Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Coral Gables, FL 33134, USA.
J Community Health. 2013 Feb;38(1):62-9. doi: 10.1007/s10900-012-9582-8.
Health and social disparities are widespread among men who have sex with men (MSM). Although literature indicates that Black MSM (BMSM) are no more likely than other MSM to report sexual risk behaviors, such as unprotected anal intercourse, studies have reported that buying and trading sex appear to be important risk factors for BMSM. Substance use generally is not significantly greater among BMSM than other MSM, studies have found that BMSM report more powder and crack cocaine use than other MSM. The lack of adequate coping skills and social support for BMSM has also been documented. This paper examines differences in substance use, sexual risk behaviors and social support among Black and non-black MSM, in a sample of 515 men participating in a randomized intervention trial. BMSM reported higher rates of substance dependence (72.2 vs. 59.5%, P = .015) and buying sex (49.1 vs. 17.4%, P < .000) than non-Black MSM. BMSM also reported lower levels of social support than other MSM on all measures included in the study; e.g., getting help and emotional support from others (38.0 vs. 52.8%, P < .006). Mediation analyses showed that BMSM's higher rates of substance dependence and buying sex are partially mediated by lower levels of social support. Our data appear to show that lack of social support is an important influence on risk behaviors among BMSM. Qualitative data also supported these findings. Sexual risk and substance use prevention interventions should address BMSM's capacity to build adequate and supportive relationships.
男男性行为者（MSM）中存在广泛的健康和社会差异。尽管文献表明，黑人男男性行为者（BMSM）报告性行为风险行为（如无保护肛交）的可能性并不高于其他 MSM，但研究报告称，购买和交易性似乎是 BMSM 的重要风险因素。研究发现，BMSM 报告的粉和快克可卡因使用量高于其他 MSM，但 BMSM 中的物质使用量一般并不比其他 MSM 显著更高。此外，BMSM 缺乏足够的应对技能和社会支持也有记录。本文在一项针对 515 名参与随机干预试验的男性的样本中，研究了黑人和非黑人 MSM 之间在物质使用、性行为风险和社会支持方面的差异。BMSM 报告的物质依赖率（72.2%比 59.5%，P =.015）和购买性的比例（49.1%比 17.4%，P <.000）均高于非黑人 MSM。BMSM 还报告在研究中包含的所有措施上的社会支持水平均低于其他 MSM；例如，从他人那里获得帮助和情感支持（38.0%比 52.8%，P <.006）。中介分析表明，BMSM 较高的物质依赖率和购买性部分是由较低的社会支持水平介导的。我们的数据似乎表明，缺乏社会支持是 BMSM 风险行为的一个重要影响因素。定性数据也支持了这些发现。性风险和物质使用预防干预措施应解决 BMSM 建立足够和支持性关系的能力。
