University of California, San Francisco Center for AIDS Prevention Studies, San Francisco, CA 94105, USA.
Drug Alcohol Depend. 2012 Jun 1;123(1-3):79-83. doi: 10.1016/j.drugalcdep.2011.10.020. Epub 2011 Nov 15.
Prior research established that psychological factors are associated with the frequency of stimulant (i.e., cocaine, crack, and methamphetamine) use among substance-using men who have sex with men (MSM). The present investigation examined whether and how psychological factors are associated with engagement in any stimulant use in the broader population of MSM.
A probability sample of 879 MSM residing in San Francisco was obtained using random digit dialing from May of 2002 through January of 2003. Of these, 711 participants (81%) completed a mail-in questionnaire that assessed psychological factors and substance use. After accounting for demographic factors, a multiple logistic regression analysis examined correlates of any self-reported stimulant use during the past 6 months. Path analyses examined if the use of alcohol or other substances to avoid negative mood states (i.e., substance use coping) mediated the associations of sexual compulsivity and depressed mood with stimulant use.
Younger age (adjusted OR [AOR]=0.58; 95% CI=0.47-0.70), HIV-positive serostatus (AOR=2.55; 95% CI=1.61-4.04), greater depressed mood (AOR=1.26; 95% CI=1.05-1.52) and higher sexual compulsivity (AOR=1.46; 95% CI=1.18-1.80) were independently associated with increased odds of stimulant use. Substance use coping partially mediated the associations of sexual compulsivity (β(indirect)=0.11, p<.001) and depressed mood (β(indirect)=0.13, p<.001) with stimulant use.
Clinical research is needed to examine if interventions targeting sexual compulsivity and emotion regulation reduce stimulant use among MSM.
先前的研究表明，心理因素与使用兴奋剂（即可卡因、快克和冰毒）的男性性活跃者（MSM）的使用频率有关。本研究旨在检验心理因素是否以及如何与更广泛的 MSM 群体中任何兴奋剂的使用有关。
2002 年 5 月至 2003 年 1 月，通过随机拨号从旧金山获得了一个概率样本，共 879 名 MSM 参与了此次研究。其中，711 名参与者（81%）完成了一份邮件问卷调查，评估了心理因素和物质使用情况。在考虑了人口统计学因素后，多因素逻辑回归分析检验了过去 6 个月中任何自我报告的兴奋剂使用的相关因素。路径分析检验了使用酒精或其他物质来避免负面情绪状态（即物质使用应对）是否在性强迫和抑郁情绪与兴奋剂使用之间起中介作用。
年龄较小（调整后的 OR [AOR]=0.58；95% CI=0.47-0.70）、HIV 阳性血清学状态（AOR=2.55；95% CI=1.61-4.04）、抑郁情绪更严重（AOR=1.26；95% CI=1.05-1.52）和性强迫更高（AOR=1.46；95% CI=1.18-1.80）与兴奋剂使用的几率增加独立相关。物质使用应对部分中介了性强迫（β（间接）=0.11，p<.001）和抑郁情绪（β（间接）=0.13，p<.001）与兴奋剂使用的关系。
需要开展临床研究来检验针对性强迫和情绪调节的干预措施是否可以减少 MSM 中兴奋剂的使用。
