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Card KG, Shen T, Barath J, Sang J, Lal A, Moore DM, Lachowsky NJ. Patterns of Event-Level Concurrent Substance Use During Sex Among Gay, Bisexual, and Other Men Who Have Sex with Men in Metro Vancouver. AIDS Behav 2023:10.1007/s10461-023-04036-w. [PMID: 36943600 DOI: 10.1007/s10461-023-04036-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2023] [Indexed: 03/23/2023]
Abstract
This study identified patterns of sexualized substance use among gay, bisexual, and other men who have sex with men (gbMSM) and examined associated risk factors for sexually transmitted and blood borne infections (STBBI). Data were from a longitudinal cohort recruited using respondent-driven sampling between Feb-2017 and Feb-2019. Participants reported on events with up to five of their most recent sexual partners. Latent class analysis examined patterns of concurrent substance use 2 h prior to or during sex. Multinomial regression identified demographic, partner-level, and event-level factors associated across 11,877 sexual events reported by 757 participants. Most combinations of substance use were rare, but most drugs were frequently combined with other drugs when they were used prior to or during a sexual event. Six latent classes of concurrent event-level substance use were identified. The referent class (58.8% of events) was characterized by limited use of any drugs. The Common Drug Use class (12.1%) was characterized by use of alcohol, cannabis, and poppers and the Licit Drug Use class (21.6%) was characterized by use of alcohol alone. The Party 'N' Play (PnP) class (2.3%) was characterized by use of crystal methamphetamine GHB, Poppers, and Erectile Drugs; The Multi-use (3.5%) class was characterized by the PnP substances plus alcohol and ecstasy; and the Cannabis + class was characterized by use of Cannabis, Erectile Drugs, and Ecstasy. Relative to the referent class, all other classes were associated with events with more behavioural and network risk factors for STBBIs-highlighting the need for harm reduction interventions for gbMSM who use these drugs.
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Affiliation(s)
- Kiffer G Card
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
| | - Tian Shen
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Justin Barath
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Jordan Sang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- British Columbia Centre on Substance Use, Vancouver, Canada
| | - Allan Lal
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - David M Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Nathan J Lachowsky
- School of Public Health and Social Policy, University of Victoria, Victoria, Canada
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Kolstee J, Prestage G, Bavinton B, Hammoud M, Philpot S, Keen P, Grulich A, Holt M. Trust, Familiarity, Optimism, and Pleasure: Australian Gay Men Accounting for Inconsistent HIV Prevention Practices in the PrEP Era. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2563-2570. [PMID: 35507124 DOI: 10.1007/s10508-021-02203-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 06/05/2021] [Accepted: 10/21/2021] [Indexed: 06/14/2023]
Abstract
Despite an increase in the range of effective HIV risk reduction strategies that are available, some gay and bisexual men (GBM) do not use any of them consistently. Understanding why GBM do not always use a protective strategy may help develop more effective responses. Semi-structured interviews with 24 sexually active GBM in Sydney, Australia were conducted and analyzed using thematic analysis. The main characteristics of encounters featuring little or no use of HIV risk reduction strategies were familiarity and trust with partners, pleasure and intoxication, expectations that partners were using HIV pre-exposure prophylaxis or treatment as prevention, and in some cases feelings of inevitability about acquiring HIV. An increase in pleasure and a reduction in anxiety about sex were noted by some GBM who had commenced PrEP. Encouraging GBM to adopt a strategy such as PrEP and to use it consistently may be easier by emphasizing benefits to mental health and the quality of sex and intimacy it can offer. However, even with the increased availability of effective biomedical HIV risk reduction strategies, not all GBM are able to consistently manage HIV risk and some continue to hold optimistic and potentially inaccurate beliefs about sexual partners that may increase HIV risk.
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Affiliation(s)
- Johann Kolstee
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Kensington, Sydney, NSW, 2052, Australia.
| | - Garrett Prestage
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Kensington, Sydney, NSW, 2052, Australia
| | - Benjamin Bavinton
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Kensington, Sydney, NSW, 2052, Australia
| | - Mohamed Hammoud
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Kensington, Sydney, NSW, 2052, Australia
| | - Steven Philpot
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Kensington, Sydney, NSW, 2052, Australia
| | - Phillip Keen
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Kensington, Sydney, NSW, 2052, Australia
| | - Andrew Grulich
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Kensington, Sydney, NSW, 2052, Australia
| | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
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Violette LR, Niemann LA, McMahan VM, Katz DA, Chavez PR, Clark HA, Cornelius-Hudson A, Ethridge SF, McDougal SJ, Ure Ii G, Stekler JD, Delaney KP. Group Sex Events Among Cisgender Men Who Have Sex With Men: Cross-Sectional and Longitudinal Survey Study to Explore Participation and Risk-Taking Behaviors. JMIR Res Protoc 2019; 8:e15426. [PMID: 31774403 PMCID: PMC6906620 DOI: 10.2196/15426] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 11/13/2022] Open
Abstract
Background Group sex events (GSEs) are common among cisgender men who have sex with men (MSM), pose a unique risk profile for HIV and sexually transmitted disease (STD) transmission, and may be on the rise, in part because of Web-based networking platforms. However, collecting data on GSEs can be challenging, and many gaps exist in our knowledge about GSE participation among MSM. Objective The objective of this study was to develop survey questions addressing aggregate and partner-specific group sex behaviors to measure prevalence of GSEs and associated risks in persons participating in Project Diagnostic Evaluation To Expand Critical Testing Technologies (DETECT), including MSM seeking HIV and STD testing at a public clinic in Seattle, Washington. Methods We developed a computer self-assisted survey that included questions about participant demographics, sexual history, and risk behaviors, including group sex, as a part of Project DETECT, a Centers for Disease Control and Prevention–funded study evaluating point-of-care HIV tests. Aggregate and partner-specific questions asked about participation in all GSEs, threesomes, and four-or-more-somes including questions about number and HIV status of sex partners and condom use during the events. To evaluate question performance, we assessed the discrepancies in reporting between the aggregate and partner-specific questions, quantified question refusal rates, and calculated the additional time required to answer the GSE questions. Information about network density (number of partnerships of overlapping duration) was estimated and compared for MSM who did and did not report GSEs. Results Among 841 visits by 690 MSM who were asked any group sex survey question, participation in a GSE of any type in the past 3 months was reported at 293 visits (293/841, 34.8%). We found that 9.0% (76/841) of MSM in the sample reported ≥1 four-or-more-some in the partner-specific questions but did not report in the aggregate. The proportion of refusals on any given aggregate GSE-related question ranged from 0% (0/273) to 10.6% (15/141) (median 2.6%) and partner-specific questions ranged from 0% (0/143) to 22% (5/23) (median 3.0%), with questions about four-or-more-somes having the highest proportions of refusals. Completing the aggregate group sex questions added 1 to 2 minutes and the partner-specific questions added an additional 2 to 4 minutes per partner to the total survey length. As expected, the partner-specific GSE questions documented higher density of sexual networks that was not captured by asking about total partner counts and overlap of specific partnerships. Conclusions We found that the Project DETECT survey was able to obtain nuanced information about GSEs. The question skip patterns and consistency checks were effective, and survey fatigue was minimal. More research is needed on GSEs, and our survey represents a promising data collection tool to help fill gaps in knowledge about the subject.
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Affiliation(s)
- Lauren R Violette
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - Lisa A Niemann
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - Vanessa M McMahan
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - David A Katz
- HIV/STD Program, Public Health - Seattle & King County, Seattle, WA, United States
| | - Pollyanna R Chavez
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Hollie A Clark
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Steven F Ethridge
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sarah J McDougal
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - George Ure Ii
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - Joanne D Stekler
- Department of Medicine, University of Washington, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States.,Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Kevin P Delaney
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
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de Vries HJC, Baral S. Assessing the health and well-being of gay, bisexual and other men who have sex with men around the world. Sex Transm Infect 2017; 93:303-304. [PMID: 28729515 DOI: 10.1136/sextrans-2016-052679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 06/03/2017] [Indexed: 11/03/2022] Open
Affiliation(s)
- Henry John Christiaan de Vries
- STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands.,Department of Dermatology, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Infection & Immunity Institute (AI&II), Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Stefan Baral
- Key Populations Program, Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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