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Sexual Risk Behaviors among Club Drug Users in Shanghai, China: Prevalence and Correlates

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Abstract

We surveyed 276 club drug users in Shanghai, China. Overall, 43.8 % reported ≥2 sex partners in the past 30 days, and 48.9 % reported having sex with non-regular partners, 67.4 % of whom had unprotected sex. Having ≥2 recent sex partners was associated with being 35 years or older, male, living with friends or others, introduced to club drug use by non-regular sex partners, using methamphetamine recently, self-identified as gay/lesbian or bisexual, had sexual debut before 20 years old, and recently had sex under the influence of drugs. Having unprotected sex with non-regular partners in the past 30 days was associated with lower education levels, having sex to obtain drugs, and lower levels of HIV/AIDS knowledge. Club drug users should be targeted for intervention programs. Future research needs to identify other protective and risk factors for sexual risk behaviors and design interventions to reduce club drug use and associated sexual risk behaviors.

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References

  1. Degenhardt L, Copeland J, Dillon P. Recent trends in the use of “club drugs”: an Australian review. Subst Use Misuse. 2005;40(9–10):1241–56.

    Article  PubMed  Google Scholar 

  2. United Nations Office on Drugs and Crime (UNODC). Patterns and trends of amphetamine-type stimulants and other drugs: Asia and the Pacific. 2011. http://www.unodc.org/documents/scientific/Asia_and_the_Pacific_2011_Regional_ATS_Report.pdf.Accessed 18 Oct 2012.

  3. United Nations Office on Drugs and Crime (UNODC). Amphetamines and Ecstasy: 2011 Global ATS Assessment. http://www.unodc.org/documents/ATS/ATS_Global_Assessment_2011.pdf. Accessed 16 April 2012.

  4. Colfax G, Guzman R. Club drugs and HIV infection: a review. Clin Infect Dis. 2006;42:1463–9.

    Article  PubMed  Google Scholar 

  5. Drumright LN, Patterson TL, Strathdee SA. Club drugs as causal risk factors for HIV acquisition among men who have sex with men: a review. Subst Use Misuse. 2006;41(10–12):1551–601.

    Article  PubMed  Google Scholar 

  6. Maxwell J. Party drugs: properties, prevalence, patterns, and problems. Subst Use Misuse. 2005;40:1203–40.

    Article  PubMed  Google Scholar 

  7. Mansergh G, Colfax GN, Marks G, Rader M, Guzman R, Buchbinder S. The circuit party men’s health survey: findings and implications for gay and bisexual men. Am J Pub Hlth. 2001;91(6):953–8.

    Article  CAS  Google Scholar 

  8. Mattison AM, Ross MW, Wolfson T. San Diego HIV Neurobehavioral Research Center Group. Circuit party attendance, club drug use, and unsafe sex in gay men. J Subst Abuse. 2001;13(1–2):119–26.

    Article  PubMed  CAS  Google Scholar 

  9. National Institute of Drug Abuse (NIDA). Drug Facts: Club Drugs (GHB, Ketamine, and Rohypnol). Revised July 2010. http://www.drugabuse.gov/publications/drugfacts/club-drugs-ghb-ketamine-rohypnol. Accessed 1 May 2012.

  10. Parsons JT, Kelly BC, Weiser JD. Initiation into methamphetamine use for young gay and bisexual men. Drug Alcohol Depend. 2007;90(2–3):135–44.

    Article  PubMed  Google Scholar 

  11. Jia Z, Wang W, Dye C, Bao Y, Liu Z, Lu L. Exploratory analysis of the association between new-type drug use and sexual transmission of HIV in China. Am J Drug Alcohol Abuse. 2010;36(2):130–3.

    Article  PubMed  Google Scholar 

  12. Yang X, Xia G. Causes and consequences of increasing club drug use in China: a descriptive assessment. Subst Use Misuse. 2010;45(1–2):224–39.

    Article  PubMed  Google Scholar 

  13. Halkitis PN, Parsons JT. Recreational drug use and HIV-risk sexual behavior among men frequenting gay social venues. J Gay Lesbian Soc Serv. 2002;14(4):19–39.

    Article  Google Scholar 

  14. Ostrow DG. Substance use, HIV, and gay men. Focus. 1996;11(7):1.

    PubMed  CAS  Google Scholar 

  15. Halkitis PN, Shrem MT, Martin FW. Sexual behavior patterns of methamphetamine using gay and bisexual men in New York City. Subst Use Misuse. 2005;40:703–19.

    Article  PubMed  Google Scholar 

  16. Halkitis PN, Mukherjee PP, Palamar JJ. Longitudinal modeling of methamphetamine use and sexual risk behaviors in gay and bisexual men. AIDS Behav. 2009;13(4):783–91.

    Article  PubMed  Google Scholar 

  17. Klitzman RL, Greenberg JD, Pollack LM, Dolezal C. MDMA (“ecstasy”) use and its association with high risk behaviors, mental health, and other factors among gay/bisexual men in New York City. Drug Alcohol Depend. 2002;66(2):115–25.

    Article  PubMed  Google Scholar 

  18. Heckathorn DD. Respondent-driven sampling: a new approach to the study of hidden populations. Soc Probl. 1997;44:174–99.

    Article  Google Scholar 

  19. Heckathorn DD. Respondent-driven sampling II: deriving valid population estimates from chain-referral samples of hidden populations. Soc Probl. 2002;49:11–34.

    Article  Google Scholar 

  20. Hathaway AD, Hyshka E, Erickson PG, et al. RDS: an investigation of respondent driven sampling as a method of recruiting mainstream marijuana users. Harm Reduct J. 2010;9(7):15.

    Article  Google Scholar 

  21. Heckathorn DD, Semaan S, Broadhead RS, Hughes JJ. Extensions of respondent-driven sampling: a new approach to the study of injection drug users aged 18–25. AIDS Behav. 2002;6:55–67.

    Article  Google Scholar 

  22. Platt L, Wall M, Rhodes T, et al. Methods to recruit hard-to-reach groups: comparing two chain referral sampling methods of recruiting injecting drug users across nine studies in Russia and Estonia. J Urban Hlth. 2006;83(Suppl 6):i39–53.

    Article  Google Scholar 

  23. Wang J, Carlson RG, Falck RS, Siegal HA, Rahman A, Li L. Respondent-driven sampling to recruit MDMA users: a methodological assessment. Drug Alc Depend. 2005;78(2):147–57.

    Article  Google Scholar 

  24. Zung WW. A self-rating depression scale. Arch Gen Psychiatr. 1965;12:63–70.

    Article  PubMed  CAS  Google Scholar 

  25. Li L, Ji G, Liang LJ, Ding Y, Tian J, Xiao Y. A multi-level intervention for HIV affected families: together for empowerment activities (TEA). Soc Sci Med. 2011;73(8):1214–21.

    Article  PubMed  Google Scholar 

  26. Li L, Liang L, Ding Y, Ji G. Facing HIV as a family: predicting depressive symptoms with correlated responses. J Fam Psychol. 2011;25(2):202–9.

    Article  PubMed  Google Scholar 

  27. Salganik MJ. Variance estimation, design effects, and sample size calculations for respondent-driven sampling. J Urban Hlth. 2006;83(Suppl 7):98–112.

    Article  Google Scholar 

  28. Salganik MJ, Heckathorn DD. Sampling and estimation in hidden populations using respondent-driven sampling. Sociol Methodol. 2004;34:193–239.

    Article  Google Scholar 

  29. Heckathorn DD. Extensions of respondent driven sampling: analysing continuous variables and controlling for differential recruitment. Sociol Methodol. 2007;37(1):151–207.

    Article  Google Scholar 

  30. Johnston L, O’Bra H, Chopra M, et al. The associations of voluntary counseling and testing acceptance and the perceived likelihood of being HIV-infected among men with multiple sex partners in a South African township. AIDS Behav. 2010;14(4):922–31.

    Article  PubMed  Google Scholar 

  31. Jerome RC, Halkitis PN, Siconolfi DE. Club drug use, sexual behavior, and HIV seroconversion: a qualitative study of motivations. Subst Use Misuse. 2009;44(3):431–47.

    Article  PubMed  Google Scholar 

  32. Weeks MR, Liao S, Li F, et al. Challenges, strategies, and lessons learned from a participatory community intervention study to promote female condoms among rural sex workers in Southern China. AIDS Educ Prev. 2010;22(3):252–71.

    Article  PubMed  Google Scholar 

  33. Wu Z, Rou K, Cui H. The HIV/AIDS epidemic in China: history, current strategies and future challenges. AIDS Educ Prev. 2004;16(3 Suppl A):7–17.

    Article  PubMed  Google Scholar 

  34. Zhang K, Detels R, Liao S, Cohen M, Yu D. China’s HIV/AIDS epidemic: continuing challenges. Lancet. 2008;372(9652):1791–3.

    Article  PubMed  Google Scholar 

  35. Do M, Meekers D. Multiple sex partners and perceived risk of HIV infection in Zambia: attitudinal determinants and gender differences. AIDS Care. 2009;21(10):1211–21.

    Article  PubMed  Google Scholar 

  36. Uchudi J, Magadi M, Mostazir M. A multilevel analysis of the determinants of high-risk sexual behaviour in sub-Saharan Africa. J Biosoc Sci. 2012;44(3):289–311.

    Article  PubMed  Google Scholar 

  37. Li L, Ding YY, Wu Z, Rotheram-Borus MJ. NIMH Collaborative HIV/STD Prevention Trial Group. Normative beliefs and sexual risk in China. AIDS Behav. 2011;15(6):1251–8.

    Article  PubMed  Google Scholar 

  38. Sterk CE, Klein H, Elifson KW. Young adult Ecstasy users and multiple sexual partners: understanding the factors underlying this HIV risk practice. J Psychoactive Drugs. 2008;40(3):237–44.

    Article  PubMed  Google Scholar 

  39. Halkitis PN, Green KA, Mourgues P. Longitudinal investigation of methamphetamine use among gay and bisexual men in New York City: findings from Project BUMPS. J Urban Hlth. 2005;82(1 Suppl 1):i18–25.

    Article  Google Scholar 

  40. Semple SJ, Patterson TL, Grant I. The context of sexual risk behavior among heterosexual methamphetamine users. Addict Behav. 2004;29(4):807–10.

    Article  PubMed  Google Scholar 

  41. Semple SJ, Gra I, Patterson TL. Negative self-perceptions and sexual risk behavior among heterosexual methamphetamine users. Subst Use Misuse. 2005;40(12):1797–810.

    Article  PubMed  Google Scholar 

  42. Taylor MM, Aynalem G, Smith LV, Montoya J, Kerndt P. Methamphetamine use and sexual risk behaviours among men who have sex with men diagnosed with early syphilis in Los Angeles County. Int J STD AIDS. 2007;18(2):93–7.

    Article  PubMed  Google Scholar 

  43. Anglin MD, Burke C, Perrochet B, Stamper E, Dawud-Noursi S. History of the methamphetamine problem. J Psychoactive Drugs. 2000;32(2):137–41.

    Article  PubMed  CAS  Google Scholar 

  44. Green AI. “Chem friendly”: the institutional basis of “club drug” use in a sample of urban gay men. Deviant Behav. 2003;24(5):427–47.

    Article  Google Scholar 

  45. Kurtz SP. Post-circuit blues: motivations and consequences of cystal meth use among gay men in Miami. AIDS Behav. 2005;2005(9):63–72.

    Article  Google Scholar 

  46. Novoa RA, Ompad DC, Wu Y, Vlahov D, Galea S. Ecstasy use and its association with sexual behaviors among drug users in New York City. J Commun Hlth. 2005;30(5):331–43.

    Google Scholar 

  47. Leigh BC. The relationship of substance use during sex to high-risk sexual activity. J Sex Res. 1990;27:199–213.

    Article  Google Scholar 

  48. Calsyn DA, Cousins SJ, Hatch-Maillette MA, et al. Sex under the influence of drugs or alcohol: common for men in substance abuse treatment and associated with high-risk sexual behavior. Am J Addict. 2010;19(2):119–27.

    Article  PubMed  Google Scholar 

  49. Calzavara LM, Coates RA, Raboud JM, et al. Ongoing high-risk sexual behaviors in relation to recreational drug use in sexual encounters. Analysis of 5 years of data from the Toronto sexual contact study. Ann Epidemiol. 1993;3(3):272–80.

    Article  PubMed  CAS  Google Scholar 

  50. McElrath K. MDMA and sexual behavior: ecstasy users’ perceptions about sexuality and sexual risk. Subst Use Misuse. 2005;40(9–10):1461–77.

    Article  PubMed  Google Scholar 

  51. Rusch M, Lampinen TM, Schilder A, Hogg RS. Unprotected anal intercourse associated with recreational drug use among young men who have sex with men depends on partner type and intercourse role. Sex Transm Dis. 2004;31(8):492–8.

    Article  PubMed  Google Scholar 

  52. Degenhardt L. Drug use and risk behaviour among regular ecstasy users: does sexuality make a difference? Cult Hlth Sex. 2005;7(6):599–614.

    Article  Google Scholar 

  53. Williams CT, Mackesy-Amiti ME, McKirnan DJ, Ouellet LJ. Differences in sexual identity, risk practices, and sex partners between bisexual men and other men among a low-income drug-using sample. J Urban Hlth. 2009;86(Suppl 1):93–106.

    Article  Google Scholar 

  54. Williams CT, Latkin CA. The role of depressive symptoms in predicting sex with multiple and high-risk partners. JAIDS. 2005;38(1):69–73.

    Article  PubMed  Google Scholar 

  55. Ahmed S, Lutalo T, Wawer M, et al. HIV incidence and sexually transmitted disease prevalence associated with condom use: a population study in Rakai. Uganda AIDS. 2001;15(16):2171–9.

    Article  CAS  Google Scholar 

  56. Kemboi GJ, Kennedy O, Ntabo OM. Socio-cultural factors that perpetuate the spread of HIV among women and girls in Keiyo District, Kenya. Int J Soc Anthropol. 2011;3(5):147–52.

    Google Scholar 

  57. Hutton HE, Lyketsos CG, Zenilman JM, Thompson RE, Erbelding EJ. Depression and HIV risk behaviors among patients in a sexually transmitted disease clinic. Am J Psychiatry. 2004;161(5):912–4.

    Article  PubMed  Google Scholar 

  58. Lehrer JA, Shrier LA, Gortmaker S, Buka S. Depressive symptoms as a longitudinal predictor of sexual risk behaviors among US middle and high school students. Pediatrics. 2006;118:189–200.

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was funded by UCLA/Fogarty AIDS International Training & Research Program D43 TW000013. We thank all the participants in this study.

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Correspondence to Roger Detels.

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Ding, Y., He, N., Zhu, W. et al. Sexual Risk Behaviors among Club Drug Users in Shanghai, China: Prevalence and Correlates. AIDS Behav 17, 2439–2449 (2013). https://doi.org/10.1007/s10461-012-0380-1

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