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      Factors associated with sex in the context of methamphetamine use in different sexual venues among HIV-positive men who have sex with men

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          Abstract

          Background

          Harm reduction has focused primarily on reduction of high-risk substance using behaviors rather than reductions in high-risk sexual behaviors. Furthermore, most studies focus on individual behavior change, with less attention paid to the social and environmental context. This paper promotes understanding of the interplay between the individual and the social context by examining the psychosocial and behavioral characteristics of 321 methamphetamine-using HIV-positive men who have sex with men (MSM) in San Diego, CA based on the locations or venues of their sexual activities when "high" on methamphetamine.

          Methods

          Participants in a safer-sex intervention study underwent a baseline assessment that queried demographic and psychosocial characteristics as well as drug use and sexual risk behaviors. For purposes of analysis, respondents were classified according to their preference of sexual venue: private (e.g., home), commercial (e.g., bathhouse), or public (e.g., public park or restroom).

          Results

          The commercial venue group was younger, better educated, more likely to identify as gay, and significantly more likely to have used "club drugs" as compared to the other two groups. Men in the commercial- and public-venue groups reported more high-risk sex compared to the private-venue group. The public-venue group reported heavier drug and alcohol use, had significantly higher Beck depression scores, reported more experiences of stigma, and scored higher on a measure of sexual compulsivity than did the other two groups.

          Conclusion

          In an effort to reduce HIV/STI risk-behaviors, future studies should investigate the feasibility of modifying personal, psychosocial and structural factors associated with the use of risky sexual venues where HIV-positive methamphetamine users engage in sexual activity when "high" on methamphetamine.

          Trial registration

          ClinicalTrials.gov NCT00432926

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          Most cited references23

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          On stigma and its consequences: evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse.

          Bruce G. Link, Elmer L. Struening, Michael Rahav … (1997)
          Numerous studies have demonstrated a strong connection between the experience of stigma and the well-being of the stigmatized. But in the area of mental illness there has been controversy surrounding the magnitude and duration of the effects of labeling and stigma. One of the arguments that has been used to downplay the importance of these factors is the substantial body of evidence suggesting that labeling leads to positive effects through mental health treatment. However, as Rosenfield (1997) points out, labeling can simultaneously induce both positive consequences through treatment and negative consequences through stigma. In this study we test whether stigma has enduring effects on well-being by interviewing 84 men with dual diagnoses of mental disorder and substance abuse at two points in time--at entry into treatment, when they were addicted to drugs and had many psychiatric symptoms and then again after a year of treatment, when they were far less symptomatic and largely drug- and alcohol-free. We found a relatively strong and enduring effect of stigma on well-being. This finding indicates that stigma continues to complicate the lives of the stigmatized even as treatment improves their symptoms and functioning. It follows that if health professionals want to maximize the well-being of the people they treat, they must address stigma as a separate and important factor in its own right.
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            Sexual sensation seeking and Sexual Compulsivity Scales: reliability, validity, and predicting HIV risk behavior.

            S Kalichman, D Rompa (1995)
            Two studies are presented that evaluate newly developed scales of sensation seeking and sexual compulsivity. Results showed that the scales were reliable and correlated with convergent and divergent measures in expected directions in samples of both gay men (N = 296) and inner city low-income men and women (N = 158). Consistent with theories of sensation seeking, the scales corresponded to an attraction toward a range of sexual practices, including increased frequencies of unprotected intercourse and a greater number of sexual partners. As expected, sexual compulsivity was not related to variety and novelty in sexual practices, but was associated with lower levels of self-esteem and resistance to adopting sexual risk-reducing strategies. However important differences were observed between the gay men and heterosexual samples; scales correlated with substance use only among gay men, and sexual compulsivity was related to a range of sexual practices only among heterosexuals. The sensation seeking and Sexual Compulsivity Scales were therefore reliable, appeared valid, and useful in predicting sexual risk behaviors.
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              Motivations associated with methamphetamine use among HIV+ men who have sex with men.

              Shirley Semple, Thomas L Patterson, Igor Grant (2002)
              Previous research has documented an association between methamphetamine (meth) use and high-risk sex among HIV- men who have sex with men (MSM); however, little is known about the sexual risk behaviors of HIV+ meth-using MSM. The purpose of this study was to explore personal motivators of meth use among HIV+ MSM, and to elaborate upon the interaction between meth use and risky sex. Thematic analysis of qualitative data from 25 HIV+ MSM revealed meth use was associated with high rates of anal sex, low rates of condom use, multiple sex partners, sexual marathons, and anonymous sex. Personal motivations associated with meth use included: sexual enhancement; and self-medication of negative affect associated with HIV+ serostatus. A variety of treatment approaches are used to describe how client insights into motivations can be used by clinicians to promote change in drug use and sexual risk behavior.
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central
                ISSN (Electronic): 1471-2458
                Publication date Collection: 2010
                Publication date (Electronic): 1 April 2010
                Volume: 10
                Page: 178
                Affiliations
                [1 ]Department of Psychiatry (MC 0680), University of California - San Diego, 9500 Gilman Drive, La Jolla, California 92093-0680, USA
                [2 ]Division of Global Public Health, Department of Medicine (MC 0507), University of California - San Diego, 9500 Gilman Drive, La Jolla, California 92093-0507, USA
                Article
                Publisher ID: 1471-2458-10-178
                DOI: 10.1186/1471-2458-10-178
                PMC ID: 2858118
                PubMed ID: 20359362
                SO-VID: 0560429a-9d33-4e7c-a116-f228b7f20630
                Copyright © Copyright ©2010 Semple et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 11 December 2009
                Date accepted : 1 April 2010
                Categories
                Subject: Research article

                ScienceOpen disciplines: Public health
                Data availability:
                ScienceOpen disciplines: Public health

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