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HIV Risk and Protective Factors in the Context of Alcohol and Substance Use During Pride

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Abstract

This investigation sought to identify HIV-risk and -protective factors among men-who-have-sex-with-men (MSM) who engaged in anal sex following alcohol or substance use during an international Pride Festival. MSM attending World Pride were surveyed regarding (1) alcohol, substance use, and sex during the past 24 h; and (2) HIV-risk and -protective factors. Valid data were provided by 1123 MSM. Anal sex was reported by 195 MSM, among whom the majority (n = 105) consumed alcohol or substances prior to sex. Among MSM aware of their HIV status who consumed alcohol or substances prior to sex (n = 99), those who engaged in serodiscordant condomless anal sex (n = 22) were more likely to be HIV+ (AOR = 10.14, 95% CI 1.48–69.35); report multiple sex partners (AOR = 9.05, 95% CI 1.70–48.12); and possess lower condom efficacy (AOR = 0.47, 95% CI 0.23–0.93) and social support (AOR = 0.08, 95% CI 0.01–0.46). Bolstering condom negotiation skills and social support could potentially reduce HIV acquisition/transmission-risk behavior, even when under the influence of alcohol or substances.

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Notes

  1. Pre-exposure prophylaxis (PrEP) had not been approved in the jurisdiction at the time.

References

  1. Centers for Disease Control and Prevention. CDC FACT SHEET: HIV among gay and bisexual men. 2016. https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/cdc-msm-508.pdf. Accessed 13 April 2017.

  2. Public Health Agency of Canada. Summary: estimates of HIV prevalence and incidence in Canada, 2011, Ottawa: Surveillance and Epidemiology Division and Professional Guidelines and Public Health Practice Division, Centre for Communicable Diseases and Infection Control. 2012. http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/estimat2011-eng.php. Accessed 13 April 2017.

  3. Beyrer C, Baral SD, van Griensven F, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380(9839):367–77.

    Article  PubMed  PubMed Central  Google Scholar 

  4. National Institute of Health, AIDSinfo. HIV and gay and bisexual men. 2017. https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/25/81/hiv-and-gay-and-bisexual-men. Accessed 30 Jan 2018.

  5. Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  7. Steele CM, Josephs RA. Alcohol myopia. Its prized and dangerous effects. Am Psychol. 1990;45(8):921–33.

    Article  PubMed  CAS  Google Scholar 

  8. Maisto SA, Carey MP, Carey KB, Gordon CM, Schum JL, Lynch KG. The relationship between alcohol and individual differences variables on attitudes and behavioral skills relevant to sexual health among heterosexual young adult men. Arch Sex Behav. 2004;33(6):571–84.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Noel NE, Heaton JA, Brown BP. Substance induced myopia. In: Miller P, editor. Principles of addiction. Academic Press: Cambridge; 2013. p. 349–54. https://doi.org/10.1016/B978-0-12-398336-7.00036-X.

    Chapter  Google Scholar 

  10. Lacefield K, Negy C, Schrader RM, Kuhlman C. Comparing psychosocial correlates of condomless anal sex in HIV-diagnosed and HIV-nondiagnosed men who have sex with men: a series of meta-analyses of studies from 1993–2013. LGBT Health. 2015;2(3):200–20.

    Article  PubMed  Google Scholar 

  11. Shuper PA, Joharchi N, Irving H, Rehm J. Alcohol as a correlate of unprotected sexual behavior among people living with HIV/AIDS: review and meta-analysis. AIDS Behav. 2009;13(6):1021–36.

    Article  PubMed  Google Scholar 

  12. Shuper PA, Neuman M, Kanteres F, Baliunas D, Joharchi N, Rehm J. Causal considerations on alcohol and HIV/AIDS—a systematic review. Alcohol Alcohol. 2010;45(2):159–66.

    Article  PubMed  Google Scholar 

  13. Woolf SE, Maisto SA. Alcohol use and risk of HIV infection among men who have sex with men. AIDS Behav. 2009;13(4):757–82.

    Article  PubMed  Google Scholar 

  14. Herrick AL, Stall R, Goldhammer H, Egan JE, Mayer KH. Resilience as a research framework and as a cornerstone of prevention research for gay and bisexual men: theory and evidence. AIDS Behav. 2014;18(1):1–9.

    Article  PubMed  Google Scholar 

  15. Qiao S, Li X, Stanton B. Social support and HIV-related risk behaviors: a systematic review of the global literature. AIDS Behav. 2014;18(2):419–41.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Ramirez-Valles J. The protective effects of community involvement for HIV risk behavior: a conceptual framework. Health Educ Res. 2002;17(4):389–403.

    Article  PubMed  CAS  Google Scholar 

  17. Widman L, Golin CE, Grodensky CA, Suchindran C. Do safer sex self-efficacy, attitudes toward condoms, and HIV transmission risk beliefs differ among men who have sex with men, heterosexual men, and women living with HIV? AIDS Behav. 2013;17(5):1873–82.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Qualtrics [computer program]. Version 13.018. Provo, Utah, USA. 2009.

  19. National Institute on Drug Abuse. Resource guide: screening for drug use in general medical settings. 2012. https://www.drugabuse.gov/publications/resource-guide. Accessed 13 April 2017.

  20. The Explore Team. Effects of a behavioural intervention to reduce acquisition of HIV infection among men who have sex with men: the EXPLORE randomised controlled study. Lancet. 2004;364:41–50.

    Article  Google Scholar 

  21. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988;52(1):30–41.

    Article  Google Scholar 

  22. Vanable PS, McKiman DJ, Stokes JP. Identification and involvement with the gay community scale. In: Davis CM, editor. Handbook of sexuality related measures. Sage Publications: Thousand Oak; 1992. p. 407–9.

    Google Scholar 

  23. Eaton LA, Kalichman SC, Cain DN, et al. Serosorting sexual partners and risk for HIV among men who have sex with men. Am J Prev Med. 2007;33(6):479–85.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Brennan DJ, Hellerstedt WL, Ross MW, Welles SL. History of childhood sexual abuse and HIV risk behaviors in homosexual and bisexual men. Am J Public Health. 2007;97(6):1107–12.

    Article  PubMed  PubMed Central  Google Scholar 

  25. IBM SPSS Statistics for Windows [computer program]. Version 21.0, Armonk, NY. 2012.

  26. Adam BD, Husbands W, Murray J, Maxwell J. Circuits, networks, and HIV risk management. AIDS Educ Prev. 2008;20(5):420–34.

    Article  PubMed  Google Scholar 

  27. Mustanski BS, Newcomb ME, Du Bois SN, Garcia SC, Grov C. HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions. J Sex Res. 2011;48(2–3):218–53.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Holt M, Lee E, Prestage GP, Zablotska I, de Wit J, Mao L. The converging and diverging characteristics of HIV-positive and HIV-negative gay men in the Australian Gay Community Periodic Surveys, 2000-2009. AIDS Care. 2013;25(1):28–37.

    Article  PubMed  Google Scholar 

  29. Shuper PA, Joharchi N, Rehm J. Personality as a predictor of unprotected sexual behavior among people living with HIV/AIDS: a systematic review. AIDS Behav. 2014;18(2):398–410.

    Article  PubMed  Google Scholar 

  30. Crepaz N, Hart TA, Marks G. Highly active antiretroviral therapy and sexual risk behavior: a meta-analytic review. JAMA. 2004;292(2):224–36.

    Article  PubMed  CAS  Google Scholar 

  31. UNAIDS. On the fast-track to end AID. 2016. http://www.unaids.org/sites/default/files/media_asset/20151027_UNAIDS_PCB37_15_18_EN_rev1.pdf. Accessed 30 Jan 2018.

  32. Zablotska IB, Imrie J, Prestage G, et al. Gay men’s current practice of HIV seroconcordant unprotected anal intercourse: serosorting or seroguessing? AIDS Care. 2009;21(4):501–10.

    Article  PubMed  Google Scholar 

  33. Campbell-Sills L, Stein MB. Psychometric analysis and refinement of the Connor-davidson Resilience Scale (CD-RISC): validation of a 10-item measure of resilience. J Trauma Stress. 2007;20(6):1019–28.

    Article  PubMed  Google Scholar 

  34. Emlet CA, Shiu C, Kim HJ, Fredriksen-Goldsen K. Bouncing back: resilience and mastery among HIV-positive older gay and bisexual men. Gerontologist. 2017;57(suppl 1):S40–9.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Wagnild GM, Young HM. Development and psychometric evaluation of the Resilience Scale. J Nurs Meas. 1993;1(2):165–78.

    PubMed  CAS  Google Scholar 

  36. Kalichman SC, Simbayi LC, Vermaak R, et al. Randomized trial of a community-based alcohol-related HIV risk-reduction intervention for men and women in Cape Town South Africa. Ann Behav Med. 2008;36(3):270–9.

    Article  PubMed  Google Scholar 

  37. Shoptaw S, Reback CJ, Peck JA, et al. Behavioral treatment approaches for methamphetamine dependence and HIV-related sexual risk behaviors among urban gay and bisexual men. Drug Alcohol Depend. 2005;78(2):125–34.

    Article  PubMed  Google Scholar 

  38. Hart TA, Stratton N, Coleman TA, et al. A pilot trial of a sexual health counseling intervention for HIV-positive gay and bisexual men who report anal sex without condoms. PLoS ONE. 2016;11(4):e0152762.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  39. Herbst JH, Sherba RT, Crepaz N, et al. A meta-analytic review of HIV behavioral interventions for reducing sexual risk behavior of men who have sex with men. JAIDS. 2005;39(2):228–41.

    PubMed  Google Scholar 

  40. Crepaz N, Baack BN, Higa DH, Mullins MM. Effects of integrated interventions on transmission risk and care continuum outcomes in persons living with HIV: meta-analysis, 1996–2014. AIDS. 2015;29(18):2371–83.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

This work was supported by a grant from the Ontario HIV Treatment Network (OHTN) (PI: Shuper). This project was made possible with the assistance and input from a number of community agencies and stakeholders, and we are very grateful to our research staff and all of the individuals who participated in this study.

Funding

This study was funded by a grant from the Ontario HIV Treatment Network (OHTN).

Author information

Authors and Affiliations

  1. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, M5S 2S1, Canada

    Paul A. Shuper & Narges Joharchi

  2. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

    Paul A. Shuper

  3. AIDS Committee of Toronto, Toronto, Canada

    Duncan J. MacLachlan & John Maxwell

  4. St. Michael’s Hospital, Toronto, Canada

    Tim H. Guimond

  5. Department of Psychiatry, University of Toronto, Toronto, Canada

    Tim H. Guimond

  6. Department of Sociology, Anthropology and Criminology, University of Windsor, Windsor, Canada

    Barry D. Adam

  7. Ontario HIV Treatment Network, Toronto, Canada

    Barry D. Adam

Authors
  1. Paul A. Shuper
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  2. Duncan J. MacLachlan
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  3. Narges Joharchi
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  4. Tim H. Guimond
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  5. John Maxwell
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  6. Barry D. Adam
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Correspondence to Paul A. Shuper.

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The authors declare that they have no conflicts of interest.

Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Shuper, P.A., MacLachlan, D.J., Joharchi, N. et al. HIV Risk and Protective Factors in the Context of Alcohol and Substance Use During Pride. AIDS Behav 22, 2797–2806 (2018). https://doi.org/10.1007/s10461-018-2117-2

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  • DOI: https://doi.org/10.1007/s10461-018-2117-2

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