Implications for HIV Prevention
Binary logistic regression results demonstrated that alcohol use before or during sex was predictive of having a primary sex partner, casual sex partner, higher income, previous sexually transmitted infection testing, and a higher number of male sex partners ( Implications for HIV Prevention ). Recreational drug use before or during sex was predictive of having an HIV positive status, casual sex partner, unprotected anal intercourse with a male sex partner, and being younger. These findings present significant formative implications for the influence of substance use in relation to HIV sexual risk behavior in Black gay and bisexual men.
Since the onset of the AIDS epidemic, Black gay and bisexual men have been at a substantial risk for acquiring HIV. Substance use has been identified as a significant risk factor for engaging in HIV sexual risk behavior. The purpose of this formative research investigation was to examine substance use in relation to sexual behavior through differentiating users versus nonusers of alcohol and recreational drugs before or during sex in a community-based sample of 481 Black gay and bisexual men in the New York metropolitan area.
Men who have sex with men continue to comprise the majority of all men living with HIV, as well as new HIV infections increase in the US, with black men who have sex with men having the highest HIV prevalence. Among Men who have sex with men the use of cocaine/crack and methamphetamines has been linked to unprotected anal sex, exchange of money or drugs for sex, abuse of alcohol, drug use with casual and steady partners, being younger in age, use of poppers and Viagra, and drug use before or during sex. Yet drug use in general, and stimulant use specifically, are not well documented among entirely Black Men who have sex with men samples in the US.
Unmistakably, gay and bisexual men who prefer to use drugs in conjunction with their sexual activities constitute a risk group in need of targeted intervention if their HIV risk levels are to be reduced. Other authors have written about the heightened HIV-related risks that often accompany substance use among men who have sex with other men, including some theoretical work designed to help understand and explain the interrelationship of substance use, dis-inhibition, and HIV risk taking. Some authors have taken this one step farther, by noting the additional heightening of risk that is attendant with this practice when it entails meeting men via the internet.