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The Relationship Between Alcohol and Drug Use, Compulsive Sexual Behavior, and Condomless Anal Sex in Men Who have Sex with Men: Analysis of Retrospectively-Reported Sexual Behavior

La Relación entre el Uso de Alcohol y Drogas, el Comportamiento Sexual Compulsivo y el Sexo Anal Sin Condón en Hombres que tienen Sexo con Hombres: Análisis del Comportamiento Sexual Informado Retrospectivamente

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Abstract

Men who have sex with men (MSM) are disproportionately impacted by HIV in the United States, and substance use and compulsive sexual behavior (CSB) are contributors to HIV risk behavior. This study sought to examine the direct and interactive effects of concurrent substance use and CSB on condomless anal sex (CAS) in a community sample of MSM (N = 200) utilizing a 90-day timeline follow-back assessment. Results indicated CSB did not directly increase risk for CAS when controlling for substance use and age. There was limited evidence for a direct effect of concurrent alcohol use on CAS, and no evidence for an interaction effect with CSB. The relationship between concurrent drug use and CAS was moderated by CSB, such that concurrent drug use was positively associated with CAS for those who screened positive for CSB, while the association was non-significant for those who screened negative. Implications and limitations of these findings are discussed.

Resumen

En los Estados Unidos, los hombres que tienen sexo con hombres (HSH) se ven afectados de manera desproporcionada, por el VIH, el uso de sustancias y el comportamiento sexual compulsivo (CSB), lo que contribuye al comportamiento de riesgo del VIH. Este estudio buscó examinar los efectos directos e interactivos del uso simultáneo de sustancias y el CSB sobre el sexo anal sin condón (CAS) en una muestra comunitaria de HSH (N = 200) utilizando una evaluación de retrospectiva de 90 días. Los resultados indicaron que CSB no aumentó directamente el riesgo de CAS al controlar el uso de sustancias y la edad. Se encontró evidencia limitada de un efecto directo del consumo concurrente de alcohol sobre CAS y no se encontró evidencia de efecto de interacción con la CSB. La relación entre el uso concurrente de drogas y CAS fue moderada por CSB, de modo que el uso concurrente de drogas se asoció positivamente con CAS para aquellos que dieron positivo para CSB, mientras que la asociación no fue significativa para aquellos que dieron negativo. Se discuten las implicaciones y limitaciones de estos hallazgos.

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Data Availability

The data utilized in this study are available upon request.

Code Availability

The code utilized in this study’s analyses is available upon request.

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Acknowledgements

Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under award number R01MH094229.

Funding

Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under Award Number R01MH094229.

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Authors and Affiliations

  1. Department of Psychology, University of Washington, Seattle, WA, USA

    Neil Gleason, Jessica R. Canning, William H. George & Mary E. Larimer

  2. Department of Psychology, St. Olaf College, Northfield, MN, USA

    Gabriel Smith

  3. Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA

    Todd L. Jennings

  4. Department of Family Medicine and Community Health, Institute for Sexual and Gender Health, University of Minnesota Medical School, Minneapolis, MN, USA

    Eli Coleman & Michael H. Miner

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  1. Neil Gleason
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  2. Gabriel Smith
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Contributions

Study was conceptualized, methodology was developed, funding was acquired, and data was collected by MHM and EC; Study hypotheses were developed by NG, WHG, MEL, TLJ, and MHM; Formal Analyses were conducted and written up by GS, JRC, and NG; Original draft of the manuscript was written by NG and GS; Manuscript was reviewed and edited by NG, GS, JRC, WHG, MEL, TLJ, EC, and MHM; Supervision was provided by WHG, MEL, EC, and MHM.

Corresponding author

Correspondence to Neil Gleason.

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The authors have no conflicts of interests to declare.

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All procedures were approved by the University of Minnesota’s Committee for the Protection of Human Subjects.

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All participants provided written consent to participate in study procedures.

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Gleason, N., Smith, G., Canning, J.R. et al. The Relationship Between Alcohol and Drug Use, Compulsive Sexual Behavior, and Condomless Anal Sex in Men Who have Sex with Men: Analysis of Retrospectively-Reported Sexual Behavior. AIDS Behav 27, 2317–2327 (2023). https://doi.org/10.1007/s10461-022-03961-6

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