Tobin Karin E, Latkin Carl A, Curriero Frank C
Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 2213 McElderry Street, Second Floor, Baltimore, MD 21205, USA.
Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltmore, MD 21205, USA; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltmore, MD 21205, USA.
Int J Drug Policy. 2014 May;25(3):591-7. doi: 10.1016/j.drugpo.2013.12.006. Epub 2013 Dec 17.
Drug and alcohol use are risk factors for HIV transmission. Much of the HIV behavioural research has focused on risk without consideration of the social and spatial context of the behaviour. Yet, risk may be specific or unique to place. The purpose of this study was to examine the social and spatial characteristics of places where African American men who have sex with men (AA MSM) use drugs and/or alcohol. Specifically, we examined spatial intensity and clustering of drug/alcohol places and characteristics of their social networks at these places.
Participants were recruited using outreach, on-line advertisements and word-of-mouth referrals. Inclusion criteria were: age 18 or older and sex with a man in the prior 90 days. Participants (n=51) completed a socio-spatial inventory in which they provided addresses of n=187 places where they most recently used drugs and/or drank alcohol. Participants described characteristics of people who were at these places.
The mean age of participants was 36.5 years (SD=10.9). Half (51%) identified as gay, 31% bisexual, 4% heterosexual and 10% as not sure/questioning and 27% self-reported HIV positive status. Drug/alcohol places were spatially concentrated in the inner part of the city and evidence of clustering by participant characteristics was present. Of n=187 places named where the participant drank alcohol or used drugs, 68% were described as a residence (participants or "someone one else's house"), 20% were bars/clubs or restaurants, 8% were outside places and 4% were miscellaneous (e.g. on the bus/car). There were differences in the characteristics of social network members by place-type. At residential places, a greater proportion of networks listed were sex partners or kin, compared to other place-types. A greater proportion of networks listed at bars/clubs/restaurants were gay, knew that the participant had sex with men, and were younger compared to other place-types.
AA MSM drink alcohol and use drugs in a variety of place-types and with various social network members. Little research has been done on factors that shape the geography of AA MSM substance use. Future research is needed to explore these complex associations.
药物和酒精的使用是艾滋病毒传播的风险因素。许多艾滋病毒行为研究都集中在风险上，而没有考虑行为的社会和空间背景。然而，风险可能因地点而异或具有独特性。本研究的目的是调查与男性发生性行为的非裔美国男性（AA MSM）使用药物和/或酒精的场所的社会和空间特征。具体而言，我们研究了药物/酒精场所的空间强度和聚集情况以及这些场所的社会网络特征。
通过外展、在线广告和口碑推荐招募参与者。纳入标准为：年龄在18岁及以上，且在过去90天内与男性发生过性行为。参与者（n = 51）完成了一份社会空间清单，其中他们提供了n = 187个他们最近使用药物和/或饮酒的场所的地址。参与者描述了这些场所中人员的特征。
参与者的平均年龄为36.5岁（标准差 = 10.9）。一半（51%）的人认定为同性恋，31%为双性恋，4%为异性恋，10%不确定/有疑问，27%自我报告感染艾滋病毒。药物/酒精场所集中在城市内部，并且存在按参与者特征聚类的证据。在参与者提到的n = 187个饮酒或使用药物的场所中，68%被描述为住所（参与者自己或“别人的家”），20%是酒吧/俱乐部或餐馆，8%是户外场所，4%是其他场所（如在公交车/汽车上）。不同场所类型的社会网络成员特征存在差异。与其他场所类型相比，在住所场所列出的网络中，性伴侣或亲属的比例更高。在酒吧/俱乐部/餐馆列出的网络中，同性恋者、知道参与者与男性发生性行为的人以及比其他场所类型的人更年轻的人的比例更高。
AA MSM在各种场所类型中与不同的社会网络成员一起饮酒和使用药物。关于影响AA MSM物质使用地理分布的因素，目前研究较少。未来需要进行研究以探索这些复杂的关联。
