Journal of Urban Health

, 82:i62 | Cite as

Longitudinal patterns of methamphetamine, popper (amyl nitrite), and cocaine use and high-risk sexual behavior among a cohort of San Francisco men who have sex with men

  • Grant Colfax
  • Thomas J. Coates
  • Marla J. Husnik
  • Yijian Huang
  • Susan Buchbinder
  • Beryl Koblin
  • Margaret Chesney
  • Eric Vittinghoff
  • EXPLORE Study Team
The Role of Poly-Substance Use in High-Risk Sex


Most prior studies examining drug use among men who have sex with men (MSM) have been cross-sectional or retrospective and have not determined whether periods of increased drug use are associated with high-risk sexual behavior at the individual level. In this article, we describe patterns of use of methamphetamines, poppers, and sniffed cocaine and sexual risk behavior among 736 San Francisco MSM enrolled in the EXPLORE study and followed for up to 48 months. In longitudinal analysis, use of methamphetamines, poppers, and sniffed cocaine declined during follow-up. However, compared with older participants, younger participants were more likely to increase their drug use over time. Results of conditional logistic regression demonstrated that high-risk sexual behavior was more common during reporting periods characterized by increased methamphetamine, poppers, or sniffed cocaine use. This within-person analysis found that compared with periods of no drug use, periods of both light drug use (less than weekly use of drugs) and heavier drug use (at least weekly use of at least one drug) were significantly associated with increased risk of engaging in uprotected anal sex with an HIV-positive or unknown-status partner. These results suggest that even intermittent, recreational use of these drugs may lead to high-risk sexual behavior, and that, to reduce and prevent risks of HIV, no level of use of these drugs should be considered “safe.” HIV prevention interventions should target MSM who report either light or heavy use of methamphetamines, poppers, and sniffed cocaine.


Drug use HIV Men who have sex with men Sexual risk behavior 


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Copyright information

© Oxford University Press on behalf of the New York Academy of Medicine 2005

Authors and Affiliations

  • Grant Colfax
    • 1
  • Thomas J. Coates
    • 2
  • Marla J. Husnik
    • 3
  • Yijian Huang
    • 4
  • Susan Buchbinder
    • 1
  • Beryl Koblin
    • 5
  • Margaret Chesney
    • 6
  • Eric Vittinghoff
    • 7
  • EXPLORE Study Team
  1. 1.HIV Research BranchSan Francisco Department of Public HealthSan Francisco
  2. 2.University of California, Los AngelesLos Angeles
  3. 3.Statistical Center for HIV/AIDS Research and Prevention, Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattle
  4. 4.Rollins School of Public HealthEmory UniversityAtlanta
  5. 5.The New York Blood CenterNew York
  6. 6.National Center of Complementary & Alternative MedicineBethesda
  7. 7.University of CaliforniaSan Francisco

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