The Psychological Context of Sexual Compulsivity Among Men Who Have Sex with Men.

Among men who have sex with men (MSM), sexual compulsivity is associated with overlapping psychosocial and behavioral health problems. Because difficulties with emotion regulation are thought to be one important feature, this study examined whether affective states and traumatic stress symptoms were independently associated with key dimensions of sexual compulsivity. Data were collected in San Francisco for the Urban Men's Health Study-2002 from May 24, 2002 to January 19, 2003. In total, 711 MSM recruited via probability-based sampling completed a mail-in questionnaire that assessed psychological factors and substance use. Dissociation related to traumatic stress and any stimulant use in the past 6 months were independently associated with more frequent sexual thoughts or urges. Increased anger and HIV-positive serostatus were independently associated with a greater perception that sexual behavior is difficult to control. Clinical research is needed to examine if interventions targeting emotion regulation and traumatic stress can boost the effectiveness of HIV prevention efforts among MSM who experience difficulties related to managing sexual behaviors.

Substance use and HIV risk behavior among men who have sex with men: the role of sexual compulsivity.

The relationship between substance use, sexual compulsivity and sexual risk behavior was assessed with a probability-based sample of men who have sex with men (MSM). Stimulant, poppers, erectile dysfunction medication (EDM), alcohol use, and sexual compulsivity were independently associated with higher odds of engaging in any serodiscordant unprotected anal intercourse (SDUAI). The association of sexual compulsivity with SDUAI was moderated by poppers and EDM use. Behavioral interventions are needed to optimize biomedical prevention of HIV among substance using MSM.

Methamphetamine use patterns among urban Black men who have sex with men.

The present study investigates patterns of methamphetamine, contexts of use and sources for purchasing methamphetamine in a sample of gay, bisexual and heterosexually identified Black men who have sex with men living in New York City. Participants reported using multiple substances and used, on average, nine days within the last 30 days. They spent an average of US$159 per month on methamphetamine and a median of US$398 on all substances. Frequency of monthly methamphetamine use was related to the use of powdered cocaine and alcohol use, but not to the use of other substances. Black men who have sex with men primarily used in private venues, such as at home or in the homes of friends, and reported obtaining methamphetamine from multiple sources. Men who reported exchanging sex for methamphetamine reported greater use in public venues, such as sex clubs, sex parties and circuit parties. Findings from the present study may be critical in establishing culturally-appropriate treatment modalities for Black men who have sex with men who use methamphetamine.

Club drug use, sexual behavior, and HIV seroconversion: a qualitative study of motivations.

This qualitative study funded by the National Institute on Drug Abuse examines phenomenological meanings surrounding motivations for club drug use in a sample of HIV seroconverted and seronegative gay and bisexual men. Grounded in the cognitive escape model (CEM), this study sought to clarify the synergistic relationship between club drug use, risky sexual behavior, and seroconversion. Sixteen seropositive participants were drawn from a large-scale (n = 450), longitudinal, mixed-method investigation of club drug use among gay and bisexual men in New York City from 2001-2004 and matched with 16 seronegative participants for race/ethnicity, most-frequently used substance, and educational level. Total sample size consisted of 32 participants. Sample size consisted of 13 (41%) Black/African-American, 12 (37.5%) White/Caucasian, 5 (15.5%) Hispanic/Latino, and 2 (6%) mixed/other race/ethnicity participants. Findings suggest behavioral outcomes of club drug use and HIV seroconversion result from complex interactions between physical, emotional, and social motivations.

Methamphetamine and poly-substance use among gym-attending men who have sex with men in New York City.

BACKGROUND: Methamphetamine and other drug use has been documented among men who have sex with men (MSM). Patterns of use may be influenced by point of recruitment into these studies. PURPOSE: The aim of this study is to describe patterns of methamphetamine and other drug use and to delineate psychosocial and demographic factors which accompany these patterns of use in a sample of MSM attending gyms in New York City. METHODS: Active recruitment strategies were implemented to ascertain a sample of 311 MSM. Participants completed a one-time survey regarding both health risks and health promotion. RESULTS: Methamphetamine use in the last 6 months was reported by 23.8% of men. Inhalation and smoking were the most common modes of administration, and 84% of men reported more than one mode of use. Study participants also indicated a variety of other substances used, including but not limited to alcohol, inhalant nitrates, and 3,4 methylenedioxymethamphetamine (MDMA). Compared to nonusers, methamphetamine users were more likely to report being black or Latino, depressed, HIV-positive, perceiving more benefits of unprotected sex, and understanding masculinity in sexual terms. CONCLUSIONS: These data suggest that health-risk behaviors are common among MSM who are regularly using a gym and are indicative of the complexities of health issues for this segment of the population.

A comparative analysis of methamphetamine use: black gay and bisexual men in relation to men of other races.

We investigated the patterns and correlates of methamphetamine use among Black gay and bisexual men who participated in a large-scale study of club drug use, and sexual behavior in combination with club drug use in New York City. Almost half of the Black men (49%) in the sample indicated use of methamphetamine in the 4 months prior to assessment, a proportion somewhat lower than their White counterparts. In terms of the overall sample, the proportion of the Black men in the study was equivalent to the proportion of methamphetamine users who identified as Black. Black methamphetamine users tended not to reside in neighborhoods considered traditionally gay, were more likely to be HIV-positive, have lower educational attainment, and have lower levels of income than other methamphetamine users. In terms of frequency and reasons for use, Black methamphetamine users did not differ in any substantive way compared to other races and ethnicities. In addition, they did not differ along any key demographic lines from Black non-methamphetamine users. Poly-drug use was common among all Black men in the sample, with almost all methamphetamine users also reporting use of cocaine, but cocaine users not necessarily reporting methamphetamine use. Once a drug that was considered popular only among White gay men, methamphetamine use has been shown to transcend racial and ethnic lines. Because of the synergy that exists between use of the drug, the concentrated levels of HIV in the Black gay population, and the sexual disinhibition engendered with methamphetamine use, this drug presents a potentially mounting public health challenge.