Center for Health, Identity, Behavior and Prevention Studies, 665 Broadway #800, New York, NY 10012, USA.
Center for Health, Identity, Behavior and Prevention Studies, 665 Broadway #800, New York, NY 10012, USA; Department of Biostatistics and Social and Behavioral Sciences, School of Public Health, Rutgers University, 684 Hoes Lane West, Piscataway, NJ 08854, USA.
Int J Drug Policy. 2018 May;55:207-214. doi: 10.1016/j.drugpo.2018.03.014. Epub 2018 Mar 31.
Substance use and condomless sexual behaviours are both well studied in sexual minority men, but few researchers have used event-level data collection to examine sexualised drug use in sexual and gender minority young adults. The aim of this study is to describe the co-occurrence of sex under the influence of substances and condomless sexual behaviours, using nuanced event-level data, in a racially/ethnically and socioeconomically diverse sample in New York City.
Data from one wave of a cohort of sexual and gender minority young adults who were assigned male at birth (n = 500) were used to characterise co-occurrence of sex under the influence of drugs and condomless sexual behaviours (oral receptive, anal insertive, and anal receptive sex), in the last 30 days. Logistic regression models were constructed to assess associations between sex while high and condomless sexual behaviours, controlling for sociodemographic factors.
Preliminary analyses indicated significant associations between engaging in sex while high and condomless sexual behaviours. In unadjusted regression models, sexualised and non-sexualised drug use were both significantly associated with increased odds of condomless sexual behaviours. In adjusted models, sexualised drug use remained significantly associated with condomless anal insertive sex (AOR = 3.57) and condomless anal receptive sex (AOR = 4.98). Having multiple sexual partners was also significantly associated with greater odds of condomless sexual activity in all three adjusted models.
Multivariable analyses indicated that engaging in sex while high on any drug was associated with increased condomless sexual behaviour, but that sexualised drug use was associated with particularly elevated condomless anal sex. These findings provide insight for understanding the co-occurrence of substance use and condomless sex, and suggest a need for HIV/STI risk reduction strategies that address the role of sexualised drug use.
物质使用和无保护性行为在性少数男性中都有广泛研究，但很少有研究人员使用事件级别的数据收集来研究性少数和性别少数青年成年人中的性化药物使用。本研究旨在使用细致的事件级数据，在纽约市一个种族/民族和社会经济多样化的样本中，描述受物质影响的性行为和无保护性行为的同时发生情况。
使用出生时被指定为男性的性少数和性别少数青年成年人队列的一个波次的数据（n=500），描述在过去 30 天内受药物影响的性行为和无保护性行为（口腔接受、肛门插入和肛门接受性行为）的同时发生情况。构建逻辑回归模型，控制社会人口因素，评估性行为与无保护性行为之间的关联。
初步分析表明，性行为与无保护性行为之间存在显著关联。在未调整的回归模型中，性化和非性化药物使用均与无保护性行为的几率增加显著相关。在调整后的模型中，性化药物使用与无保护肛门插入性行为（AOR=3.57）和无保护肛门接受性行为（AOR=4.98）仍然显著相关。有多个性伴侣也与所有三个调整模型中的无保护性行为几率增加显著相关。
多变量分析表明，任何药物的性行为与无保护性行为的几率增加相关，但性化药物使用与特别高的无保护肛门性行为相关。这些发现为理解物质使用和无保护性行为的同时发生情况提供了见解，并表明需要制定针对性化药物使用的 HIV/性传播感染风险降低策略。
