Klitzman Robert L, Greenberg Jason D, Pollack Lance M, Dolezal Curtis
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Department of Psychiatry, Columbia University 1051, New York, NY 10032, USA.
Drug Alcohol Depend. 2002 Apr 1;66(2):115-25. doi: 10.1016/s0376-8716(01)00189-2.
This study assesses patterns of use of methylenedioxymethamphetamine (MDMA or 'ecstasy'), and the characteristics of users, in a sample of 733 men who have sex with men (MSM) in New York City. Among respondents, 13.7% reported using MDMA in the past 6 months, with mean frequency of use of 6.24 times in that period. MDMA users were found to be younger, less educated, to have had more male partners, more one night stands with men, more visits to bars or clubs and sex clubs or bathhouses, to have unprotected anal sex with a male, to be likely to have been the victim of physical domestic violence, to have more gay/bisexual friends, to have disclosed their sexual orientation to more friends, family members, and coworkers, and to have higher levels of gay community participation and affiliation. Among MDMA users, higher frequency of MDMA use was associated with being younger, having more visits to bars or clubs, more gay/bisexual friends, and having an HIV negative test result or never having been tested. MDMA users thus constitute a group at risk for sexually transmitted diseases, including HIV, and other problems. The data suggest that MDMA use is associated with being more 'out', which may be advantageous in helping gay men deal with harmful psychological effects of stigma, but may place individuals in settings that expose them to MDMA. These men have also presumably already been well exposed to safer sex messages within the gay community, thus raising challenges for interventions aimed at prevention, as well as opportunities (e.g. MSM and community specific interventions) that need to be further explored.
本研究评估了纽约市733名男男性行为者（MSM）样本中使用亚甲基二氧甲基苯丙胺（MDMA，即“摇头丸”）的模式及其使用者的特征。在受访者中，13.7%报告在过去6个月内使用过MDMA，在此期间的平均使用频率为6.24次。研究发现，MDMA使用者更年轻，受教育程度更低，有更多男性伴侣，与男性有更多一夜情，更多次前往酒吧、俱乐部以及性俱乐部或澡堂，与男性进行无保护肛交，可能曾是家庭身体暴力的受害者，有更多同性恋/双性恋朋友，向更多朋友、家人和同事公开了自己的性取向，并且有更高的同性恋社区参与度和归属感。在MDMA使用者中，更高的MDMA使用频率与更年轻、更多次前往酒吧或俱乐部、有更多同性恋/双性恋朋友以及HIV检测结果为阴性或从未接受过检测有关。因此，MDMA使用者构成了包括HIV在内的性传播疾病以及其他问题的高危人群。数据表明，使用MDMA与更加“出柜”有关，这在帮助男同性恋者应对耻辱感带来的有害心理影响方面可能具有优势，但可能会使个体置身于接触到MDMA的环境中。这些男性大概也已经充分接触到了同性恋社区内的安全性行为信息，因此这既给旨在预防的干预措施带来了挑战，也带来了一些需要进一步探索的机会（例如针对男男性行为者和特定社区的干预措施）。
