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Park JW, Dobs AS, Ho KS, Palella FJ, Seaberg EC, Weiss RE, Detels R. Characteristics and Longitudinal Patterns of Erectile Dysfunction Drug Use Among Men Who Have Sex with Men in the U.S. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2887-2896. [PMID: 34590217 PMCID: PMC8563532 DOI: 10.1007/s10508-021-02065-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 04/26/2021] [Accepted: 06/02/2021] [Indexed: 06/02/2023]
Abstract
We investigated the longitudinal relationship between erectile dysfunction (ED) drug use with behavioral factors, including substance use and sexual activities in men who have sex with men from the Multicenter AIDS Cohort Study during 1998-2016 (n = 1636). We used a bivariate random-intercept model to evaluate ED drug use along with other behavioral factors to assess relationships between the two outcomes over time on a population level and also at the individual level. Average ED drug use among men who have sex with men (MSM) with HIV was positively correlated with average use of marijuana (r = .19), poppers (r = .27), and stimulants (r = .25). In this group, testosterone use (r = .32), multiple partners (r = .41), insertive anal intercourse with condom (r = .40), and insertive anal intercourse without condom (r = .43) all showed moderate correlations over time with average ED use (p < .001). Associations among MSM without HIV were similar, with average marijuana use (r = .19) and stimulant use (r = .22) being positively correlated with average ED drug use, and were also correlated with having multiple partners (r = .36), insertive anal intercourse with condom (r = .22), and insertive anal intercourse without condom (r = .18) over time. Positive within-individual associations between ED drug use and multiple partners and insertive anal intercourse with and without condom were observed regardless of HIV serostatus. This study showed that MSM who reported use of ED drugs were also, on average, more likely to use recreational drugs and engage in sexual activities, such as having multiple partners and insertive anal intercourse. Within individuals, average ED drug use was also positively correlated with sexual behaviors.
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Affiliation(s)
- Jee Won Park
- Department of Epidemiology, 71-269 CHS, Fielding School of Public Health, University of California, Los Angeles, CA, 90095-1772, USA
| | - Adrian S Dobs
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ken S Ho
- Department of Medicine, University of Pittsburg, Pittsburgh, PA, USA
| | - Frank J Palella
- Division of Infectious Diseases, Feinberg School of Medicine of Northwestern University, Chicago, IL, USA
| | - Eric C Seaberg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Robert E Weiss
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Roger Detels
- Department of Epidemiology, 71-269 CHS, Fielding School of Public Health, University of California, Los Angeles, CA, 90095-1772, USA.
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Masterson JM, Zhao H, Choi E, Kim HH, Anger JT. Characteristics and Long Term Follow up of Men Who Suffer Ischemic Priapism Secondary to Recreational Use of Intracavernosal Injectable Medications. Urology 2021; 156:163-168. [PMID: 34273403 DOI: 10.1016/j.urology.2021.06.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/01/2021] [Accepted: 06/28/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To better understand patient experience, risk factors, culture, and ED outcomes surrounding recreational ICI use that led to ischemic priapism. METHODS After IRB approval, men presenting for ischemic priapism secondary to recreational ICI use from January 2010 to December 2018 were contacted by mail and then via telephone. Standardized questions were asked of all study participants on the topics of erectile function (IIEF-5), sexual practices, and at-risk behavior at the time of priapism. Qualitative data analysis was performed using grounded theory methodology. RESULTS 14 men age 24-59 were successfully recruited. All men described themselves as men having sex with men (MSM) and one (7.1%) as having both male and female sexual partners. Average follow up IIEF-5 among participants was 13 (SD 4.0). Eleven men (78.6 %) described illicit drug use at the time of priapism. Qualitative data analysis yielded several preliminary themes: concomitant drug use, naivety, peer pressure, and delay in seeking treatment. Men frequently reported illicit drug use in group sex scenarios and ICI use under pressure to perform sexually or to counteract effects of illicit substances. CONCLUSIONS Recreational ICI in this cohort was part of a lifestyle of risky behavior. Methamphetamine use and group sex encounters strongly motivate recreational ICI use. Substance abuse centers may offer an entry point into this population for counseling and primary prevention.
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Affiliation(s)
- John M Masterson
- Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Hanson Zhao
- Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Eunice Choi
- Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Howard H Kim
- Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Jennifer T Anger
- Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA.
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3
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Sexual Dysfunction in Men Who Have Sex With Men. Sex Med Rev 2021; 10:130-141. [PMID: 33931381 DOI: 10.1016/j.sxmr.2021.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 01/09/2021] [Accepted: 01/10/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Historically, sexual health research has focused on men who have sex with women (MSW) and most research examining the sexual health of men who have sex with men (MSM) has focused on HIV transmission. Despite a high prevalence of sexual health disorders among MSM, there is limited research that has evaluated the diversity of sexual issues in these patients. OBJECTIVES The purpose of this review is to describe the unique sexual behaviors, concerns, and dysfunctions of MSM by evaluating the literature on sexual health in this specific patient population. METHODS A PubMed literature search was conducted through December 2020 to identify all relevant publications related to the sexual health, sexual practices, and sexual dysfunction of MSM. Original research, review articles, and meta-analyses were reviewed, including comparisons of sexual behavior and dysfunction between MSM and non-MSM populations and between gay/bisexual men and heterosexual men. Approximately 150 relevant articles were reviewed and 100 were included in the manuscript. RESULTS Minority stress can lead to an increase in high-risk sexual behavior, sexual dysfunction, and mental health disorders in MSM. MSM engage in a variety of sexual behaviors, which can lead to differences in sexual dysfunction, such as anodyspareunia during receptive anal intercourse. MSM have higher rates of erectile dysfunction than non-MSM counterparts. MSM have unique activators of sexual pathologies, such as insertive anal intercourse for Peyronie's disease. Prostate cancer treatment may cause MSM to change sexual roles and practices following treatment due to ED, anodyspareunia, or decrease in pleasure from receptive anal intercourse after prostatectomy. CONCLUSION MSM have been neglected from sexual medicine research, which translates to disparities in health care. Further research that focuses on the MSM population is necessary to better educate healthcare practitioners so that MSM patients can receive adequate care that is tailored to their specific needs. PJ Cheng, Sexual Dysfunction in Men Who Have Sex With Men. Sex Med Rev 2021;XX:XXX-XXX.
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Sang JM, Cui Z, Sereda P, Armstrong HL, Olarewaju G, Lal A, Card KG, Roth EA, Hogg RS, Moore DM, Lachowsky NJ. Longitudinal Event-Level Sexual Risk and Substance Use among Gay, Bisexual, and Other Men Who Have Sex with Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3183. [PMID: 33808675 PMCID: PMC8003364 DOI: 10.3390/ijerph18063183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 01/19/2023]
Abstract
(1) Background: Condomless anal sex and substance use are associated with STI risk among gay, bisexual, and other men who have sex with men (gbMSM). Our first study objective was to describe event-level sexual risk and substance use trends among gbMSM. Our second study objective was to describe substances associated with event-level sexual risk. (2) Methods: Data come from the Momentum Health Study in Vancouver, British Columbia and participants were recruited from 2012-2015, with follow-up until 2018. Stratified by self-reported HIV status, we used generalized estimating equations to assess trends of sexual event-level substance use and assessed interactions between substance use and time period on event-level higher risk sex defined as condomless anal sex with an HIV serodifferent or unknown status partner. (3) Results: Event-level higher risk anal sex increased across the study period among HIV-negative/unknown (baseline prevalence: 13% vs. study end prevalence: 29%) and HIV-positive gbMSM (baseline prevalence: 16% vs. study end prevalence: 38%). Among HIV-negative/unknown gbMSM, event-level erectile drug use increased, while alcohol use decreased over the study period. Overall, interactions between substance use and time on higher risk anal sex were not statistically significant, regardless of serostatus. However, we found a number of time-specific significant interactions for erectile drugs, poppers, Gamma-hydroxybutyrate (GHB), crystal methamphetamine and ecstasy/MDMA use among HIV-negative/unknown gbMSM. (4) Conclusion: Significant differences in substance use trends and associated risks exist and are varied among gbMSM by serostatus. These findings provide a more comprehensive understanding of the effects of event-level substance use on sexual risk through longitudinal follow-up of nearly six years.
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Affiliation(s)
- Jordan M. Sang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (Z.C.); (P.S.); (G.O.); (A.L.); or (R.S.H.); (D.M.M.); (N.J.L.)
| | - Zishan Cui
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (Z.C.); (P.S.); (G.O.); (A.L.); or (R.S.H.); (D.M.M.); (N.J.L.)
| | - Paul Sereda
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (Z.C.); (P.S.); (G.O.); (A.L.); or (R.S.H.); (D.M.M.); (N.J.L.)
| | | | - Gbolahan Olarewaju
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (Z.C.); (P.S.); (G.O.); (A.L.); or (R.S.H.); (D.M.M.); (N.J.L.)
| | - Allan Lal
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (Z.C.); (P.S.); (G.O.); (A.L.); or (R.S.H.); (D.M.M.); (N.J.L.)
| | - Kiffer G. Card
- School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada; (K.G.C.); (E.A.R.)
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC V8P 5C2, Canada
| | - Eric A. Roth
- School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada; (K.G.C.); (E.A.R.)
| | - Robert S. Hogg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (Z.C.); (P.S.); (G.O.); (A.L.); or (R.S.H.); (D.M.M.); (N.J.L.)
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - David M. Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (Z.C.); (P.S.); (G.O.); (A.L.); or (R.S.H.); (D.M.M.); (N.J.L.)
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Nathan J. Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada; (Z.C.); (P.S.); (G.O.); (A.L.); or (R.S.H.); (D.M.M.); (N.J.L.)
- School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada; (K.G.C.); (E.A.R.)
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC V8P 5C2, Canada
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Ahuja N, Schmidt M, Dillon PJ, Alexander AC, Kedia S. Online Narratives of Methamphetamine Use and Risky Sexual Behavior: Can Shame-Free Guilt Aid in Recovery? ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:323-332. [PMID: 32671499 DOI: 10.1007/s10508-020-01777-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 06/10/2020] [Accepted: 06/13/2020] [Indexed: 06/11/2023]
Abstract
Methamphetamine (meth) use is a recurring public health challenge in the U.S. In 2016, approximately 1.6 million Americans reported using meth. Meth use is associated with a number of adverse outcomes, including those associated with users' sexual health. In particular, meth use is linked to an increased risk for sexually transmitted infections and unplanned pregnancies. While studies have examined associations between substance use of various types-including meth use, and shame and guilt-few studies have examined relationships among substance use, sexual risk behaviors, and shame and guilt. No qualitative studies, to our knowledge, have studied all three of these phenomena in a sample of meth users. The present qualitative study explored the sexual risk behaviors and associated feelings of shame and guilt in relation to meth use. It draws from anonymous letters and stories (N = 202) posted to an online discussion forum by meth users and their family members. A grounded theory analysis of these narratives identified four primary themes pertaining to meth use and sexual behaviors: (1) feeling heightened sexual arousal and stimulation on meth, (2) experiencing sexual dissatisfaction on meth, (3) responding to sexual arousal and dissatisfaction, and (4) feeling ashamed and/or guilty. Ultimately, the present findings indicate that feelings of shame and guilt may arise more from the consequences of sexual risk behaviors stemming from meth use rather than meth use itself. The emotional toll of meth-induced sexual risk behaviors, particularly shame and guilt over the loss of meaningful relationships and self-respect due to multiple sexual partners, may provide an important opportunity for interventionists.
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Affiliation(s)
- Nikhil Ahuja
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA
| | - Michael Schmidt
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, OH, USA
| | - Adam C Alexander
- The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Satish Kedia
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA.
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Donnadieu-Rigole H, Peyrière H, Benyamina A, Karila L. Complications Related to Sexualized Drug Use: What Can We Learn From Literature? Front Neurosci 2020; 14:548704. [PMID: 33328844 PMCID: PMC7732585 DOI: 10.3389/fnins.2020.548704] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022] Open
Abstract
Chemsex is described as the use of specific psychoactive substances (PS) during sexual activity to sustain, enhance, disinhibit or facilitate the sexual experience. It preferentially concerns men who have sex with men (MSM). They use new synthetic substances like cathinones, methamphetamines, gamma-butyrolactone/gamma-hydroxybutyrate (GBL/GHB), ketamine, and cocaine. The prevalence of chemsex varies from 3 to 31% during lifetime. The Internet has participated significantly in the evolution of sexual behaviors, both in terms of sexual dating and the availability of new synthetic substances. The advent of geolocation applications contributed to the development of chemsex. The literature describes many complications linked to these sexual practices; the main clinical effects related to cathinones consumption were psychiatric symptoms; agitation, hallucinations, anxiety, suicidal ideation, paranoia, and confusion. Regular GBL/GHB consumption alter cognitive functions, particularly memory and emotion management. Use of these drugs in party and play is dramatically associated with high-risk sexual behaviors. The prevalence of hepatitis B, hepatitis C syphilis, and HIV is higher in men who use methamphetamine and Viagra and/or who declared they practiced slamming, chemsex, and fisting. Other sexually transmitted infections (STIs) such as gonorrhea have increased with methamphetamine and GHB/GBL use. Actually, the care of individuals who practice Chemsex in a problematic way is currently not codified, but the use of integrative and specific interventions is necessary.
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Affiliation(s)
- Hélène Donnadieu-Rigole
- Addictions Department, Saint Eloi Hospital, University Hospital of Montpellier, Montpellier, France.,INSERM U 1058, Pathogenesis and Control of Chronic Infections (PCCI), Montpellier, France
| | - Hélène Peyrière
- INSERM U 1058, Pathogenesis and Control of Chronic Infections (PCCI), Montpellier, France.,Addictovigilance Center, Department of Medical Pharmacology and Toxicology, University Hospital of Montpellier, Montpellier, France
| | - Amine Benyamina
- Centre d'Enseignement, de Recherche et de Traitement des Addictions, Hôpital Universitaire Paul-Brousse (APHP), Villejuif, France.,Paris-Saclay University, Saint-Aubin, France
| | - Laurent Karila
- Centre d'Enseignement, de Recherche et de Traitement des Addictions, Hôpital Universitaire Paul-Brousse (APHP), Villejuif, France.,Paris-Saclay University, Saint-Aubin, France.,Unité de Recherche PSYCOMADD, Villejuif, France
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7
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Noroozi M, Higgs P, Noroozi A, Armoon B, Mousavi B, Alikhani R, Bazrafshan MR, Astaneh AN, Bayani A, Moghaddam LF. Methamphetamine use and HIV risk behavior among men who inject drugs: causal inference using coarsened exact matching. Harm Reduct J 2020; 17:66. [PMID: 32957982 PMCID: PMC7507738 DOI: 10.1186/s12954-020-00411-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 09/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding the association between methamphetamine (MA) use and HIV risk behavior among people who inject drugs (PWID) will assist policy-makers and program managers to sharpen the focus of HIV prevention interventions. This study examines the relationship between MA use and HIV risk behavior among men who inject drugs (MWID) in Tehran, Iran, using coarsened exact matching (CEM). METHODS Data for these analyses were derived from a cross-sectional study conducted between June and July 2016. We assessed three outcomes of interest-all treated as binary variables, including distributive and receptive needle and syringe (NS) sharing and condomless sex during the month before interview. Our primary exposure of interest was whether study participants reported any MA use in the month prior to the interview. Firstly, we report the descriptive statistics for the pooled samples and matched sub-samples using CEM. The pooled and matched estimates of the associations and their 95% CI were estimated using a logistic regression model. RESULTS Overall, 500 MWID aged between 18 and 63 years (mean = 28.44, SD = 7.22) were recruited. Imbalances in the measured demographic characteristics and risk behaviors between MA users and non-users were attenuated using matching. In the matched samples, the regression models showed participants who reported MA use were 1.82 times more likely to report condomless sex (OR = 1.82 95% CI 1.51, 4.10; P = 0.031), and 1.35 times more likely to report distributive NS sharing in the past 30 days, as compared to MA non-users (OR = 1.35 95% CI 1.15-1.81). Finally, there was a statistically significant relationship between MA use and receptive NS sharing in the past month. People who use MA in the last month had higher odds of receptive NS sharing when compared to MA non-users (OR = 4.2 95% CI 2.7, 7.5; P = 0.013). CONCLUSIONS Our results show a significant relationship between MA use and HIV risk behavior among MWID in Tehran, Iran. MA use was related with increased NS sharing, which is associated with higher risk for HIV exposure and transmission.
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Affiliation(s)
- Mehdi Noroozi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Peter Higgs
- Department of Public Health, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Alireza Noroozi
- Department of Neuroscience and Addiction, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
| | - Bentolhoda Mousavi
- Psychosis Research Center, Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Rosa Alikhani
- Psychosis Research Center, Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Rafi Bazrafshan
- Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran
| | - Ali Nazeri Astaneh
- Department of Psychiatry, University of Social Welfare and Rehabilitation Science, Tehran, Iran
| | - Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ladan Fattah Moghaddam
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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8
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Reynolds GL, Fisher DG, Erlyana E, Otterloo LV. Rectal douching in a community sample of men and women. Int J STD AIDS 2020; 31:1082-1092. [PMID: 32914687 DOI: 10.1177/0956462419837483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rectal douching (RD) may be a vector for sexually transmitted infection (STI) acquisition. The aim of this study was to describe the relationship between RD, and the prevalence of various STIs and sexual behaviors in a sample of women and men in Long Beach, California. Five hundred and forty-seven men (mean age 42.8 years) and 530 women (mean age 37 years) recruited from a community-based setting between April 2010 and August 2014 completed the Risk Behavior Assessment and a questionnaire eliciting information on use of lubricants and enemas for vaginal intercourse (VI) and anal intercourse (AI). Participants were screened for high-risk behaviors for human immunodeficiency virus infection including injection drug use. Bivariate analyses were conducted separately for women and men. Based on the empirical results, separate logistic regression models for women and men were constructed. Sensitivity analysis was conducted to assess model fit for reduced samples of only those men and women who reported AI. For men, RD was associated with a lower odds of being hepatitis C antibody positive, greater odds of being positive for hepatitis B virus surface antigen, syphilis, and using lubricants for receptive anal intercourse (RAI). RD in women was associated with higher odds of a positive test for syphilis, ever vaginally douching for VI, and using lubricants for RAI. Men and women who practice RD report positive syphilis test results and use of lubricants for RAI. RD should not be perceived as preventing STIs.
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Affiliation(s)
- Grace L Reynolds
- Department of Health Care Administration, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA.,Center for Behavioral Research and Services, Psychology Department, California State University, Long Beach, CA, USA
| | - Dennis G Fisher
- Center for Behavioral Research and Services, Psychology Department, California State University, Long Beach, CA, USA.,Center for Behavioral Research and Services, Department of Health Care Administration, California State University, Long Beach, CA, USA
| | - Erlyana Erlyana
- Department of Health Care Administration, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA.,Center for Behavioral Research and Services, Psychology Department, California State University, Long Beach, CA, USA
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Griffiths A, Hadley L. The prevalence of gamma-hydroxybutyrate (GHB) in motor vehicle drivers and its co-administration with amphetamine type substances (ATS) in Queensland, Australia (2011-2018). Forensic Sci Int 2019; 303:109958. [PMID: 31542401 DOI: 10.1016/j.forsciint.2019.109958] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/02/2019] [Accepted: 09/05/2019] [Indexed: 11/16/2022]
Abstract
The routine analysis of driver specimens for gamma-hydroxybutyrate (GHB) is rarely performed by toxicology laboratories as the physical and chemical properties of GHB make it unamenable to the screening methods usually employed. The prevalence of the drug in driver populations has therefore only rarely been reported. This study outlines the results of the routine analysis for GHB in the blood of motor vehicle drivers in Queensland, Australia, over an eight-year period (2011-2018). The methodology for GHB analysis was updated over the course of the study; screening for GHB was conducted using GC/FID or GC/MS between 2011 and 2016 and by LC/MS/MS from 2017 onwards. Due to the endogenous nature of GHB, any specimens containing greater than 5mg/kg GHB were subjected to quantitative analysis by either; GC/MS after liquid-liquid extraction and derivatisation with BSTFA+1%TMCS (2011-2016), or by LC/MS/MS analysis after solvent precipitation from 2017 onwards. Of the 15,061 specimens analysed, 160 were positive for GHB (1.1% of all cases, range 0.4-1.8%). GHB positive drivers were 66.9% male (33.1% female) and had an average age of 32 years. The mean GHB concentration identified was 89mg/kg (range 6-354mg/kg). GHB was found to be closely associated with amphetamine type substances (ATS), particularly methylamphetamine. Though GHB was present in only 2.2% of all ATS positive specimens submitted to the laboratory, 91.2% of all GHB positive cases contained an ATS. Other drugs commonly co-administered with GHB were THC, cocaine, benzodiazepines and erectile dysfunction drugs. GHB was found to be more commonly identified in drivers from city areas and a geographical localisation of the use of the drug was identified in the Gold Coast region of Queensland.
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Affiliation(s)
- Andrew Griffiths
- Forensic Toxicology Laboratory, Forensic and Scientific Services, Health Support Queensland, 39 Kessels Road, Coopers Plains, Queensland, 4108, Australia.
| | - Lenore Hadley
- Forensic Toxicology Laboratory, Forensic and Scientific Services, Health Support Queensland, 39 Kessels Road, Coopers Plains, Queensland, 4108, Australia
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10
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Kuiper LB, Coolen LM. Compulsive Sexual Behavior in Humans and Preclinical Models. CURRENT SEXUAL HEALTH REPORTS 2018. [DOI: 10.1007/s11930-018-0157-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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11
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Swartz JA, McCarty-Caplan D. A Study of the Longitudinal Patterns of Stimulant and Amyl Nitrite Use and Sexual Behavior Pre- and Post-HIV Seroconversion Among MSM. AIDS Behav 2018; 22:1395-1409. [PMID: 29248970 DOI: 10.1007/s10461-017-2008-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The use of stimulant drugs alone or in combination with amyl nitrites (stimulant/nitrites) has been associated with higher rates of risky sexual behavior and predictive of HIV infection among men who have sex with men. However, the temporal pattern of stimulant/nitrite use pre- and post-seroconversion has not been well established. This study assessed changes in stimulant/nitrite use and risky sexual behavior among seroconverting MSM over time. Data were collected in the Baltimore-Washington, DC; Pittsburgh; Chicago; and Los Angeles sites of the Multicenter AIDS Cohort Study (MACS), a longitudinal study of the natural history of HIV infection among MSM. We used propensity scores to select 1044 MSM from 7087 MACS participants composed of 348 seroconverting, 348 seronegative, and 348 seroprevalent participants matched on demographics, recruitment cohort, and study visits. We centered up to four-years of semi-annual data around the seroconversion visit of the seroconverting case within each matched group of participants. Mixed effects regressions estimated the effects of serostatus, recruitment cohort, and time on self-reported stimulant/nitrite use, numbers of male intercourse partners, and numbers of unprotected receptive anal intercourse (URAI) partners. Covariates included demographics, binge drinking, and marijuana use. Seroconverters had the highest odds of stimulant/inhaled nitrite use (AOR 10.3, CI 4.8-22.0), incident rates of intercourse (IRR 1.6, CI 1.3-2.1), and URAI partners (IRR 5.1, CI 3.5-7.3). All participants decreased drug use and sexual risk behavior over time. However, the decreases were largest for seroconverters who nevertheless maintained the highest rates of stimulant/nitrite use and sexual risk. Cohort-related effects were associated with sharp reductions in stimulant/nitrite use and URAI in the early 1990s that rebounded considerably within the first decade of the 2000s. Although all participants decreased risky sexual behavior and stimulant and/or nitrite use over time, seroconverters had the largest decreases. There was no evidence for abrupt or substantial increases in drug use or risky sex post-seroconversion. However, there was substantial variation at the individual level, with the factors underlying this variation not well understood and worth further study. Moreover, stimulant/nitrite use and risky sexual behavior appear to have been strongly influenced by contextual historical and socio-cultural effects. The manner in which contextual factors influence individual behavior is also not well understood and also warrants further study.
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Saw YM, Saw TN, Chan N, Cho SM, Jimba M. Gender-specific differences in high-risk sexual behaviors among methamphetamine users in Myanmar-China border city, Muse, Myanmar: who is at risk? BMC Public Health 2018; 18:209. [PMID: 29390989 PMCID: PMC5796492 DOI: 10.1186/s12889-018-5113-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 01/23/2018] [Indexed: 01/15/2023] Open
Abstract
Background Methamphetamine (MA) use is a significant public health concern due to its negative effects on health. However, to date, no epidemiological research has examined high-risk sexual behaviors (inconsistent condom use, having multiple sexual partners and having a history of sexually transmitted infections) among MA users. This topic is particularly important in Myanmar, which is recognized as one of the key MA production countries in the Southeast Asia region. Therefore, this study examined factors associated with high-risk sexual behaviors among MA users in Muse city, Myanmar. Methods A community-based cross-sectional study was conducted from January to March 2013 in Muse city, Northern Shan State, Myanmar. In total, 1183 MA users (772 male; 411 female) were recruited using respondent-driven sampling and a computer assisted self-interviewing method. Generalized estimating equation models were used to examine factors associated with high-risk sexual behaviors. Results A large proportion of MA users engaged in high-risk sexual behaviors (inconsistent condom use: males, 90.7%, females, 85.2%; multiple sexual partners: males, 94.2%, females, 47.2%; and history of STIs: males, 55.7%, females, 56.0%). Among males, being a multiple stimulants drug user (adjusted odds ratio [AOR] =1.77; 95% confidence interval [CI] =1.30–2.41) and being a client of sex workers (AOR = 1.41; 95% CI = 1.08–1.83) were risk factors for engaging in high-risk sexual behaviors. Among females, being a migrant worker (AOR = 2.70; 95% CI = 1.86–3.93) and being employed (AOR = 1.57; 95% CI = 1.13–2.18) were risk factors for engaging in high-risk sexual behaviors as well. Conclusions High-risk sexual behaviors were particularly pronounced among both male and female MA users. MA prevention programs that reflect gender considerations should be developed to pay more attention to vulnerable populations such as migrants, clients of sex workers, and less educated female MA users.
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Affiliation(s)
- Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. .,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Thu Nandar Saw
- Myanma Perfect Research, Yangon, Myanmar.,Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nyein Chan
- Department of Social Research, Defence Services Medical Research Centre, Tatkone Township, Nay Pyi Taw, Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Rich AJ, Lachowsky NJ, Cui Z, Sereda P, Lal A, Birch R, Montaner J, Moore D, Hogg RS, Roth EA. Substance use, sexual behaviour and prevention strategies of Vancouver gay and bisexual men who recently attended group sex events. CULTURE, HEALTH & SEXUALITY 2015; 18:361-76. [PMID: 26443295 PMCID: PMC4773192 DOI: 10.1080/13691058.2015.1084649] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Group sex events are an epidemiologically important part of some gay and bisexual men's sexual culture in Canada. Associated with condomless anal intercourse and polysubstance use, such events have been cited as disproportionally contributing to HIV infection rates. We analysed questionnaire data from the Momentum Health Study in Vancouver, Canada, to understand substance use, sexual behaviour, psychosocial variables (Sexual Sensation Seeking, Sexual Escape Motivation, Treatment Optimism) and HIV prevention strategies (sero-sorting, strategic positioning, avoiding anal sex, disclosure, treatment as prevention) of men attending such events, which were defined as group (n ≥ 4 partners) sex parties, blackout events and darkrooms. Analysis by multivariable logistic regression compared men attending group sex events within the past six months (n = 180) with non-attendees (n = 539). Results showed that attendees reported: (1) significantly higher use of sex drugs and alcohol consumption, (2) higher scores on the Sexual Sensation Scale, more anal sex partners, greater odds of any condomless anal sex with sero-discordant partners and greater odds of reporting fisting and sex toy use and (3) different prevention practices that varied by HIV-serostatus. Findings are interpreted in light of the importance of pleasure, sociality and HIV/STI prevention strategies associated with group sex events. Findings contribute to the development of appropriate education and intervention for attendees.
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Affiliation(s)
- Ashleigh J Rich
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Nathan J Lachowsky
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Zishan Cui
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Paul Sereda
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Allan Lal
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Robert Birch
- Department of Anthropology, University of Victoria, Victoria, Canada
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, Canada
| | - Julio Montaner
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - David Moore
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Robert S Hogg
- Department of Epidemiology & Population Health, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Eric A Roth
- Department of Anthropology, University of Victoria, Victoria, Canada
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, Canada
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Lacefield K, Negy C, Schrader RM, Kuhlman C. Comparing Psychosocial Correlates of Condomless Anal Sex in HIV-Diagnosed and HIV-Nondiagnosed Men Who Have Sex with Men: A Series of Meta-Analyses of Studies from 1993-2013. LGBT Health 2015; 2:200-20. [PMID: 26788669 DOI: 10.1089/lgbt.2014.0069] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Men who have sex with men (MSM) continue to be overrepresented in rates of incidence and prevalence of human immunodeficiency virus (HIV). Both HIV-diagnosed (HIV-D) and HIV-nondiagnosed (HIV-N) MSM report a variety of reasons for intentional and unintentional nonuse of condoms. Elucidating and comparing reasons for continued engagement in condomless anal sex specific to both HIV-D and HIV-N MSM likely is important to identifying effective prevention. METHODS This study employed meta-analytic methods to evaluate and compare correlates to condomless anal sex in both HIV-D and HIV-N MSM from primary studies from 1993 to February 2013. RESULTS Of the 19 individual correlates assessed within the subgroup of HIV-D MSM, variables that achieved significant effect were alcohol, mind-altering substance use, sexual-enhancement medication, intentional condom nonuse, self-efficacy, attitudes toward condom use, social support, gay identity, compulsivity, trading sex, and number of sex partners. Those that were statistically non-significant were intention to use a condom, perceived risk, perceived norms, perceived responsibility, HIV medical management, treatment optimism, mental health, and setting. Of the 12 correlates assessed within the subgroup of HIV-N MSM, variables that achieved significant effect were alcohol, mind-altering substance use, intentional condom nonuse, attitudes toward condom use, perceived risk, and setting. Those observed as statistically non-significant were perceived norms, social support, gay identity, mental health, trading sex, and number of sex partners. CONCLUSION Study results have clinical implications that may guide future prevention research and practice by highlighting risk variables shared between HIV-N and HIV-D MSM, as well as variables observed to be unique to each group that may warrant more tailored intervention. Further investigation is recommended to elucidate the relationships among these variables such that optimal intervention can be determined.
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Affiliation(s)
- Katharine Lacefield
- 1 Department of Psychology, VA Maryland Healthcare System , Baltimore, Maryland.,2 Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Charles Negy
- 3 Department of Psychology, University of Central Florida , Orlando, Florida
| | - Ronald M Schrader
- 4 Department of Dialysis, DCI Corporate Quality Management , Albuquerque, New Mexico
| | - Christina Kuhlman
- 3 Department of Psychology, University of Central Florida , Orlando, Florida
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15
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Yu G, Wall MM, Chiasson MA, Hirshfield S. Complex drug use patterns and associated HIV transmission risk behaviors in an Internet sample of U.S. men who have sex with men. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:421-8. [PMID: 25104104 PMCID: PMC4381804 DOI: 10.1007/s10508-014-0337-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 01/27/2014] [Accepted: 03/04/2014] [Indexed: 05/21/2023]
Abstract
Although the relationship between drug use and HIV risk among men who have sex with men (MSM) is well described, relatively few studies have employed empirical methods to assess underlying classes of drug use that may better predict the risk of HIV or sexually transmitted infections (STIs) among MSM. The aim of this study was to determine whether latent class analysis (LCA) would identify underlying drug classes reported prior to sex, as well as predict unprotected anal intercourse (UAI) in the last sexual encounter among MSM. From 2004 to 2005, an anonymous online survey was conducted among 8,717 sexually active MSM recruited from gay-affiliated U.S. websites. LCA clustered participants into six distinct drug use classes based on the specific types and number of drugs used: (1) low/no drug use, (2) recreational drug use, (3) poppers with prescription erectile dysfunction (ED) drug use, (4) poppers with both prescription and non-prescription ED drug use, (5) recreational, club, and ED drug use, and (6) high polydrug use. Compared with men in Class 1, men in the highest drug use class were 4.84 times more likely to report UAI in their last sexual encounter and 3.78 times more likely to report an STI in the past year (both ps < .001). Younger MSM aged 18-29 were significantly more likely to report an STI than men aged 50 and above (p < .001). There is a need to better understand the complex relationship between a diverse set of drugs used among MSM and how polydrug use impacts sexual negotiation over time.
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Affiliation(s)
- Gary Yu
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
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Prestage G, Jin F, Bavinton B, Grulich A, Brown G, Pitts M, Hurley M. Australian Gay and Bisexual Men's Use of Erectile Dysfunction Medications During Recent Sexual Encounters. J Sex Med 2014; 11:809-19. [DOI: 10.1111/jsm.12407] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Hunter LJ, Dargan PI, Benzie A, White JA, Wood DM. Recreational drug use in men who have sex with men (MSM) attending UK sexual health services is significantly higher than in non-MSM. Postgrad Med J 2014; 90:133-8. [PMID: 24390619 DOI: 10.1136/postgradmedj-2012-131428] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The aim of this study was to investigate the pattern of recreational drug use in patients attending a genitourinary medicine clinic, and to determine whether drug use was greater among men who have sex with men (MSM) patients, when compared to non-MSM male patients. METHODS A questionnaire was given to all patients attending the genitourinary medicine clinics at two inner city teaching hospitals over 3 months (July to September 2011). The questionnaire was self-completed by patients while waiting to be seen by a clinician. Data were collected on age, gender, gender of sexual partner(s), and previous/current recreational drug use (type/frequency of drugs used). Only data from male respondents have been analysed in this paper. RESULTS 1328 questionnaires were completed. Of the male respondents (n=729), 475 (65.2%) were identified as non-MSM and 254 (34.8%) were identified as MSM. The mean ± SD age of male respondents was 31 ± 9 years years. Lifetime and last month use of mephedrone, ketamine, volatile nitrites ('poppers'), sildenafil (Viagra), GHB, and GBL were all significantly higher in the MSM group compared to the non-MSM group. Lifetime use of cocaine powder, MDMA, amphetamine, and methamphetamine were also significantly higher in the MSM group; however, there was no significant difference in last month use of these drugs between MSM and non-MSM groups. CONCLUSIONS Both lifetime and last month use of most recreational drugs was more common in MSM, when compared to non-MSM males. Sexual health clinics may provide an opportunistic encounter to identify patterns of recreational drug use, explore motivations for use, and implement strategies to reduce harms related to drug use. This will require a multidisciplinary approach to address the psychosocial aspects of drug taking behaviours, in combination with healthcare professionals experienced in the management of recreational drug use.
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Affiliation(s)
- L J Hunter
- Emergency Medicine and Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, , London, UK
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19
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High-risk Sexual Behavior is Associated with Post-Exposure Prophylaxis Non-adherence among Men who have Sex with Men Enrolled in a Combination Prevention Intervention. JOURNAL OF SEXUALLY TRANSMITTED DISEASES 2013; 2013:210403. [PMID: 24527254 PMCID: PMC3920980 DOI: 10.1155/2013/210403] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Methamphetamine use among men who have sex with men (MSM) is associated with increased HIV prevalence, due to increased engagement in high-risk sexual behavior. Fifty-three HIV-negative, methamphetamine-using MSM were enrolled in a biobehavioral combination prevention intervention in Los Angeles, CA, to assess the feasibility of administering postexposure prophylaxis (PEP) in combination with contingency management (CM) to prevent HIV seroconversion. The study combined a CM behavioral intervention targeting reductions in methamphetamine use with a PEP biomedical intervention for HIV prevention. Those who reported recent exposure to HIV were initiated on tenofovir/emtricitabine- (Truvada)-based PEP (n=35). This secondary analysis sought to determine whether recent and/or lifetime sexual risk taking was associated with PEP adherence. Regression analyses controlling for participant sociodemographics demonstrated that, at baseline, increased number of lifetime sexually transmitted diseases (STDs; Coef.=-0.07; 95% CI=(-0.12) - (-0.01)) and recent episodes of unprotected anal intercourse (UAI; Coef.=-0.01; 95% CI= (-.01) - (-0.002)) were each associated with reductions in medication adherence. Given these associations between baseline sexual risk and PEP adherence, providers working with high-risk MSM may look to target reductions in sexual risk taking; this will reduce direct risk of HIV infection and may work to optimize medication adherence in the case of PEP initiation. Clinicaltrials.gov identifier: NCT00856323.
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20
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Concurrent exposure to methamphetamine and sexual behavior enhances subsequent drug reward and causes compulsive sexual behavior in male rats. J Neurosci 2012; 31:16473-82. [PMID: 22072697 DOI: 10.1523/jneurosci.4013-11.2011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Methamphetamine (Meth) users report having heightened sexual pleasure, numerous sexual partners, and engaging in unprotected sex due to loss of inhibitory control. This compulsive sexual behavior contributes to increased prevalence of sexually transmitted infections, but the neural basis for this is unknown. We previously established a paradigm for compulsive sexual behavior in male rats in which visceral illness induced by lithium chloride was paired with sexual behavior (Davis et al., 2010; Frohmader et al., 2010a). The current study examined the effects of repeated Meth administration on sexual performance, compulsive sexual behavior, and sex or Meth reward. First, results demonstrated that seven daily administrations of 2 mg/kg, but not 1 mg/kg, Meth increased latencies to initiate mating. This impairment was evident 30 min after last Meth administration, but dissipated after 1 or 7 d of subsequent drug abstinence. Repeated 1 mg/kg Meth exposure resulted in compulsive sex-seeking behavior 2 weeks following last Meth administration. This effect was dependent on Meth administration being concurrent with sexual experience and was not observed in sexually experienced animals that received Meth alone. Moreover, concurrent Meth and sexual experience enhanced conditioned place preference (CPP) for Meth, and for concurrent Meth and mating compared with Meth or mating alone. In contrast, CPP for mating alone was decreased. Together, these data indicate that the association between drug use and mating may be required for expression of compulsive sexual behavior and is correlated with increased reward seeking for concurrent Meth exposure and mating.
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Abstract
PURPOSE OF REVIEW The present review discusses the recent finding on behavioral risk factors for HIV transmission from cohort studies in MSM. RECENT FINDINGS HIV incidence among MSM has been increasing in many countries around the world. Some data support early detection and widespread use of antiretroviral treatment (ART) to decrease HIV incidence. However, suboptimal ART adherence could lead to relapse of viremia and new transmission events. Condom use for unprotected anal sex among MSM remains an important prevention tool, but use remains low in many parts of the world. Seroadaptive behaviors by MSM, such as serosorting, may also decrease condom use. However, when serosorting is practiced by MSM who receive frequent HIV testing, the risk of HIV acquisition is reduced. Serosorting and other characteristics of sexual networks, such as concurrency, may be major determinants of transmission for HIV and sexually transmitted infections among MSM. Worldwide, detailed evaluation of the factors related to rising MSM HIV incidence, as well as access to testing and care, is limited by stigma and criminalization of HIV and homosexuality. SUMMARY Cohort studies of MSM remain an important strategy to characterize the behavioral factors that drive HIV transmission and how use of ART for prevention and treatment may affect both the risk of HIV transmission and acquisition by MSM.
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Storholm ED, Halkitis PN, Siconolfi DE, Moeller RW. Cigarette smoking as part of a syndemic among young men who have sex with men ages 13-29 in New York City. J Urban Health 2011; 88:663-76. [PMID: 21479753 PMCID: PMC3157504 DOI: 10.1007/s11524-011-9563-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The prevalence of cigarette smoking among young men who have sex with men (YMSM) is significantly higher than among their heterosexual peers. We undertook an analysis to examine cigarette smoking in relation to demographic factors and other risk behaviors among 580 YMSM, ages 13-29, in New York City. Cross-sectional data were collected as part of larger study of risk behaviors using palm devices and targeted active recruitment strategies across all five boroughs of the city. Multivariate modeling suggests that Asian or Pacific Islander and White YMSM are more likely to report cigarette smoking than other racial and ethnic groups, as are men reporting a middle class socioeconomic status. In addition, smoking was related to the likelihood of using a variety of illicit substances, as well as alcohol and pharmaceuticals without a prescription, during the period of assessment. YMSM who smoke cigarettes reported a greater number of casual sex partners and a greater number of transactional sex partners than non-smokers. Episodic analysis of sexual behaviors with casual partners indicated that smokers were more likely to engage in illicit drug and alcohol use immediately before or during sex than did non-smokers. These findings are understood as part of a larger syndemic among YMSM, and suggest that smoking prevention and cessation programs should be embedded as part of larger more holistic health and wellness programs targeting YMSM.
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Affiliation(s)
- Erik David Storholm
- Center for Health, Identity, Behavior & Prevention Studies, the Steinhardt School of Culture, Education, and Human Development, New York University, 82 Washington Square East, Pless 555, New York, NY 10003 USA
| | - Perry N. Halkitis
- Center for Health, Identity, Behavior & Prevention Studies, the Steinhardt School of Culture, Education, and Human Development, New York University, 82 Washington Square East, Pless 555, New York, NY 10003 USA
| | - Daniel E. Siconolfi
- Center for Health, Identity, Behavior & Prevention Studies, the Steinhardt School of Culture, Education, and Human Development, New York University, 82 Washington Square East, Pless 555, New York, NY 10003 USA
| | - Robert W. Moeller
- Center for Health, Identity, Behavior & Prevention Studies, the Steinhardt School of Culture, Education, and Human Development, New York University, 82 Washington Square East, Pless 555, New York, NY 10003 USA
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Shindel AW, Horberg MA, Smith JF, Breyer BN. Sexual dysfunction, HIV, and AIDS in men who have sex with men. AIDS Patient Care STDS 2011; 25:341-9. [PMID: 21501095 PMCID: PMC3101920 DOI: 10.1089/apc.2011.0059] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
HIV infection is associated with sexual dysfunction. Using validated instruments, we investigated the relationship between HIV/AIDS and sexual function in a contemporary cohort of men who have sex with men (MSM). An anonymous Internet-based survey was disseminated to MSM via organizations and social networking sites that cater to this population. Information on ethnodemographic variables, health status (including HIV status, disease stage, and other health conditions), and sexual behavior was collected. Men were categorized as HIV-negative, HIV-positive/AIDS-negative, or HIV-positive /AIDS-positive. A modified validated version of the International Index of Erectile Function (IIEF) for use in MSM and the Premature Ejaculation Diagnostic Tool (PEDT) were used to stratify risk of sexual dysfunction. The study cohort included 1361 men (236 of whom were HIV-positive) who provided complete data on HIV status, IIEF, and PEDT. There was a significant trend toward greater prevalence of erectile dysfunction (ED) in men with progressive HIV infection 40-59 years of age relative to age matched HIV-negative men (p=0.02). In a logistic regression model controlling for other variables, HIV infection without AIDS was not associated with greater odds of ED; however, HIV infection with AIDS was associated with greater odds of ED (p=0.006). In a separate logistic regression model, HIV infection with or without AIDS was not significantly associated with greater odds of premature ejaculation (p>0.05). Use of phosphodiesterase 5 (PDE5) inhibitor drugs was much more common in HIV-infected men. HIV infection is a risk factor for poorer sexual function primarily due to higher risk of erectile dysfunction in men with AIDS.
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Affiliation(s)
- Alan W. Shindel
- Department of Urology, University of California, Davis, Sacramento, California
| | - Michael A. Horberg
- HIV Interregional Initiative of Kaiser Permanente and Permanente Federation, Division of Research, Oakland, California
| | - James F. Smith
- Department of Urology, University of California, San Francisco, San Francisco, California
| | - Benjamin N. Breyer
- Department of Urology, University of California, San Francisco, San Francisco, California
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Hirshfield S, Chiasson MA, Wagmiller RL, Remien RH, Humberstone M, Scheinmann R, Grov C. Sexual dysfunction in an Internet sample of U.S. men who have sex with men. J Sex Med 2011; 7:3104-14. [PMID: 19968773 DOI: 10.1111/j.1743-6109.2009.01636.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Relatively little is known about sexual dysfunction (SD) in men who have sex with men (MSM). AIM In order to better understand SD symptoms in MSM, we assessed self-reported SD symptoms, individually and by latent class analysis (LCA). METHODS In 2004-2005 an Internet sample of U.S. MSM was recruited from gay-oriented sexual networking, chat and news websites. The analytic sample comprised 7,001 men aged 18 or older who reported lifetime male sex partners and oral or anal sex with a male partner in their most recent encounter within the past year. MAIN OUTCOME MEASURES Seven questions on SD symptoms that occurred during the past 12 months inquired about low sexual desire, erection problems, inability to achieve an orgasm, performance anxiety, premature ejaculation, pain during sex, and sex not being pleasurable. RESULTS Self-reported symptoms of SD were high. Overall, 79% of men reported one or more SD symptoms in the past year, with low sexual desire, erection problems, and performance anxiety being the most prevalent. Four distinct underlying patterns of sexual functioning were identified by LCA: no/low SD, erection problems/performance anxiety, low desire/pleasure, and high SD/sexual pain. High SD/sexual pain was distinguished from the other patterns by club drug use and use of prescription and non-prescription erectile dysfunction medication before sex in the past year. Additionally, men associated with the high SD/sexual pain group were younger, single, more likely to have poor mental and physical health, and more likely to have been diagnosed with a sexually transmitted infection in the past year compared to men in the no/low SD group. CONCLUSIONS LCA enabled us to identify underlying patterns of sexual functioning among this sample of MSM recruited online. Future research should investigate these distinct subgroups with SD symptoms in order to develop tailored treatments and counseling for SD.
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Affiliation(s)
- Sabina Hirshfield
- Public Health Solutions, Department of Research & Evaluation, New York, New York 10013, USA.
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Frohmader KS, Bateman KL, Lehman MN, Coolen LM. Effects of methamphetamine on sexual performance and compulsive sex behavior in male rats. Psychopharmacology (Berl) 2010; 212:93-104. [PMID: 20623108 DOI: 10.1007/s00213-010-1930-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2010] [Accepted: 06/20/2010] [Indexed: 01/19/2023]
Abstract
RATIONALE Methamphetamine (Meth) is a highly addictive psychostimulant associated with enhanced sexual desire, arousal, and sexual pleasure. Moreover, Meth abuse is frequently linked with the practice of sexual risk behavior and increased prevalence of human immunodeficiency virus. Currently, there is a lack of studies investigating the effects of Meth on maladaptive sexual behavior under controlled experimental settings in animal studies. OBJECTIVE The overall objective of the current study was to examine the effects of Meth on various aspects of male sexual behavior including maladaptive sex-seeking behavior. METHODS First, a dose-response curve of the effects of Meth (0, 1, 2, and 4 mg/kg; s.c.) on sexual motivation and performance was conducted in sexually naïve and experienced male rats. Next, the effects of Meth (1 mg/kg; s.c.) on inhibition of maladaptive sexual behavior was tested using a sex aversion conditioning paradigm, in which visceral illness induced by lithium chloride (LiCl) was paired with sexual behavior. RESULTS Meth administration inhibited sexual performance in a dose-dependent matter as evidenced by the decreased percentages of males that mated and increased latencies to initiate sexual behavior when injected with 2 or 4 mg/kg Meth. Moreover, an acute dose of Meth prior to or following sex aversion conditioning resulted in disrupted conditioned inhibition of sexual behavior. CONCLUSIONS These data suggest that Meth administration in male rats impairs sexual motivation and performance. In addition, low doses of Meth that do not disrupt sexual function may result in maladaptive seeking of sexual behavior.
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Affiliation(s)
- Karla S Frohmader
- Department of Anatomy & Cell Biology, University of Western Ontario, London, ON, Canada
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Storholm ED, Fisher DG, Reynolds GL, Napper LE, Morrisse TA, Kochems LM. Hepatitis vaccination of men who have sex with men at gay pride events. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2010; 11:219-27. [PMID: 20049541 PMCID: PMC2858271 DOI: 10.1007/s11121-009-0164-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Prevention researchers have advocated primary prevention such as vaccination in alternative venues. However, there have been major questions about both the attendance of, and the ability to, vaccinate high-risk individuals in such settings. The current study seeks to assess the feasibility of vaccinating high-risk men who have sex with men (MSM) at Gay Pride events. The research questions are: Do gay men who are sampled at Gay Pride events engage in more or less risky behavior than gay men sampled at other venues? Do the gay men who receive hepatitis vaccinations at Gay Pride engage in more or less risky behavior than gay men at Gay Pride who do not receive hepatitis vaccination? Of the 3689 MSM that completed the Field Risk Assessment (FRA), 1095/3689 = 29.68% were recruited at either the 2006 or 2007 Long Beach, California Gay Pride events. The remaining, 2594/3689 = 70.32% were recruited at Long Beach gay bars, gay community organizations and institutions, and through street recruitment in various gay enclaves in the Long Beach area. Logistic regression analysis yielded eight factors that were associated with non-attendance of Gay Pride: Age, had sex while high in the last 12 months, had unprotected anal intercourse (UAI) in the last 12 months, had sex for drugs/money in the last 12 months, been diagnosed with a sexually transmitted infection (STI) in the last 12 months, used nitrites (poppers) in the last 12 months, and used methamphetamine in the last 12 months. Identifying as White, Asian, or African American compared to Hispanic was also associated with non-attendance. Bivariate analysis indicated that, of the MSM sampled at Gay Pride, 280/1095 = 25.57% received a hepatitis vaccination there. The MSM sampled at Gay Pride who reported engaging in UAI or having used any stimulant (cocaine, crack-cocaine, or methamphetamine) in the last 12 months were more likely to receive hepatitis vaccination on-site. The results provide evidence for the viability of successfully vaccinating high-risk MSM at Gay Pride events. However, it is vital that no-cost vaccinations are also funded in other community settings such as STI clinics, drug treatment programs, prisons, universities, and other community resource centers in order to reach those additional high-risk MSM who do not attend Gay Pride.
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Affiliation(s)
- Erik David Storholm
- Center for Health, Identity, Behavior & Prevention Studies, New York University, New York, NY USA
| | - Dennis G. Fisher
- Center for Behavioral Research and Services, California State University, 1090 Atlantic Avenue, Long Beach, CA 90813 USA
| | - Grace L. Reynolds
- Center for Behavioral Research and Services, California State University, 1090 Atlantic Avenue, Long Beach, CA 90813 USA
| | - Lucy E. Napper
- Center for Behavioral Research and Services, California State University, 1090 Atlantic Avenue, Long Beach, CA 90813 USA
| | | | - Lee M. Kochems
- Center for Behavioral Research and Services, California State University, 1090 Atlantic Avenue, Long Beach, CA 90813 USA
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Napper LE, Fisher DG, Johnson ME, Wood MM. The reliability and validity of drug users' self reports of amphetamine use among primarily heroin and cocaine users. Addict Behav 2010; 35:350-4. [PMID: 20053503 PMCID: PMC2821802 DOI: 10.1016/j.addbeh.2009.12.006] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 10/09/2009] [Accepted: 12/10/2009] [Indexed: 10/20/2022]
Abstract
Relatively few studies have addressed the psychometric properties of self-report measures of amphetamine use. This study examines the reliability and validity of the Risk Behavior Assessment's (RBA) lifetime and recent amphetamine-use questions. To evaluate validity, 4027 out-of-treatment primarily cocaine and heroin users provided urine samples that were compared to self-report data; to evaluate reliability, 218 completed the RBA at two time points, 48h apart. In the overall sample, self-reports demonstrated moderately high validity, with a 95% accuracy rate (kappa=.54). When analysis was restricted to recent amphetamine users validity was slightly lower (71.5% accuracy; kappa=.41). Test-retest data indicated good reliability for self-reports of ever having used amphetamine (kappa=.79), and amphetamine use in the past 30 days (.75
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Affiliation(s)
- Lucy E. Napper
- Center for Behavioral Research and Services, California State University, Long Beach, Long Beach, CA 90813
| | - Dennis G. Fisher
- Center for Behavioral Research and Services, California State University, Long Beach, Long Beach, CA 90813
| | - Mark E. Johnson
- Behavioral Health Research and Services, University of Alaska Anchorage, Anchorage, AK 99508
| | - Michele M. Wood
- Health Science Department, California State University, Fullerton, Fullerton, CA 92831
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Cook RL, McGinnis KA, Samet JH, Fiellin DA, Rodriguez-Barradas MC, Kraemer KL, Gibert CL, Braithwaite RS, Goulet JL, Mattocks K, Crystal S, Gordon AJ, Oursler KK, Justice AC, Justice AC. Erectile dysfunction drug receipt, risky sexual behavior and sexually transmitted diseases in HIV-infected and HIV-uninfected men. J Gen Intern Med 2010; 25:115-21. [PMID: 19921112 PMCID: PMC2837496 DOI: 10.1007/s11606-009-1164-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 08/21/2009] [Accepted: 10/15/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Health care providers may be concerned that prescribing erectile dysfunction drugs (EDD) will contribute to risky sexual behavior. OBJECTIVES To identify characteristics of men who received EDD prescriptions, determine whether EDD receipt is associated with risky sexual behavior and sexually transmitted diseases (STDs), and determine whether these relationships vary for certain sub-groups. DESIGN Cross-sectional study. PARTICIPANTS Two thousand seven hundred and eighty-seven sexually-active, HIV-infected and HIV-uninfected men recruited from eight Veterans Health Affairs outpatient clinics. Data were obtained from participant surveys, electronic medical records, and administrative pharmacy data. MEASURES EDD receipt was defined as two or more prescriptions for an EDD, risky sex as having unprotected sex with a partner of serodiscordant or unknown HIV status, and STDs, according to self-report. RESULTS Overall, 28% of men received EDD in the previous year. Eleven percent of men reported unprotected sex with a serodiscordant/unknown partner in the past year (HIV-infected 15%, HIV-uninfected 6%, P < 0.001). Compared to men who did not receive EDD, men who received EDD were equally likely to report risky sexual behavior (11% vs. 10%, p = 0.9) and STDs (7% vs 7%, p = 0.7). In multivariate analyses, EDD receipt was not significantly associated with risky sexual behavior or STDs in the entire sample or in subgroups of substance users or men who had sex with men. CONCLUSION EDD receipt was common but not associated with risky sexual behavior or STDs in this sample of HIV-infected and uninfected men. However, risky sexual behaviors persist in a minority of HIV-infected men, indicating ongoing need for prevention interventions.
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Affiliation(s)
- Robert L Cook
- Department of Epidemiology and Biostatistics, University of Florida, PO Box 100231, Gainesville, FL 32610, USA.
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Abstract
PURPOSE OF REVIEW Methamphetamine (meth) use has been shown in the literature to be associated with high-risk sexual behavior for both homosexual (MSM) and heterosexual samples for over a decade. The use of Viagra has also been shown to be associated with high-risk sexual behavior. The purpose of this review is to update the record on Viagra and on the combination of Viagra and meth use. RECENT FINDINGS There is now strong evidence that the use of Viagra is associated with HIV seroconversion in MSM. The combination of taking both meth and Viagra is strongly associated with much higher sexually transmitted disease and HIV rates. There is some evidence that Viagra is associated with insertive and meth is associated with receptive anal intercourse by men. SUMMARY The evidence is strong to support the relationship between Viagra use and HIV seroconversion now that more sophisticated analyses have been done. The meth-Viagra recreational drug combination is of very high risk. More research is needed to generate longitudinal and event-level data that are necessary to answer fine-grained questions about drug combinations and the relationship with sexual behavior.
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