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Event-Level Analysis of Anal Sex Roles and Sex Drug Use Among Gay and Bisexual Men in Vancouver, British Columbia, Canada


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.

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This work was supported by the Canadian Institutes for Health Research [107544]; 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.

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Correspondence to Eric A. Roth.

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The co-authors acknowledge that they have no financial interest or benefit arising from the direct application of this research to disclose.

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Rich, A.J., Lachowsky, N.J., Cui, Z. et al. Event-Level Analysis of Anal Sex Roles and Sex Drug Use Among Gay and Bisexual Men in Vancouver, British Columbia, Canada. Arch Sex Behav 45, 1443–1451 (2016). https://doi.org/10.1007/s10508-015-0607-0

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  • Sexual partnerships
  • Event-level data
  • Anal sex roles
  • Gay and bisexual men
  • Substance use