, Volume 4, Issue 2, pp 205-219

The Role of Drugs in the Sexual Lives of Men Who Have Sex with Men: Continuing Barriers to Researching This Question

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Abstract

Barriers to researching links between drug use among men who have sex with men (MSM) and HIV risk fall into three categories: (1) institutional barriers, (2) lack of appropriate theoretical models, and (3) stigmatization of sexual minorities. This paper reviews the status of the progress on the first two issues and presents a historical account of research on the role of drugs in the sexual lives of MSM during the AIDS epidemic. The paper first reviews the history of research on drug use and sexual behavior using Rofes' four-stage model of the gay community's responses to the AIDS epidemic (crisis stage, organizing stage, ‘degaying’ stage, and ‘post-AIDS’ stage) as an organizing strategy. Discussions follow which address the institutional and theoretical barriers that remain and progress that has been made in overcoming these barriers. Finally, there is a review of the published literature on HIV prevention interventions for homosexually active drug users with a focus on their relevance for drug-using (DU) MSM and recommendations for future research. While the published literature on interventions for DU-MSM is in its infancy, it indicates that a variety of intervention models can produce significant changes in drug-related sexual behavior and HIV-risk taking. The future of this field holds promise in both the development of effective interventions for DU-MSM and increased understanding of the causal mechanisms which link drug use to risky sexual behaviors.