Comparison of different measurements of sexual risk in relation to use of sex drugs among MSM

Published: July 22, 2010

Comparison of different measurements of sexual risk in relation to use of sex drugs among MSM

D.J. Brennan, S.L. Craig

University of Toronto, Faculty of Social Work, Toronto, Canada

Background: Inconsistent measurement of sexual risk among men who have sex with men (MSM) can have profound implications for HIV/STI research and interventions. Measures range from single self-report items to behavioral checklists of unprotected anal intercourse (UAI), to more complex calculations of serodiscordant unprotected anal sex (SDUAI), which may not measure frequency of risk. Infrequent UAI may not pose a significant risk, whereas, an increased frequency of UAI (regardless of partner serostatus) may be high risk for HIV/STIs. The current study sought to contrast measurement tools by comparing UAI frequency and SDUAI outcomes on sexual substance use in the same sample of MSM.
Methods: Cross-sectional data were gathered from racially diverse MSM attending the Pride Toronto 2008 Festival (n=510). Eligibility included being at least age 16, male, and one same-sex sexual incident during the last year. Two multiple regression analyses were conducted upon the same dependent variable, a composite measure of substance use before/during sex in the last three months. Two measures of sexual risk functioned as independent variables:
1) dichotomous SDUAI and
2) frequency of UAI. Other independent variables included HIV status, gay/bisexual identity, education, race, STI history, history of childhood sexual abuse (CSA) and disordered eating risk (DES).
Results: Differential analysis determined that risk measurement significantly impacted results. The more conservative SDUAI model found that being non-White, bisexual and having CSA history were associated with increased frequency of sexual substance use while the UAI model added HIV-positive, and total UAI as predictors of increased frequency of sexual substance use.
Conclusions: Frequency of UAI, but not SDUAI, was associated with increased frequency of sexual substance use. Risk measurement strategies must be specific in order to avoid missing critical factors that may influence potential interventions to reduce HIV/STI risk among MSM, particularly those who are HIV-positive.
 

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