Event-Level Analysis of Anal Sex Roles and Sex Drug Use Among Gay and Bisexual Men in Vancouver, British Columbia, Canada
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This study analyzed event-level partnership data from a computer-assisted survey of 719 gay and bisexual men (GBM) enrolled in the Momentum Health Study to delineate potential linkages between anal sex roles and the so-called “sex drugs,” i.e., erectile dysfunction drugs (EDD), poppers, and crystal methamphetamine. Univariable and multivariable analyses using generalized linear mixed models with logit link function with sexual encounters (n = 2514) as the unit of analysis tested four hypotheses: (1) EDD are significantly associated with insertive anal sex roles, (2) poppers are significantly associated with receptive anal sex, (3) both poppers and EDD are significantly associated with anal sexual versatility, and (4) crystal methamphetamine is significantly associated with all anal sex roles. Data for survey respondents and their sexual partners allowed testing these hypotheses for both anal sex partners in the same encounter. Multivariable results supported the first three hypotheses. Crystal methamphetamine was significantly associated with all anal sex roles in the univariable models, but not significant in any multivariable ones. Other multivariable significant variables included attending group sex events, venue where first met, and self-described sexual orientation. Results indicate that GBM sex-drug use behavior features rational decision-making strategies linked to anal sex roles. They also suggest that more research on anal sex roles, particularly versatility, is needed, and that sexual behavior research can benefit from partnership analysis.
KeywordsSexual partnerships Event-level data Anal sex roles Gay and bisexual men Substance use
This work was supported by the Canadian Institutes for Health Research ; National Institutes for Health, National Institute for Drug Abuse [R01DA031055] and Health Canada. We thank our community colleagues at the Health Initiative for Men, YouthCO HIV & HepC Society of BC, and Positive Living BC for their support. We also thank the research participants for sharing their important data with the Momentum Health Study. DMM is supported by a Scholar Award from the Michael Smith Foundation for Health Research.
Compliance with Ethical Standards
The co-authors acknowledge that they have no financial interest or benefit arising from the direct application of this research to disclose.
- Allison, P. (2012). Logistic regression using SAS. Cary, NC: SAS Press.Google Scholar
- Colfax, G., Vittinghoff, E., Husnik, M. J., McKirnan, D., Buchbinder, S., Koblin, B., … Coates, T. J. (2004). Substance use and sexual risk: A participant-and episode-level analysis among a cohort of men who have sex with men. American Journal of Epidemiology, 159, 1002–1012.Google Scholar
- Forrest, J. I., Stevenson, B., Rich, A., Michelow, W., Pai, J., Jollimore, J., … Roth, E. A. (2014). Community mapping and respondent-driven sampling of gay and bisexual men’s communities in Vancouver, Canada. Culture, Health & Sexuality, 16, 288–301.Google Scholar
- Godbole, S., Sane, S. Kamble, P. Raj, Y. Dulhani, N. Venkatsh, S., … Risbud, A. (2014). Predictors of bisexual behavior among MSM attending intervention sites may help in prevention interventions for this bridge to the heterosexual epidemic in India: Data from HIV sentinel surveillance. PLOS One, 9, e107439. doi: 10.1371/journal.pone.0107439.
- Lima, V.D., Geller, J., Bangsberg, D.R., Patterson, T.L., Daniel, M., Kerr, T., … Hogg, R.S. (2007). The effect of adherence on the association between depressive symptoms and mortality among HIV-infected individuals first initiating HAART. AIDS, 21, 1175–1183.Google Scholar
- Lyons, A., Pitts, M., Smith, G., Grierson, J., Smith, A., McNally, S., & Couch, M. (2011). Versatility and HIV vulnerability: Investigating the proportion of Australian gay men having both insertive and receptive anal intercourse. Journal of Sexual Medicine, 8, 2164–2171.CrossRefPubMedGoogle Scholar
- Mansergh, G., Shouse, R., Marks, G., Guzman, R., Rader, M., Buchbinder, S., & Colfax, G. (2006). Methamphetamine and sildenafil (Viagra) use are linked to unprotected receptive and insertive anal sex, respectively, in a sample of men who have sex with men. Sexually Transmitted Infections, 82, 131–134.CrossRefPubMedPubMedCentralGoogle Scholar
- Meng, X., Zou, H., Fan, S., Zheng, B., Zhang, L., Dai, X., … Lu, B. (2014). Relative risk for HIV infection among men who have sex with men engaging in different roles in anal sex: A systematic review and meta-analysis on global data. AIDS and Behavior, 19, 882–889.Google Scholar
- Montaner, J., Lima, V., Harrigan, P., Lourenço, L., Yip, B., Nosyk, B., … Kendall, P. (2014). Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: The “HIV Treatment as Prevention” experience in a Canadian setting. PLoS One, 9, e87872.Google Scholar
- Ostrow, D., & Stall, R. (2008). Alcohol, tobacco and drug use among gay and bisexual men. In R. Wolitiski, R. Stall, & E. Valdiserri (Eds.), Unequal opportunity: Health disparities affecting gay and bisexual men in the United States (pp. 121–158). Oxford: Oxford University Press.Google Scholar
- Prestage, G., Hudson, J., Down, I., Bradley, J., Corrigan, N., Hurley, M., … McInnes, D. (2009). Gay men who engage in group sex are at increased risk of HIV infection and onward transmission. AIDS and Behavior, 13, 724–730.Google Scholar
- Roth, E., Rich, A., Birch, R., Jollimore, J., & Howard, T. (2014). Applying the concept of positive deviance to group sex events. Paper presented at the Gay Men’s Health Summit, Vancouver, BC, Canada.Google Scholar
- Volz, E., Wejnert, C., Cameron, C., Spiller, M., Barash, V., Degani, I., & Heckathorn, D. (2012). Respondent-driven sampling analysis tool (RDSAT) Version 7.1. Ithaca, NY: Cornell University.Google Scholar