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Published on: October 6, 2016
Risk behaviors among HIV-positive gay and bisexual men at party-oriented vacations
Michael P Fisher1, Rajeev Ramchand, Sarah Bana
1RAND Corporation, Arlington, VA 22202, USA. mfisher@rand.org
Objective:
This study examined substance use (intended and actual), unprotected sex, and HIV disclosure practices (disclosure and questioning) among HIV-positive men who have sex with men (MSM) at two party-oriented vacations, where substance use and sexual risk may be heightened.
Method:
A random sample of 489 MSM attending one of two party-oriented vacations participated in PartyIntents, a short-term longitudinal survey. Nearly half (47%) completed a follow-up assessment at the event or online for up to 2 weeks after the event. We examined rates of baseline intentions to use substances, actual substance use, and unprotected intercourse among HIV-positive men in attendance.Rates among HIV-negative men were estimated for comparison. Multiple logistic regression was used to assess the impact of illegal drug use and HIV status on unprotected anal intercourse (UAI).
Results:
HIV-positive attendees (17%) were significantly more likely than HIV-negative attendees to use nitrite inhalants (or "poppers") (24.3% vs. 10.7%). HIV-positive attendees were also significantly more likely to have insertive UAI (64.3% vs. 34.1%) and receptive UAI (68.8% vs. 22.2%). Multivariate models showed associations between HIV status and illegal drug use with UAI (for HIV status, odds ratio [OR] = 4.5, p = .001; for any illegal drug use, OR = 16.4, p < .001). There was no evidence that the influence of drug use moderated risk by HIV status. Rates of HIV disclosure and questioning did not differ by HIV status.
Conclusions:
HIV-positive men attending these events engaged in higher rates of illegal drug use and sexual risk than HIV-negative men. Prevention campaigns targeting MSM at high-risk events should include messages geared toward HIV-positive men.
Insights
HIV-positive men who have sex with men (MSM) at party events reported higher illegal drug use and sexual risk. Prevention campaigns should target these risks for HIV-positive MSM.
Area of Science:
- Public Health
- Epidemiology
- Behavioral Science
Background:
- Party-oriented vacations are environments where substance use and sexual risk behaviors may be heightened.
- Understanding substance use and sexual practices among men who have sex with men (MSM), particularly those with HIV, is crucial for targeted prevention.
Purpose of the Study:
- To examine substance use, unprotected sex, and HIV disclosure practices among HIV-positive MSM at party-oriented vacations.
- To compare these practices between HIV-positive and HIV-negative MSM.
- To assess the impact of illegal drug use and HIV status on unprotected anal intercourse (UAI).
Main Methods:
- A sample of 489 MSM attending two party-oriented vacations participated in the PartyIntents longitudinal survey.
- Follow-up assessments were completed by 47% of participants up to 2 weeks post-event.
- Multiple logistic regression analyzed the association between illegal drug use, HIV status, and UAI.
Main Results:
- HIV-positive MSM were significantly more likely to use nitrite inhalants ('poppers') and engage in insertive and receptive UAI compared to HIV-negative MSM.
- Both HIV status (OR=4.5) and illegal drug use (OR=16.4) were significantly associated with UAI.
- No significant difference was found in HIV disclosure or questioning rates based on HIV status.
Conclusions:
- HIV-positive MSM attending these events exhibited higher rates of illegal drug use and sexual risk behaviors.
- Prevention efforts targeting MSM at high-risk events should incorporate specific messages for HIV-positive individuals to address these elevated risks.
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