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Drug Use, High-Risk Sex Behaviors, and Increased Risk for Recent HIV Infection among Men who Have Sex with Men in Chicago and Los Angeles

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Abstract

We examined how drugs, high-risk sexual behaviors, and socio-demographic variables are associated with recent HIV infection among men who have sex with men (MSM) in a case–control study. Interviewers collected risk factor data among 111 cases with recent HIV infection, and 333 HIV-negative controls from Chicago and Los Angeles. Compared with controls, cases had more unprotected anal intercourse (UAI) with both HIV-positive and HIV-negative partners. MSM with lower income or prior sexually transmitted infections (STI) were more likely to be recently HIV infected. Substances associated with UAI included amyl nitrate (“poppers”), methamphetamine, Viagra® (or similar PDE-5 inhibitors), ketamine, and gamma hydroxybutyrate (GHB). Cases more frequently used Viagra®, poppers, and methamphetamine during UAI compared with controls. In multivariate analysis, income, UAI with HIV-positive partners, Viagra®, and poppers remained associated with recent HIV seroconversion. Better methods are needed to prevent HIV among MSM who engage in high-risk sex with concurrent drug use.

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Acknowledgements

The authors thank Stephanie Behel, Steve Jones, Elise Levin, Kristina Bowles, Duncan MacKellar, Vel McKleroy, Michael Plankey, David Purcell, John Sheridan, Laura Syster, Stephen Tregear, and Patrick Wenzel. We also thank the staff at the health departments in Chicago and Los Angeles, the HIV/AIDS program clinics assisting our investigation, and our study participants. This study was funded by CDC cooperative agreement number 00005b, as part of the “Context of HIV Infection Project (CHIP).

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The findings and conclusions in this report are those of the authors and do not necessarily reflect the views of the Centers for Disease Control and Prevention (CDC).

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Correspondence to James W. Carey.

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Carey, J.W., Mejia, R., Bingham, T. et al. Drug Use, High-Risk Sex Behaviors, and Increased Risk for Recent HIV Infection among Men who Have Sex with Men in Chicago and Los Angeles. AIDS Behav 13, 1084–1096 (2009). https://doi.org/10.1007/s10461-008-9403-3

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