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Gebru NM, Canidate SS, Liu Y, Schaefer SE, Pavila E, Cook RL, Leeman RF. Substance Use and Adherence to HIV Pre-Exposure Prophylaxis in Studies Enrolling Men Who Have Sex with Men and Transgender Women: A Systematic Review. AIDS Behav 2023; 27:2131-2162. [PMID: 36538138 PMCID: PMC10869193 DOI: 10.1007/s10461-022-03948-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
Optimal adherence to pre-exposure prophylaxis (PrEP) is critical, but challenging. Men who have sex with men and transgender women have high rates of HIV incidence and substance use. Substance use is associated with reduced adherence to other medications, but associations between substance use and adherence to PrEP are less clear. Thus, the current review 1) systematically evaluates the measurement of substance use and PrEP adherence in studies examining both and 2) summarizes reported findings. Peer-reviewed articles published between 2010 - April 2021 examining associations between substance use and PrEP adherence were reviewed. Fifty studies met inclusion criteria. Assessment of substance use (i.e., mostly via self-reports at baseline) and PrEP adherence (i.e., often via tenofovir diphosphate [TFV-DP] concentration levels at follow-up) varied considerably across studies. Many studies used categorical variables (e.g., substance use: yes/no). Studies using TFV-DP levels defined adherence consistently (i.e., TFV-DP ≥ 700 fmol/punch), with slight variations. Qualitative studies (n = 10) indicated that substance use (mainly alcohol) is related to poorer PrEP adherence. While quantitative findings to date are equivocal for alcohol, there is a pattern of findings linking stimulant use with poorer PrEP adherence. This review reveals four methodological gaps, which can be addressed in future research by: 1) use of uniform benchmarks for substance use measures, 2) prospective assessment for substance use, 3) use of continuous outcome variables wherever possible, and 4) more extensive consideration of potential confounders. Addressing these methodological gaps may help us reach more definitive conclusions regarding associations between substance use and PrEP adherence.
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Affiliation(s)
- Nioud Mulugeta Gebru
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 S. Main St, Box G-S121-3, 02912, Providence, RI, USA.
- Department of Health Education & Behavior, University of Florida, Gainesville, FL, USA.
| | - Shantrel S Canidate
- Department of Health Education & Behavior, University of Florida, Gainesville, FL, USA
- Southern HIV and Alcohol Research Consortium (SHARC), University of Florida, Gainesville, FL, USA
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Yiyang Liu
- Department of Health Education & Behavior, University of Florida, Gainesville, FL, USA
- Southern HIV and Alcohol Research Consortium (SHARC), University of Florida, Gainesville, FL, USA
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Sage E Schaefer
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 S. Main St, Box G-S121-3, 02912, Providence, RI, USA
| | - Emmely Pavila
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 S. Main St, Box G-S121-3, 02912, Providence, RI, USA
| | - Robert L Cook
- Department of Health Education & Behavior, University of Florida, Gainesville, FL, USA
- Southern HIV and Alcohol Research Consortium (SHARC), University of Florida, Gainesville, FL, USA
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Robert F Leeman
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 S. Main St, Box G-S121-3, 02912, Providence, RI, USA
- Department of Health Education & Behavior, University of Florida, Gainesville, FL, USA
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Gebru NM, Benvenuti MC, Rowland BHP, Kalkat M, Chauca PG, Leeman RF. Relationships among Substance Use, Sociodemographics, Pre-Exposure Prophylaxis (PrEP) Awareness and Related Attitudes among Young Adult Men Who Have Sex with Men. Subst Use Misuse 2022; 57:786-798. [PMID: 35188880 PMCID: PMC9082761 DOI: 10.1080/10826084.2022.2040030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Men who have sex with men (MSM) account for two-thirds of new HIV diagnoses. Pre-exposure prophylaxis (PrEP), a highly efficacious HIV preventive medication, is underutilized. Identifying correlates of PrEP awareness and attitudes may help increase PrEP use. Thus, we evaluated (1) PrEP awareness; (2) differences in awareness related to substance use and sociodemographics; (3) initial PrEP information sources; and (4) possible associations between information sources and PrEP-related attitudes. Young adult (ages 18-30) HIV-negative MSM from Southern U.S. undertook a web survey including questions about substance use, sexual behaviors, perceived HIV risk, and PrEP. Participants were recruited using in-person and online approaches between January 2018-January 2020. Of 506 participants, 89% were aware of PrEP. Participants with high alcohol consumption and greater perceived HIV risk had higher odds of PrEP unawareness with a trend for minority race/ethnicity. PrEP-aware participants reported high overall perceived safety, confidence in PrEP's efficacy, and low perceived difficulties with adherence though those with higher perceived HIV risk and individuals who used tobacco had less favorable attitudes. Most participants first heard about PrEP from the internet. There were no statistically significant differences in PrEP-related attitudes across initial information sources. Associations between substance use and racial/ethnic minority status and lack of PrEP awareness suggest priority subgroups for educational campaigns. Future campaigns may tailor outreach materials to the respective audience (e.g., Spanish materials for Hispanic people) and disseminate where individuals who use substances may be more likely to see them (e.g., liquor and convenience stores). Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2022.2040030 .
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Affiliation(s)
- Nioud Mulugeta Gebru
- Department of Health Education & Behavior, College of Health & Human Performance; Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
- Southern HIV and Alcohol Research Consortium, University of Florida, Gainesville, FL, USA
| | - Maria Costanza Benvenuti
- Department of Health Education & Behavior, College of Health & Human Performance; Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
- Southern HIV and Alcohol Research Consortium, University of Florida, Gainesville, FL, USA
| | - Bonnie H. P. Rowland
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Meher Kalkat
- Department of Health Education & Behavior, College of Health & Human Performance; Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
| | - Patricia G. Chauca
- Department of Health Education & Behavior, College of Health & Human Performance; Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
- Southern HIV and Alcohol Research Consortium, University of Florida, Gainesville, FL, USA
| | - Robert F. Leeman
- Department of Health Education & Behavior, College of Health & Human Performance; Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
- Southern HIV and Alcohol Research Consortium, University of Florida, Gainesville, FL, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Sanders JM. Seeking Acceptance: LGBTQ and Membership in Alcoholics Anonymous (AA). ALCOHOLISM TREATMENT QUARTERLY 2020. [DOI: 10.1080/07347324.2020.1738295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Jolene M. Sanders
- Department of Sociology & Social Work, Hood College, Frederick, Maryland, USA
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Ristuccia A, LoSchiavo C, Kapadia F, Halkitis PN. Motivations for alcohol use to intoxication among young adult gay, bisexual, and other MSM in New York City: The P18 Cohort Study. Addict Behav 2019; 89:44-50. [PMID: 30248547 DOI: 10.1016/j.addbeh.2018.09.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 09/08/2018] [Accepted: 09/09/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Motivations for alcohol use to intoxication vary among young adults depending on social setting and other contextual factors. However, there is limited research exploring the role of different drinking motivations among young men who have sex with men (YMSM). METHODS Data from a racially/ethnically and socioeconomically diverse sample of YMSM (n = 426) were used to examine associations between recent (last 30 days) alcohol use to intoxication and scores on three distinct drinking motivation subscales: convivial, intimate, and negative coping drinking. Multinomial logistic regression models were constructed to examine associations between drinking motivations and days of alcohol use to intoxication, controlling for sociodemographic characteristics. RESULTS YMSM who scored higher on all three drinking motivation subscales were more likely to engage in recent alcohol use to intoxication compared to those who reported no alcohol use to intoxication. In multivariable models, Black and Hispanic YMSM had lower odds of intoxication compared to White YMSM, and those reporting lower perceived familial SES had lower odds compared to higher SES. In a final model including all three motivations, only convivial drinking was significantly associated with days of intoxication (1-2 days: AOR = 1.22; 3+ days: AOR = 1.45). CONCLUSIONS This study identifies distinct associations between different motivations for drinking and alcohol use to intoxication in a sample of YMSM. These findings highlight a need to incorporate an understanding of motivations for alcohol use to intoxication into research and clinical practice with YMSM, as different reasons for drinking carry respective potential health risks.
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W Hawkins B, Armstrong HL, Kesselring S, Rich AJ, Cui Z, Sereda P, Howard T, Forrest JI, Moore DM, Lachowsky NJ, Hogg RS, Roth EA. Substance Use as a Mechanism for Social Inclusion among Gay, Bisexual, and Other Men Who Have Sex with Men in Vancouver, Canada. Subst Use Misuse 2019; 54:1945-1955. [PMID: 31142175 PMCID: PMC7055638 DOI: 10.1080/10826084.2019.1621901] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background: Previous research demonstrates that substance use preferences and social-sexual environments are highly interrelated for gay, bisexual, and other men who have sex with men (gbMSM). Objective: We conducted a qualitative study to explore the socio-cultural context of substance use among local gbMSM communities in Metro Vancouver, Canada. Methods: Twenty gbMSM were purposively sampled from the larger Momentum Health Study cohort, a sexual health study of gbMSM in Greater Vancouver. Participants were demographically diverse in terms of HIV serostatus, age, income, ethnicity, and area of residence within the city and neighboring suburbs. Community maps generated by participants during formative research served as prompts for semi-structured interviews which were audio recorded and transcribed verbatim. Thematic analysis identified three themes of common experience. Results: First, participants indicated that substance use is intrinsically social in Vancouver gbMSM communities and that it functions as both a means of social inclusion and exclusion. Second, a distinction was made between types of substances and the location and context of their use, with specific substances having particular uses and meanings. Third, analysis suggested that gbMSM change their substance use over the life course and that this is affected by shifting priorities as people age. Discussion: For Vancouver gbMSM communities, substance use serves several social-cultural functions and can simultaneously serve as both a potential facilitator and barrier for community connection. Future research and health programing should consider venue and context specific messaging and recognize the heterogeneity of substance use within the larger gbMSM population.
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Affiliation(s)
- Blake W Hawkins
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS , Vancouver , British Columbia , Canada.,Interdisciplinary Studies Graduate Program, University of British Columbia , Vancouver , British Columbia , Canada
| | - Heather L Armstrong
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS , Vancouver , British Columbia , Canada.,Faculty of Medicine, University of British Columbia , Vancouver , British Columbia , Canada
| | - Sarah Kesselring
- Population Data BC, University of British Columbia , Vancouver , British Columbia , Canada
| | - Ashleigh J Rich
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS , Vancouver , British Columbia , Canada.,Faculty of Medicine, University of British Columbia , Vancouver , British Columbia , Canada
| | - Zishan Cui
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS , Vancouver , British Columbia , Canada
| | - Paul Sereda
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS , Vancouver , British Columbia , Canada
| | - Terry Howard
- Community Advisory Board, Momentum Health Study , Vancouver , British Columbia , Canada
| | - Jamie I Forrest
- Faculty of Medicine, University of British Columbia , Vancouver , British Columbia , Canada
| | - David M Moore
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS , Vancouver , British Columbia , Canada.,Faculty of Medicine, University of British Columbia , Vancouver , British Columbia , Canada
| | - Nathan J Lachowsky
- School of Public Health & Social Policy, University of Victoria , Victoria , British Columbia , Canada.,Centre for Addictions Research BC , Victoria , British Columbia , Canada
| | - Robert S Hogg
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS , Vancouver , British Columbia , Canada.,Faculty of Health Sciences, Simon Fraser University , Burnaby , British Columbia , Canada
| | - Eric A Roth
- Department of Anthropology, University of Victoria , Victoria , British Columbia , Canada
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Do people with intersecting identities report more high-risk alcohol use and lifetime substance use? Int J Public Health 2018; 63:621-630. [DOI: 10.1007/s00038-018-1095-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 01/24/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022] Open
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Halkitis PN, Bub K, Stults CB, Bates FC, Kapadia F. Latent Growth Curve Modeling of Non-Injection Drug Use and Condomless Sexual Behavior from Ages 18 to 21 in Gay, Bisexual, and Other YMSM: The P18 Cohort Study. Subst Use Misuse 2018; 53:101-113. [PMID: 28820622 PMCID: PMC6085877 DOI: 10.1080/10826084.2017.1334067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND HIV/AIDS continues to be a health disparity faced by sexual minority men, and is exacerbated by non-injection drug use. OBJECTIVES We sought to delineate growth in non-injection drug use and condomless sex in a sample of racially and economically diverse of gay, bisexual, and other young men who have sex with men (YMSM) as they emerged into adulthood between the ages of 18 and 21 and who came of age in the post-HAART era. METHODS Behavioral data on drug use and condomless sex, collected via a calendar based technique over 7 waves of a cohort study of 600 YMSM, were analyzed using latent growth curve modeling to document patterns of growth in these behaviors, their associations, and the extent to which patterns and associations are moderated by race/ethnicity and socioeconomic status. RESULTS Significant growth was noted in the frequencies of condomless oral and anal intercourse, alcohol to intoxication, marijuana use, and inhalant nitrate use. High levels of association were noted between all behaviors across time but associations did not differ by either race/ethnicity or socioeconomic status. The link between drug use and risky sexual behavior continue to be evident in YMSM with significant increases in these behaviors demonstrated as YMSM transition between adolescence and young adulthood. Conclusions/Importance: Healthcare for a new generation of sexual minority males must address the synergy of these behaviors and also nest HIV prevention and care within a larger context of sexual minority health that acknowledges the advances made in the last three decades.
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Affiliation(s)
- Perry N Halkitis
- a Department of Biostatistics, School of Public Health , Rutgers University , Piscataway Township , New Jersey , USA.,b Department of Social and Behavioral Health Sciences, School of Public Health , Rutgers University , Piscataway Township , New Jersey , USA.,c Center for Health, Identity, Behavior & Prevention Studies , College of Global Public Health, New York University , New York , New York , USA
| | - Kristen Bub
- e College of Education , University of Illinois , Chicago , Illinois , USA
| | - Christopher B Stults
- c Center for Health, Identity, Behavior & Prevention Studies , College of Global Public Health, New York University , New York , New York , USA
| | - Francesca C Bates
- c Center for Health, Identity, Behavior & Prevention Studies , College of Global Public Health, New York University , New York , New York , USA
| | - Farzana Kapadia
- c Center for Health, Identity, Behavior & Prevention Studies , College of Global Public Health, New York University , New York , New York , USA.,d Department of Population Health, School of Medicine , New York University
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Helmers BR, Harbke CR, Herbstrith JC. Sexual willingness with same- and other-sex prospective partners: Experimental evidence from the bar scene. The Journal of Social Psychology 2017; 158:109-124. [PMID: 28375807 DOI: 10.1080/00224545.2017.1314248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Sex is ubiquitous in the media, but only a fraction depicts sexual interactions between same-sex partners. This field study, conducted outside of bars in the Midwestern United States, examined 83 heterosexuals' sexual willingness with a same- or other-sex partner. Participants viewed a randomly assigned video vignette of a same- or other-sex partner. Alcohol intake, partner attractiveness, and sexual willingness were measured. Using moderated regression analysis, we found that alcohol intake predicted sexual willingness with the male target for both men and women, but not with the female target. The attractiveness of same-sex partners was related to sexual willingness. Sexual willingness was only influenced by alcohol intake and perceived attractiveness of a same-sex prospective partner. Most notably, alcohol intake was related to increased sexual willingness of men with a same-sex partner, suggesting a potential shift in normative casual sexual behavior among heterosexual men.
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Talley AE, Gilbert PA, Mitchell J, Goldbach J, Marshall BDL, Kaysen D. Addressing gaps on risk and resilience factors for alcohol use outcomes in sexual and gender minority populations. Drug Alcohol Rev 2016; 35:484-93. [PMID: 27072658 PMCID: PMC4930390 DOI: 10.1111/dar.12387] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/30/2015] [Accepted: 01/06/2016] [Indexed: 12/11/2022]
Abstract
ISSUES In 2011, the Institute of Medicine released a report that constituted the first comprehensive effort by a federal body to understand the current state of science pertinent to the health needs of sexual and gender minority populations. This mini-review summarises recent empirical, methodological and theoretical advances in alcohol-related research among to lesbian, gay, bisexual and transgender (LGBT) populations and highlights progress towards addressing gaps, with a particular interest in those identified by the Institute of Medicine report. APPROACH Articles published since 2011 were identified from PsycINFO and PubMed database searches, using various combinations of keyword identifiers (alcohol, alcohol abuse, substance abuse, LGBT, lesbian, gay, bisexual, transgender). Reference sections of included articles were also examined for additional citations. KEY FINDINGS Recent empirical work has contributed to a greater understanding of sub-group differences within this diverse population. Evidence has supported theorised influences that can account for alcohol-related disparities, yet important gaps remain. Studies that examine the role of gender identity and its intersection with sexual identity within transgender and gender non-conforming sub-populations are lacking. Methodological advances in this literature have begun to allow for examinations of how minority-specific and general risk factors of alcohol misuse may contribute to patterns of alcohol involvement over time and within social-relational contexts CONCLUSIONS The recommendations made in the current mini-review are meant to facilitate future collaborative efforts, scale development, thoughtful methodological design and analysis and theoretically driven nuanced hypotheses to better understand, and ultimately address, alcohol-related disparities among sexual and gender minority populations. [Talley AE, Gilbert PA, Mitchell J, Goldbach J, Marshall BDL, Kaysen D. Addressing gaps on risk and resilience factors for alcohol use outcomes in sexual and gender minority populations. Drug Alcohol Rev 2016;35:484-493].
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Affiliation(s)
- Amelia E. Talley
- Psychological Sciences, Texas Tech University, Lubbock, United States
| | - Paul A. Gilbert
- Community and Behavioral Health, University of Iowa, Iowa City, United States
| | - Jason Mitchell
- University of Miami Miller School of Medicine, Miami, United States
| | - Jeremy Goldbach
- School of Social Work, University of Southern California University of Southern California, Los Angeles, United States
| | - Brandon D. L. Marshall
- Department of Epidemiology, School of Public Health, Brown University, Providence, United States
| | - Debra Kaysen
- Center for the Study of Health and Risk Behaviors, University of Washington, Seattle, United States
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Roche A, Kostadinov V, Fischer J, Nicholas R, O'Rourke K, Pidd K, Trifonoff A. Addressing inequities in alcohol consumption and related harms. Health Promot Int 2016; 30 Suppl 2:ii20-35. [PMID: 26420810 DOI: 10.1093/heapro/dav030] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Social determinants, or the conditions in which individuals are born, grow, live, work and age, can result in inequities in health and well-being. However, to-date little research has examined alcohol use and alcohol-related problems from an inequities and social determinants perspective. This study reviewed the evidence base regarding inequities in alcohol consumption and alcohol-related health outcomes in Australia and identified promising approaches for promoting health equity. Fair Foundations: the VicHealth framework for health equity was used as an organizing schema. The review found that social determinants can strongly influence inequities in alcohol consumption and related harms. In general, lower socioeconomic groups experience more harm than wealthier groups with the same level of alcohol consumption. While Australia has implemented numerous alcohol-related interventions and policies, most do not explicitly aim to reduce inequities, and some may inadvertently exacerbate existing inequities. Interventions with the greatest potential to decrease inequities in alcohol consumption and alcohol-related harms include town planning, zoning and licensing to prevent disproportionate clustering of outlets in disadvantaged areas; interventions targeting licensed venues; and interventions targeting vulnerable populations. Interventions that may worsen inequities include national guidelines, technological interventions and public drinking bans. There is a need for further research into the best methods for reducing inequities in alcohol consumption and related harms.
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Affiliation(s)
- Ann Roche
- National Centre for Education and Training on Addiction (NCETA), Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
| | - Victoria Kostadinov
- National Centre for Education and Training on Addiction (NCETA), Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
| | - Jane Fischer
- National Centre for Education and Training on Addiction (NCETA), Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
| | - Roger Nicholas
- National Centre for Education and Training on Addiction (NCETA), Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
| | - Kerryn O'Rourke
- Victorian Health Promotion Foundation, 15-31 Pelham Street, Carlton Victoria 3053, Melbourne, Australia
| | - Ken Pidd
- National Centre for Education and Training on Addiction (NCETA), Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
| | - Allan Trifonoff
- National Centre for Education and Training on Addiction (NCETA), Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
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Martinez O, Wu E, Levine EC, Muñoz-Laboy M, Spadafino J, Dodge B, Rhodes SD, Rios JL, Ovejero H, Moya EM, Baray SC, Carballo-Diéguez A, Fernandez MI. Syndemic factors associated with drinking patterns among Latino men and Latina transgender women who have sex with men in New York City. ADDICTION RESEARCH & THEORY 2016; 24:466-476. [PMID: 28077938 PMCID: PMC5222534 DOI: 10.3109/16066359.2016.1167191] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Alcohol consumption is a significant public health concern among Latino men and Latina transgender women who have sex with men. However, characteristics and behaviors associated with alcohol consumption in this population, particularly in regard to the complex influence of syndemic factors, remain understudied. The purpose of this study was to examine predictors of high-risk alcohol consumption (i.e. binge or heavy drinking). Between January and March of 2014, 176 Latino men and Latina transgender women in New York City completed an interviewer-administered questionnaire. We developed a syndemics scale to reflect the total number of syndemic factors - clinically significant depression, childhood sexual abuse, intimate partner violence, and discrimination - reported by each participant. We also carried out a multinomial logistic regression model predicting binge and heavy drinking. Forty-seven percent of participants reported high-risk alcohol consumption in the past 30 days (21% binge and 26% heavy). Approximately 16% of participants reported no syndemic factors, 27% reported one factor, 39% reported two factors, and 18% reported three or four. In the multinomial logistic regression model, our syndemic factors scale was not significantly associated with binge drinking. However, participants who reported three or four factors were significantly more likely to report heavy drinking. In addition, having multiple sexual partners was associated with an increased risk of binge and heavy drinking; involvement in a same-sex relationship was associated with binge drinking. Further work is needed to develop effective prevention intervention approaches for high-risk alcohol consumption within this population.
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Affiliation(s)
- Omar Martinez
- Temple University School of Social Work, Philadelphia, PA, USA
| | - Elwin Wu
- School of Social Work at Columbia University, New York, NY, USA
| | - Ethan C. Levine
- Department College of Liberal Arts at Temple University, Philadelphia, PA, USA
| | | | | | - Brian Dodge
- School of Public Health at Indiana University - Bloomington, Bloomington, IN, USA
| | | | - Javier López Rios
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Hugo Ovejero
- Lutheran Family Health Center, Brooklyn, NY, USA
| | - Eva M. Moya
- School of Social Work at the University of Texas at El Paso, El Paso, TX, USA
| | - Silvia Chavez Baray
- School of Social Work at the University of Texas at El Paso, El Paso, TX, USA
| | - Alex Carballo-Diéguez
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - M. Isabel Fernandez
- Department of Public Health at Nova Southeastern University, Fort Lauderdale, FL, USA
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Validity of the CAGE questionnaire for men who have sex with men (MSM) in China. Drug Alcohol Depend 2016; 160:151-6. [PMID: 26850511 PMCID: PMC4767580 DOI: 10.1016/j.drugalcdep.2015.12.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 12/03/2015] [Accepted: 12/31/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Detection of heavy drinking among men who have sex with men (MSM) is crucial for both intervention and treatment. The CAGE questionnaire is a popular screening instrument for alcohol use problems. However, the validity of CAGE for Chinese MSM is unknown. METHOD Data were from three waves of cross-sectional assessments among general MSM (n=523) and men who sell sex to other men ("money boys" or MBs, n=486) in Shanghai, China. Specifically, participants were recruited using respondent-driven, community popular opinion leader, and venue-based sampling methods. The validity of the CAGE was examined for different cutoff scores and individual CAGE items using self-reported heavy drinking (≥14 drinks in the past week) as a criterion. RESULTS In the full sample, 75 (7.4%) of participants were classified as heavy drinkers. 32 (6.1%) of general MSM and 43 (8.9%) of MBs were heavy drinkers. The area under curve statistics for overall sample was 0.7 (95% CI: 0.36-0.77). Overall, the sensitivities (ranging from 18.7 to 66.7%), specificities (ranging from 67.5 to 95.8%), and positive predictive values (ranging from 14.1 to 26.4%) for different cutoff scores were inadequate using past week heavy drinking as the criterion. The ability of CAGE to discriminate heavy drinkers from non-heavy drinkers was limited. CONCLUSIONS Our findings showed the inadequate validity of CAGE as a screening instrument for current heavy drinking in Chinese MSM. Further research using a combination of validity criteria is needed to determine the applicability of CAGE for this population.
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Rendina HJ, Moody RL, Ventuneac A, Grov C, Parsons JT. Aggregate and event-level associations between substance use and sexual behavior among gay and bisexual men: Comparing retrospective and prospective data. Drug Alcohol Depend 2015; 154:199-207. [PMID: 26190557 PMCID: PMC4536153 DOI: 10.1016/j.drugalcdep.2015.06.045] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 06/23/2015] [Accepted: 06/23/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Despite limited research, some evidence suggests that examining substance use at multiple levels may be of greater utility in predicting sexual behavior than utilizing one level of measurement, particularly when investigating different substances simultaneously. We aimed to examine aggregate and event-level associations between three forms of substance use - alcohol, marijuana, and club drugs - and two sexual behavior outcomes - sexual engagement and condomless anal sex (CAS). METHOD Analyses focused on both 6-week timeline follow-back (TLFB; retrospective) and 30-day daily diary (prospective) data among a demographically diverse sample of 371 highly sexually active HIV-positive and HIV-negative gay and bisexual men. RESULTS Models from both TLFB and diary showed that event-level use of alcohol, marijuana, and club drugs was associated with increased sexual engagement, while higher aggregated frequency marijuana and any frequency club drug use were associated with decreased sexual engagement. Event-level use of club drugs was consistently associated with increased odds of CAS across both TLFB and diary models while higher frequency marijuana use was most consistently associated with a lower odds of CAS. CONCLUSIONS Findings indicated that results are largely consistent between retrospective and prospective data, but that retrospective results for substance use and sexual engagement were generally greater in magnitude. These results suggest that substance use primarily acts to increase sexual risk at the event-level and less so through individual-level frequency of use; moreover, it primarily does so by increasing the likelihood of sex on a given day with fewer significant associations with the odds of CAS on sex days.
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Affiliation(s)
- H. Jonathon Rendina
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA
| | - Raymond L. Moody
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA,Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Ana Ventuneac
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA
| | - Christian Grov
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA,Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York (CUNY), Brooklyn, NY, USA,CUNY School of Public Health, New York, NY, USA
| | - Jeffrey T. Parsons
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA,Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA,CUNY School of Public Health, New York, NY, USA,Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
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14
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Halkitis PN, Kapadia F, Bub KL, Barton S, Moreira AD, Stults CB. A Longitudinal Investigation of Syndemic Conditions Among Young Gay, Bisexual, and Other MSM: The P18 Cohort Study. AIDS Behav 2015; 19:970-80. [PMID: 25192900 DOI: 10.1007/s10461-014-0892-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The persistence of disparities in STI/HIV risk among a new generation of emerging adult gay, bisexual, and other men who have sex with men (YMSM) warrant holistic frameworks and new methodologies for investigating the behaviors related to STI/HIV in this group. In order to better understand the continued existence of these disparities in STI/HIV risk among YMSM, the present study evaluated the presence and persistence of syndemic conditions among YMSM by examining the co-occurrence of alcohol and drug use, unprotected sexual behavior, and mental health burden over time. Four waves of data, collected over the first 18 months of a 7 wave, 36-month prospective cohort study of YMSM (n=600) were used to examine the extent to which measurement models of drug use, unprotected sexual behavior, and mental health burden remained consistent across time using latent class modeling. Health challenges persisted across time as these YMSM emerged into young adulthood and the measurement models for the latent constructs of drug use and unprotected sexual behavior were essentially consistent across time whereas models for mental health burden varied over time. In addition to confirming the the robustness of our measurement models which capture a more holistic understandings of the health conditions of drug use, unprotected sex, and mental health burden, these findings underscore the ongoing health challenges YMSM face as they mature into young adulthood. These ongoing health challenges, which have been understood as forming a syndemic, persist over time, and add further evidence to support ongoing and vigilant comprehensive health programming for sexual minority men that move beyond a sole focus on HIV.
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15
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Hess KL, Chavez PR, Kanny D, DiNenno E, Lansky A, Paz-Bailey G. Binge drinking and risky sexual behavior among HIV-negative and unknown HIV status men who have sex with men, 20 US cities. Drug Alcohol Depend 2015; 147:46-52. [PMID: 25555622 PMCID: PMC4579526 DOI: 10.1016/j.drugalcdep.2014.12.013] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 12/11/2014] [Accepted: 12/12/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Men who have sex with men (MSM) represent over half of new HIV infections in the United States. It is important to understand the factors associated with engaging in risky sexual behavior to develop effective prevention interventions. Binge drinking (≥5 drinks on ≥1 occasion) is the most common form of excessive alcohol consumption. This study examines the relationship between binge drinking and sexual risk behaviors among MSM who are current drinkers and who were either HIV-negative or unaware of their HIV status. METHODS Using the 2011 National HIV Behavioral Surveillance system and multivariable Poisson models with robust error estimates, we assessed the association between binge drinking and sexual risk behaviors among current drinkers. Prevalence ratios (PR) and 95% confidence intervals (CI) are presented. RESULTS Overall, 85% of MSM were current drinkers, and 59% of MSM who drank reported ≥1 episode of binge drinking in the preceding 30 days. In multivariable models, binge drinking was associated with condomless anal intercourse (CAI) at last sex with an HIV-positive or unknown status partner (receptive: PR 1.3, 95% CI 1.1-1.6; insertive: PR 1.2, 95% CI 1.0-1.4), having exchanged sex for money or drugs at last sex (PR: 1.4, 95% CI 1.1-1.7), having concurrent partners in the past year (PR: 1.1, 95% CI 1.1-1.2), and having more CAI partners in the past year (PR: 1.2, 95% CI 1.0-1.4) compared to non-binge drinkers. CONCLUSIONS Evidence-based strategies for reducing binge drinking could help reduce risky sexual behavior among MSM.
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Affiliation(s)
- Kristen L Hess
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS-E46, Atlanta, GA 30329, USA.
| | - Pollyanna R Chavez
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS-E46, Atlanta, GA 30329, USA.
| | - Dafna Kanny
- Excessive Alcohol Use Prevention Team, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS-F78, Atlanta, GA 30329, USA.
| | - Elizabeth DiNenno
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS-E46, Atlanta, GA 30329, USA.
| | - Amy Lansky
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS-D21, Atlanta, GA 30329, USA.
| | - Gabriela Paz-Bailey
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS-E46, Atlanta, GA 30329, USA.
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16
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Lea T, Ryan D, Prestage G, Zablotska I, Mao L, de Wit J, Holt M. Alcohol use among a community-based sample of gay men: Correlates of high-risk use and implications for service provision. Drug Alcohol Rev 2014; 34:349-57. [PMID: 25546071 DOI: 10.1111/dar.12234] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 10/23/2014] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND AIMS International research has shown that gay, bisexual and other homosexually active men (hereafter 'gay men') report disproportionately higher rates of risky alcohol use and associated problems compared with heterosexual men. However, little is known about alcohol use among this population in Australia. This study aimed to examine rates of risky alcohol use among a community-based sample of gay men in Sydney and characteristics of men reporting high-risk alcohol use and adverse consequences. DESIGN AND METHODS A cross-sectional survey of gay men was conducted in Sydney in August 2013 as part of the ongoing Gay Community Periodic Surveys (n = 1546 eligible respondents). The Alcohol Use Disorders Identification Test-Consumption questions were used to assess alcohol use in the previous 12 months. RESULTS Nine percent of respondents were categorised as abstinent from alcohol, 33% as low-risk drinkers, 42% as moderate-risk drinkers and 16% as high-risk drinkers. In separate multivariate logistic regression analyses, high-risk drinking and reporting ≥4 adverse alcohol consequences were associated with younger age, being Australian-born, recruitment from licensed premises and having met men for sex at gay bars and dance parties. Fifty-eight percent of high-risk drinkers reported a desire to reduce their alcohol use. DISCUSSION AND CONCLUSIONS In this community-based sample of gay men, we found high levels of moderate- to high-risk alcohol use. The results suggest that gay men should be a priority population for health promotion campaigns and treatment services.
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Affiliation(s)
- Toby Lea
- Centre for Social Research in Health, UNSW Australia (The University of New South Wales), Sydney, Australia
| | | | - Garrett Prestage
- The Kirby Institute, UNSW Australia (The University of New South Wales), Sydney, Australia
| | - Iryna Zablotska
- The Kirby Institute, UNSW Australia (The University of New South Wales), Sydney, Australia
| | - Limin Mao
- Centre for Social Research in Health, UNSW Australia (The University of New South Wales), Sydney, Australia
| | - John de Wit
- Centre for Social Research in Health, UNSW Australia (The University of New South Wales), Sydney, Australia
| | - Martin Holt
- Centre for Social Research in Health, UNSW Australia (The University of New South Wales), Sydney, Australia
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17
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Halkitis PN, Siconolfi DE, Stults CB, Barton S, Bub K, Kapadia F. Modeling substance use in emerging adult gay, bisexual, and other YMSM across time: the P18 cohort study. Drug Alcohol Depend 2014; 145:209-16. [PMID: 25456332 PMCID: PMC4254590 DOI: 10.1016/j.drugalcdep.2014.10.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 10/17/2014] [Accepted: 10/18/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To examine patterns of substance use over time in a new generation of emerging adult gay, bisexual, and other young men who have sex with men (YMSM). METHODS Data were drawn from the first four waves of on ongoing prospective cohort study of YMSM who were ages 18 to 19 at baseline and were assessed each 6 months for substance use via calendar based methods. Latent growth curve modeling was utilized to assess changes over time for four drug use categories: alcohol, marijuana, inhalant nitrates, and other drugs (e.g., cocaine, ecstasy) and between groups (race/ethnicity, perceived familial socioeconomic status; SES). RESULTS Use of all substances increased steadily across the follow-up period. White YMSM demonstrated higher levels of alcohol use at the 18-mo follow-up visit compared to other racial/ethnic groups, while rates of change across groups were similar. Marijuana use at 18 months was highest for Hispanics who also indicated the highest rate of change. Finally, YMSM who reported higher perceived SES reported the lowest use and lowest rates of change for other drug use. Controlling for perceived SES, differences in patterns of drug use by race/ethnicity were evident but differences were not as large. CONCLUSIONS Increases in substance use in the emerging adulthood of YMSM indicate the need for structural and behavioral interventions tailored to address substance use in these young men before chronic patterns of use develop. Differences in patterns of drug use across racial/ethnic and SES groups suggest that interventions need to consider person-level differences.
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Affiliation(s)
- Perry N Halkitis
- Center for Health, Identity, Behavior & Prevention Studies, New York University, 726 Broadway Suite 525, New York, NY 10003, United States; Global Institute of Public Heath, New York University, New York, NY 10003, United States; Department of Population Health, Langone School of Medicine, New York University, New York, NY 10003, United States.
| | - Daniel E Siconolfi
- Department of Health Behavior & Society, John Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Christopher B Stults
- Center for Health, Identity, Behavior & Prevention Studies, New York University, 726 Broadway Suite 525, New York, NY 10003, United States
| | - Staci Barton
- Center for Health, Identity, Behavior & Prevention Studies, New York University, 726 Broadway Suite 525, New York, NY 10003, United States
| | - Kristen Bub
- College of Education, University of Illinois at Urban-Champaign, Champaign, IL, United States
| | - Farzana Kapadia
- Center for Health, Identity, Behavior & Prevention Studies, New York University, 726 Broadway Suite 525, New York, NY 10003, United States; Global Institute of Public Heath, New York University, New York, NY 10003, United States; Department of Population Health, Langone School of Medicine, New York University, New York, NY 10003, United States
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18
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Tobin K, Davey-Rothwell M, Yang C, Siconolfi D, Latkin C. An examination of associations between social norms and risky alcohol use among African American men who have sex with men. Drug Alcohol Depend 2014; 134:218-221. [PMID: 24210770 PMCID: PMC4499778 DOI: 10.1016/j.drugalcdep.2013.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 10/01/2013] [Accepted: 10/01/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Research has indicated associations between risky alcohol consumption and sexual risk behavior, which may in turn present risk of HIV acquisition or transmission. Little is known about social determinants of problematic alcohol use among African American MSM (AA MSM), a risk group disproportionately affected by HIV. The present study sought to explore associations between risky alcohol use and perceived peer norms of alcohol use among a sample of urban African American men who have sex with men (AA MSM). METHODS A cross-sectional survey was administered to 142 AA MSM in Baltimore, Maryland, recruited using active and passive methods. Risky and hazardous alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT) and participants self-reported descriptive and injunctive peer norms regarding frequency and quantity of alcohol consumption. RESULTS Nearly half reported hazardous or high risk consumption of alcohol. Perceived peer alcohol norms, both descriptive and injunctive, were associated with alcohol use, including hazardous use. CONCLUSIONS The findings highlight the role of social factors on problematic alcohol use among AA MSM. Results indicate that AA MSM's use of alcohol is associated with their perceptions of peer alcohol use. Potential interventions could include norms-based campaigns that seek to reduce risky alcohol consumption among AA MSM as well as programs to screen and identify individuals with problematic alcohol use.
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Affiliation(s)
- Karin Tobin
- Johns Hopkins Bloomberg School of Public Health, United States.
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19
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Tobin KE, Latkin CA, Curriero FC. An examination of places where African American men who have sex with men (MSM) use drugs/drink alcohol: a focus on social and spatial characteristics. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2013; 25:591-7. [PMID: 24484732 DOI: 10.1016/j.drugpo.2013.12.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 09/13/2013] [Accepted: 12/06/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Drug and alcohol use are risk factors for HIV transmission. Much of the HIV behavioural research has focused on risk without consideration of the social and spatial context of the behaviour. Yet, risk may be specific or unique to place. The purpose of this study was to examine the social and spatial characteristics of places where African American men who have sex with men (AA MSM) use drugs and/or alcohol. Specifically, we examined spatial intensity and clustering of drug/alcohol places and characteristics of their social networks at these places. METHODS Participants were recruited using outreach, on-line advertisements and word-of-mouth referrals. Inclusion criteria were: age 18 or older and sex with a man in the prior 90 days. Participants (n=51) completed a socio-spatial inventory in which they provided addresses of n=187 places where they most recently used drugs and/or drank alcohol. Participants described characteristics of people who were at these places. RESULTS The mean age of participants was 36.5 years (SD=10.9). Half (51%) identified as gay, 31% bisexual, 4% heterosexual and 10% as not sure/questioning and 27% self-reported HIV positive status. Drug/alcohol places were spatially concentrated in the inner part of the city and evidence of clustering by participant characteristics was present. Of n=187 places named where the participant drank alcohol or used drugs, 68% were described as a residence (participants or "someone one else's house"), 20% were bars/clubs or restaurants, 8% were outside places and 4% were miscellaneous (e.g. on the bus/car). There were differences in the characteristics of social network members by place-type. At residential places, a greater proportion of networks listed were sex partners or kin, compared to other place-types. A greater proportion of networks listed at bars/clubs/restaurants were gay, knew that the participant had sex with men, and were younger compared to other place-types. CONCLUSION AA MSM drink alcohol and use drugs in a variety of place-types and with various social network members. Little research has been done on factors that shape the geography of AA MSM substance use. Future research is needed to explore these complex associations.
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Affiliation(s)
- Karin E Tobin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 2213 McElderry Street, Second Floor, Baltimore, MD 21205, USA.
| | - Carl A Latkin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 2213 McElderry Street, Second Floor, Baltimore, MD 21205, USA.
| | - Frank C Curriero
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltmore, MD 21205, USA; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltmore, MD 21205, USA.
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20
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Mutchler MG, McDavitt B, Gordon KK. "Becoming bold": alcohol use and sexual exploration among Black and Latino young men who have sex with men (YMSM). JOURNAL OF SEX RESEARCH 2013; 51:696-710. [PMID: 23730733 PMCID: PMC3766459 DOI: 10.1080/00224499.2013.772086] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Alcohol use is correlated with unprotected sex, which may place young men who have sex with men (YMSM) who use alcohol with sex at increased risk for contracting HIV. However, little is known about how this link develops. This study used qualitative interviews to explore how alcohol became associated with sex and sexual risk among YMSM. We purposively sampled 20 Black and 20 Latino YMSM (N = 40), ages 21 to 24, who used substances (alcohol, marijuana, and crystal methamphetamine) with sex. Interviews focused on participants' personal histories to trace how these associations developed for each individual. Drawing on sexual script, emotion regulation, and alcohol expectancy theories, analyses followed a modified grounded theory approach. Participants stated that alcohol enabled them to engage in sexual behaviors with men that they wanted to try, allowing them to be more "bold," overcome stigma about homosexuality, and feel increased comfort with their sexual desires and identities. The use of alcohol during sex was helpful to some of the participants but could also lead to sexual risk behaviors. Intervention programs seeking to reduce alcohol misuse and sexual risk should take into account how YMSM conceptualize associations between alcohol and sex. These programs may be more effective if they provide support for sexual identity exploration.
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Affiliation(s)
- Matt G. Mutchler
- CSU-Dominguez Hills, Carson, California
- AIDS Project Los Angeles, Los Angeles, California
| | - Bryce McDavitt
- CSU-Dominguez Hills, Carson, California
- AIDS Project Los Angeles, Los Angeles, California
- Pacifica Graduate Institute, Carpinteria, California
| | - Kristie K. Gordon
- CSU-Dominguez Hills, Carson, California
- AIDS Project Los Angeles, Los Angeles, California
- University of Alabama, Tuscaloosa
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