Algarin Angel B, Lara Marisol Valenzuela, Hernandez-Avila Mauricio, Baruch-Dominguez Ricardo, Sanchez Travis, Strathdee Steffanie A, Smith Laramie R
Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ USA.
Department of Epidemiology, Emory University, Atlanta, GA USA.
Sex Res Social Policy. 2024;21(4):1406-1417. doi: 10.1007/s13178-023-00861-9. Epub 2023 Aug 11.
Drug use behaviors are closely associated with increased risk for HIV and other STIs among men who have sex with men (MSM) globally. Less is known about the drug use characteristics and their association with HIV/STI risk among MSM in Mexico, who have 13 times higher risk of acquiring HIV than the general population. We characterized distinct classes of drug use behaviors among a nationwide sample of MSM in Mexico and tested their associations with HIV risk behaviors.
We used latent class analysis (LCA) to analyze injection/non-injection drug use data collected by the online self-administered survey among 15,875 MSM living in Mexico between May-June 2017. MSM were recruited on general social media sites (e.g. Facebook and Twitter), popular LGBT + focused web pages (e.g. Soy Homosensual and Desastre), and dating apps (e.g. Grindr and Hornet). We used robust Poisson regression to examine associations between drug use classes and recent sexual risk behaviors while adjusting for sociodemographic characteristics.
Most participants were under 30 years of age (65.5%), received a Bachelor's degree or higher (65.2%), gay-identified (82.5%), HIV negative (58.1%), and lived in the Mexico City/State of Mexico region (34.5%). We identified five distinct drug use classes: Limited Drug Use (75.4%), Marijuana Only (15.1%), Sex Event Popper + Marijuana (4.3%), Club Drug + Marijuana (4.2%), and Elevated Polydrug Use (1.0%). Compared to the Limited Drug Use class, participants in all other drug use classes were significantly more likely to engage in condomless anal intercourse (aPR = 1.14-1.39; p < 0.001), sex exchange (aPR = 1.37-4.99; p < 0.001), anonymous sex (aPR = 1.22-2.01; p < 0.001), group sex (aPR = 1.50-3.28; p < 0.001), and report an STI diagnosis in the past 12 months (aPR = 1.24-2.20; p < 0.002). Estimates were largest among the Elevated Polydrug Use class.
This study is the first to characterize drug use behaviors and HIV/STI risk among a national sample of MSM in Mexico. Understanding how distinct combinations of drug use behaviors impact sexual risk and prevention behaviors among MSM can inform how best to target and tailor future interventions to reduce HIV/STI incidence.
The online version contains supplementary material available at 10.1007/s13178-023-00861-9.
在全球范围内，男男性行为者（MSM）的吸毒行为与感染艾滋病毒及其他性传播感染的风险增加密切相关。墨西哥的MSM感染艾滋病毒的风险是普通人群的13倍，然而，关于该国MSM的吸毒特征及其与艾滋病毒/性传播感染风险的关联，我们却知之甚少。我们对墨西哥全国范围内的MSM样本中的不同吸毒行为类别进行了特征描述，并测试了它们与艾滋病毒风险行为的关联。
我们使用潜在类别分析（LCA）来分析2017年5月至6月期间通过在线自填式调查收集的15875名居住在墨西哥的MSM的注射/非注射吸毒数据。MSM是在一般社交媒体网站（如Facebook和Twitter）、以LGBT+为重点的流行网页（如Soy Homosensual和Desastre）以及约会应用程序（如Grindr和Hornet）上招募的。我们使用稳健泊松回归来检验吸毒类别与近期性风险行为之间的关联，同时对社会人口学特征进行调整。
大多数参与者年龄在30岁以下（65.5%），拥有学士学位或更高学历（65.2%），自我认同为同性恋（82.5%），艾滋病毒检测呈阴性（58.1%），居住在墨西哥城/墨西哥州地区（34.5%）。我们确定了五个不同的吸毒类别：有限吸毒（75.4%）、仅吸食大麻（15.1%）、性活动时使用Poppers+大麻（4.3%）、俱乐部毒品+大麻（4.2%）以及高频率多药滥用（1.0%）。与有限吸毒类别相比，所有其他吸毒类别的参与者进行无保护肛交的可能性显著更高（调整后风险比[aPR]=1.14 - 1.39；p<0.001）、性交易（aPR = 1.37 - 4.99；p<0.001）、匿名性行为（aPR = 1.22 - 2.01；p<0.001）、群交（aPR = 1.50 - 3.28；p<0.00
