Alcohol and drug use among HIV positive and HIV negative men who have sex with men
B.U. Moseng1, R.M. Angeltvedt1, E. Klouman2
1Gay and Lesbian Health Norway, Oslo, Norway, 2University of Tromsø, Tromsø, Norway
Background: Previous European and North-American research has shown a higher prevalence of alcohol and drug use among men who have sex with men (MSM). However, within-group differences among homosexually experienced men at risk for drug and alcohol abuse and its association with HIV-related sexual risk taking has not been widely studied. The ongoing Norwegian research project, which is a co-operation between The Norwegian Institute of Public Health and Gay and Lesbian Health Norway, is examining life forms as predictors of unsafe sex among men who meet their sexual partners over the Internet.
Methods: 2598 MSM were surveyed on the Norwegian gay Internet site Gaysir.no
Results: This study indicates that men who use the Internet to meet sexual partners are at higher risk for problematic substance use that is associated with HIV-related sexual risk taking. However, levels of increased risk vary within the MSM population. Heterosexually experienced or bisexually active men and especially HIV-positive MSM, report higher and riskier alcohol or drug use (hashish/marijuana, heroine, GHB, ecstasy, cocaine, amphetamines, meth-amphetamines, Viagra, poppers), HIV-related sexual risk taking while being intoxicated, more depressions/affective disorders and poorer general health than men who are HIV-negative or who are exclusively homosexually active.
Conclusions: HIV prevention among MSM in Europe/North-America has overwhelmingly focused on condom use and ignorance of sexual risk factors such as serosorting and unprotected anal intercourse. This study suggests that HIV prevention among MSM might become more effective by adressing a broader range of risk factors such as substance abuse, general psychological distress and the heterogeinity of risk within the population of individuals who report markers on non-heterosexual orientation. An undisputed identity as gay seems to protect against alcohol or drug-abuse and unsafe sex.