Department of Psychiatry (MC 0680), University of California - San Diego, 9500 Gilman Drive, La Jolla, California 92093-0680, USA.
BMC Public Health. 2010 Apr 1;10:178. doi: 10.1186/1471-2458-10-178.
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.
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).
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.
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.
减少危害主要侧重于减少高危物质的使用行为，而不是减少高危性行为。此外，大多数研究都集中在个体行为改变上，而对社会和环境背景的关注较少。本文通过考察 321 名在圣地亚哥使用冰毒的感染艾滋病毒的男男性行为者（MSM）在“兴奋”状态下的性活动地点或场所，了解个体与社会背景之间的相互作用，探讨了他们的心理社会和行为特征。
在一项安全性行为干预研究中，参与者接受了基线评估，询问了人口统计学和心理社会特征以及药物使用和性风险行为。为了进行分析，根据他们对性场所的偏好将受访者分类：私人场所（如家庭）、商业场所（如浴室）或公共场所（如公共公园或洗手间）。
商业场所组更年轻、受教育程度更高、更倾向于认同同性恋，并且与其他两组相比，更有可能使用“俱乐部毒品”。商业和公共场所组的男性报告的高危性行为比私人场所组更多。与其他两组相比，公共场所组报告的药物和酒精使用量更大，贝克抑郁评分显著更高，经历的污名化更多，性强迫测量得分更高。
为了减少艾滋病毒/性传播感染风险行为，未来的研究应该调查修改与在“兴奋”状态下使用高危性场所相关的个人、心理社会和结构因素的可行性，这些场所是艾滋病毒阳性冰毒使用者进行性活动的地方。
