Chard Anna N, Metheny Nicholas S, Sullivan Patrick S, Stephenson Rob
a Department of Environmental Health, Rollins School of Public Health , Emory University ; Clifton Road, Atlanta , Georgia , USA.
b Department of Health Behavior and Biological Science, School of Nursing , University of Michigan , Ann Arbor , Michigan , USA.
Subst Use Misuse. 2018 Jan 2;53(1):42-50. doi: 10.1080/10826084.2017.1322985. Epub 2017 Aug 9.
Rates of drug and alcohol use are higher among men who have sex with men (MSM) than the general adult male population, and are often associated with increased sexual risk-taking.
We aim to examine the prevalence of drunk or high sex and their associations with socio-demographic characteristics, gay social network size, and social stress among an online sample of MSM drawn from seven countries.
Sexually-active MSM aged over 18 residing in Australia, Brazil, Canada, South Africa, Thailand, the United Kingdom, or the United States were recruited through Facebook for a quantitative survey (n = 2,403) in 2012. Two outcomes were examined via logistic regression: reporting being buzzed/drunk at last sex, and reporting being high at last sex.
Results highlight the role of social stressors in shaping drug use among MSM. Results were context-specific, though commonalities were seen across countries. Being in a male-male sexual relationship was associated with lower odds of being buzzed/drunk at last sex in five countries. Higher scores on measures of external homonegative discrimination and internalized homonegativity were associated with greater odds of reporting being high at last sex in three countries. Conclusions/Importance: Social networks and minority stressors can have significant effects on drug use and sex while drunk or high. This points to the importance of focusing on structural issues when designing interventions for MSM aimed at reducing the transmission of HIV and other STIs.
男男性行为者（MSM）中的药物和酒精使用率高于一般成年男性人群，且往往与性冒险行为增加有关。
我们旨在调查在来自七个国家的男男性行为者在线样本中，醉酒或嗑药性行为的患病率及其与社会人口学特征、同性恋社交网络规模和社会压力的关联。
2012年通过脸书招募了居住在澳大利亚、巴西、加拿大、南非、泰国、英国或美国的18岁以上性活跃男男性行为者进行定量调查（n = 2403）。通过逻辑回归分析了两个结果：报告上次性行为时处于微醺/醉酒状态，以及报告上次性行为时处于嗑药状态。
结果凸显了社会压力源在男男性行为者药物使用形成过程中的作用。结果因具体情况而异，不过各国之间也有共性。在五个国家，处于男男性关系与上次性行为时处于微醺/醉酒状态的较低几率相关。在三个国家，外部同性恋负面歧视和内化同性恋负面性测量得分较高与报告上次性行为时处于嗑药状态的较高几率相关。结论/重要性：社交网络和少数群体压力源可能对醉酒或嗑药时的药物使用和性行为产生重大影响。这表明在设计旨在减少艾滋病毒和其他性传播感染传播的男男性行为者干预措施时，关注结构性问题非常重要。
