142nd APHA Annual Meeting and Exposition

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310512
Individual-Level and Event-Level Associations Between Substance Use and Sexual Risk Behavior Among Gay and Bisexual Men

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014

H. Jonathon Rendina, PhD, MPH , Center for HIV/AIDS Educational Studies and Training (CHEST), Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY
Raymond Moody, BA , Center for HIV/AIDS Educational Studies and Training (CHEST) and Doctoral Program in Psychology, Hunter College and the Graduate Center of the City University of New York (CUNY), New York, NY
Ana Ventuneac, PhD , Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY
Christian Grov, PhD, MPH , Department of Health and Nutrition Sciences, Brooklyn College and the Graduate Center of CUNY, and the Center for HIV/AIDS Educational Studies and Training, Brooklyn, NY
Jeffrey T. Parsons, PhD , Department of Psychology and the Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College and the Graduate Center of the City University of New York (CUNY), New York, NY
  
Background: Although much is known about the association between substance use and sexual behavior, less is known about the relative contribution of individual-level (i.e., typical frequency of use) and event-level (i.e., daily occurrence) mechanisms to these associations.

Methods: We recruited a diverse sample of 375 highly sexually active (≥ 9 partners in 90 days) gay and bisexual men, aged 18-73 (M=36.9), who completed a retrospective timeline follow-back (TLFB) interview followed by 30 days of a prospective, online daily diary. Aggregated substance use frequency (TLFB) was entered it into multilevel models along with day-level substance use to predict daily sexual behavior, adjusting for HIV and relationship status.

Results: In the model predicting having any sexual activity, marijuana (AOR=0.99, p=.001), club drugs (AOR=0.98, p<.001), and heavy drinking (AOR=0.99, p=.056) frequency were associated with decreased odds of engaging in sex, while marijuana (AOR=1.78, p<.001), club drugs (AOR=3.36, p<.001), and heavy drinking (AOR=1.99, p<.001) on a given day increased the odds of sexual activity. In the model predicting unprotected anal intercourse (UAI) on sex days, marijuana (AOR=0.98, p=.001) and heavy drinking (AOR=0.98, p<.05) frequency were associated with decreased odds of UAI, while club drugs (AOR=1.84, p=.009) and heavy drinking (AOR=1.65, p=.003) on a given day increased the odds of UAI.

Conclusions: When examined simultaneously, individual-level patterns of substance use and event-level substance use on a given day have opposite effects on sexual behaviors. These findings suggest that frequency may be suggestive of interference with sexual pursuits, while event-level use may indicate impairment in decision-making.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Differentiate individual-level and event-level mechanisms for investigating substance use and sexual risk. Explain distinct contributions of individual-level and event-level substance use on sexual risk.

Keyword(s): Sexual Risk Behavior, Drug Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been conducting research on substance use and sexual risk among gay and bisexual men for more than 8 years. I have held a National Institute of Mental Health NRSA Predoctoral Fellowship and have more than 15 publications in the area.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5057.0: Substance Use and HIV/AIDS