSM in the Southern U.S. is lacking. In this study, focus groups and in-depth interviews were conducted in order to understand the motives, context, and other facilitators and barriers of methamphetamine use among non-addicted MSM residing in Atlanta. Participants included 30 non-addicted, methamphetamine-using MSM and 16 local mental and public health officials. Findings from the first of this two-phase formative research project will result in the initial development of a community-tested, culturally-specific social marketing campaign and an individual-based intervention based in HIV-testing facilities.
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Affiliation(s)
- Brian J Dew
- Georgia State University, Department of Counseling & Psychological Services, Atlanta, GA 30302-3980, USA
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17
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Nanin JE, Bimbi DS, Grov C, Parsons JT. Community reactions to a syphilis prevention campaign for gay and bisexual men in Los Angeles County. JOURNAL OF SEX RESEARCH 2009; 46:525-34. [PMID: 19291502 PMCID: PMC2878487 DOI: 10.1080/00224490902829590] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
"Stop the Sores" (STS), a humor-based syphilis prevention campaign, was implemented in response to increasing syphilis prevalence among gay and bisexual men in Los Angeles County. In 2004, 564 men completed surveys measuring exposure and reactions to the campaign and syphilis testing. Mean age was 39, and men of color comprised a significant proportion of the sample (46.8%). Most men reported being HIV-negative (79.3%). Overall, 7.8% of the sample reported ever having syphilis; HIV-positive men were six times more likely to report this. Over one half of the sample (58.5%) reported exposure to the campaign. Men reporting any recent unprotected anal sex were twice more likely (than those who did not) to see the campaign. Men of color were twice more likely than White men to report wanting to speak to their friends about it. Finally, 39.1% of men exposed to the campaign reported being tested for syphilis as a result. Factors related to higher likelihood to test for syphilis included HIV seropositive status, any recent unprotected anal insertive sex, recent use of methamphetamine, recent use of "poppers," and recent use of erectile dysfunction drugs. Although STS was somewhat effective, outreach efforts to particular subgroups may need to increase.
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Affiliation(s)
- Jose E Nanin
- Kingsborough Community College of the City University of New York, and the Center for HIV Educational Studies and Training, USA.
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Kelly BC, Bimbi DS, Nanin JE, Izienicki H, Parsons JT. Sexual compulsivity and sexual behaviors among gay and bisexual men and lesbian and bisexual women. JOURNAL OF SEX RESEARCH 2009; 46:301-308. [PMID: 19148829 DOI: 10.1080/00224490802666225] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Within the existing body of research, the information pertaining to sexual compulsivity (SC) among women, both homo- and heterosexual, remains rather limited in comparison to men. The aim of this study was to assess the prevalence of SC in a community sample of gay and bisexual men and lesbian and bisexual women and to identify differences in sexual practices based on classification as sexually compulsive within gender. Supporting previous research, the findings indicated that gay and bisexual men were significantly higher in SC when compared to lesbian and bisexual women. Similarly, sexually compulsive gay and bisexual men were more likely to report drug use with sex than their non-sexually compulsive peers, suggesting that "party n' play" may play a larger role for men with SC. In addition, the findings demonstrated empirical support for the proposition that lesbian and bisexual women with symptoms of SC were more likely to engage in specialized sexual behaviors in comparison to their non-sexually compulsive peers. These data suggest that SC manifests differently in gay, lesbian, and bisexual men and women.
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Affiliation(s)
- Brian C Kelly
- Department of Sociology and Department of Anthropology, Purdue University, USA
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McElhiney MC, Rabkin JG, Rabkin R, Nunes EV. Provigil (modafinil) plus cognitive behavioral therapy for methamphetamine use in HIV+ gay men: a pilot study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2009; 35:34-7. [PMID: 19152204 DOI: 10.1080/00952990802342907] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate the efficacy of modafinil combined with cognitive behavioral therapy (CBT) for treatment of methamphetamine (MA) dependence among HIV+ gay men. METHODS In a single blind trial, modafinil was administered for 12 weeks, followed by a 4-week placebo phase. CBT was conducted for 18 sessions over the 16-week study. Primary outcome measures were self-reported use of days per week plus urine toxicology assays. Additional measures included the Beck Depression Inventory, Cravings Scale, and O/C Crystal Use Scale. Response was defined as > 50% decline in days used per week. Thirteen patients were enrolled over an 18-month period. RESULTS Ten patients (77%) completed the trial, although two discontinued modafinil due to side effects. Six of the ten study completers reduced their MA use by > 50%. CONCLUSIONS These preliminary results suggest good retention using combined medication and psychotherapy, and support further examination of modafinil and CBT in double-blind placebo controlled trials.
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Affiliation(s)
- Martin C McElhiney
- Therapeutics, New York State Psychiatric Institute, New York, New York, USA.
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Grov C, Bux D, Parsons JT, Morgenstern J. Recruiting hard-to-reach drug-using men who have sex with men into an intervention study: lessons learned and implications for applied research. Subst Use Misuse 2009; 44:1855-71. [PMID: 20001284 PMCID: PMC2874238 DOI: 10.3109/10826080802501570] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Drug (ab)use researchers and service providers across the globe have been challenged with locating target populations and subsequently enrolling participants into their programs. This study presents data from nearly 3 years (2004-2006) of recruiting "high-risk" drug-using gay and bisexual men into a clinical research trial based in New York City. During the enrollment period, two recruitment/marketing strategies were utilized: (1) marketing of the intervention research study itself to men who were in the early stages of identifying problems with their drug use and risky sexual behavior and (2) two-stage recruitment via a lower-threshold/commitment (i.e., brief survey) and subsequent offering/enrollment into the full trial upon completion of the initial visit (i.e., a foot-in-the-door). The second approach was substantially more effective in enrolling participants into the full trial (6.3 participants/month vs. 2.5 participants/month). Furthermore, recruitment costs for the foot-in-the-door approach were substantially reduced ($356.57 per participant vs. $497.03 per participant). Compared to the marketing of interventions themselves to target populations, a two-stage recruitment strategy incorporating lower-threshold interactions may be a more effective approach to recruit for interventions.
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Affiliation(s)
- Christian Grov
- Center for HIV/AIDS Educational Studies and Training, New York, NY
- National Development and Research Institutes, Inc. New York, NY
- Public Health Solutions, New York, NY
| | - Donald Bux
- Columbia University College of Physicians & Surgeons and the Research Foundation for Mental Hygiene, Inc
| | - Jeffrey T. Parsons
- Center for HIV/AIDS Educational Studies and Training, New York, NY
- Hunter College and the Graduate Center of the City University of New York, New York, NY
| | - Jon Morgenstern
- Columbia University College of Physicians & Surgeons and the Research Foundation for Mental Hygiene, Inc
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21
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Chiadmi F, Schlatter J. Crystal meth : une forme de méthamphétamine. Presse Med 2009; 38:63-7. [DOI: 10.1016/j.lpm.2008.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2008] [Revised: 06/24/2008] [Accepted: 07/04/2008] [Indexed: 10/21/2022] Open
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Nanín J, Osubu T, Walker J, Powell B, Powell D, Parsons J. "HIV is still real": Perceptions of HIV testing and HIV prevention among black men who have sex with men in New York City. Am J Mens Health 2008; 3:150-64. [PMID: 19477728 DOI: 10.1177/1557988308315154] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rising HIV infection rates have been recently occurring among Black men who have sex with men (BMSM) in the United States. As a result, promoting HIV testing among members of this population is now considered a priority among local and federal health officials. A study was conducted to explore concerns about HIV testing among BMSM in New York City. In early 2006, data were gathered from focus groups with 29 BMSM. Discussions revealed factors affecting HIV testing, including stigma, sexuality, religion, race, and class, emphasizing responsibility, testing concerns, and media influences, among others. Recommendations were submitted to New York City health officials to inform HIV testing and prevention efforts.
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Affiliation(s)
- José Nanín
- Kingsborough Community College of the City, University of New York, USA.
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23
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Grov C, Parsons JT, Bimbi DS. In the shadows of a prevention campaign: sexual risk behavior in the absence of crystal methamphetamine. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2008; 20:42-55. [PMID: 18312066 DOI: 10.1521/aeap.2008.20.1.42] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Because of its ability to reduce inhibitions and increase sexual drive, an emerging body of research has repeatedly identified crystal methamphetamine as a key variable in explaining new HIV transmissions among men who have sex with men (MSM). The implications of which have included the development of HIV prevention policies and public health campaigns centered on curbing methamphetamine use in urban gay centers throughout the United States. Data collected from a diverse sample of gay and bisexual men attending large-scale gay, lesbian, and bisexual community events in New York City (n=738) indicated that 10.2% of men used methamphetamine recently (i.e., <90 days) and that 29.9% of the sample had experienced a recent episode of unprotected anal intercourse. The majority, 81.1%, of those men reporting unsafe sex had not used methamphetamine recently. This analysis identified a bivariate relationship between methamphetamine use and sexual risk, but also highlights other variables that were significantly related to risky sexual behavior. Logistic regression analyses indicated that recent GHB use, temptation for unsafe sex, being younger in age, and identification as a barebacker were better indicators of risky sexual behavior than methamphetamine use. Policies focused on methamphetamine prevention may help to curb risky sexual behavior among select groups of individuals; however, these will not adequately address the sexual health of the many gay and bisexual men who, in the shadows of anti-methamphetamine policies and prevention programs, continue to engage in unsafe sex but are nonusers of methamphetamine.
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Affiliation(s)
- Christian Grov
- Center for HIV/AIDS Educational Studies and Training, New York, the National Development and Research Institutes, Inc., New York, USA
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Parsons JT, Kelly BC, Weiser JD. Initiation into methamphetamine use for young gay and bisexual men. Drug Alcohol Depend 2007; 90:135-44. [PMID: 17398040 PMCID: PMC1993847 DOI: 10.1016/j.drugalcdep.2007.02.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2007] [Revised: 02/20/2007] [Accepted: 02/20/2007] [Indexed: 11/25/2022]
Abstract
Research over the past 10 years has suggested that methamphetamine use has become a significant problem and is associated with risky sexual behaviors among gay and bisexual men. In order to better understand initiation into methamphetamine use among gay and bisexual men, qualitative analyses were performed on a sample of young gay and bisexual men (ages 18-29) in New York City. Participants were recruited as part of a larger study which used time-space sampling to enroll club-going young adults who indicated recent club drug (ecstasy, ketamine, GHB, methamphetamine, cocaine, and/or LSD) use. The data for this paper are derived from the qualitative interviews of 54 gay and bisexual male methamphetamine users. At initiation (1) methamphetamine was used in a social, non-sexual setting for a majority of the participants; (2) participants expressed limited knowledge of methamphetamine; and (3) many participants used cocaine as a basis for comparison when describing various effects of the drug. The understanding that at initiation methamphetamine was not solely used as a sexual enhancement for members of this community may enable health workers to more accurately target potential users when putting forth intervention efforts. Future research should aim to gain a better understanding into the role that methamphetamine plays in non-sexual contexts, particularly among gay and bisexual men who may not be part of the club "scene." The relationship between attitudes towards methamphetamine and other drugs, particularly cocaine, among gay and bisexual men should be explored.
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Affiliation(s)
- Jeffrey T Parsons
- Center for HIV/AIDS Educational Studies and Training (CHEST), 250 West 26th Street, Suite 300, New York, NY 10001, United States.
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