Physical victimization and risky sexual partners among male drug users in New York City
A. Turner, K. Jones, N. Crawford, C. Fuller
New York Academy of Medicine, Center for Urban Epidemiologic Studies, New York, United States
Background: The link between physical victimization and sexual risk has been extensively examined among women and to a lesser extent among men who have sex with men. Little is known on the impact of physical victimization on the acquisition of risky sexual partners among both MSM and non-MSM men. Our study utilized four-year, year-by-year behavioral and social network measures collected at baseline to examine if physical victimization predicts risky sexual partners in injection and non-injection drug using men.
Methods: Between 2006-2009, 456 heroin/crack/cocaine users, aged 18-40 were recruited through targeted outreach and respondent driven sampling in 36 neighborhoods ethnographically-mapped as high drug activity areas in New York City (NYC). Men reporting no high-risk sex partner four years prior to study entry were included in the analysis (n=202) and yearly assessed for first report of a high risk sexual partner (i.e., MSM, injects heroin, smokes crack, has transactional sex, or was ever in jail). Physical victimization (i.e., having been threatened with a knife/gun, beaten up, or shot/stabbed) was the primary exposure. GEE was used to account for repeated exposure and outcome measures.
Results: The sample was 50% Hispanic, 40% Black, and 4% MSM, 23% had ≥ 1 risky partner and 42% experienced physical victimization. After adjustment, participants that experienced physical victimization in any one year were 2.7 times more likely to have a risky sexual partner in the following year (CI951.4-5.2) and reporting same-sex sexual behavior (AOR=7.06;CI952.2-22.6).
Conclusions: These data suggest that physical victimization may increase the risk of high-risk sexual partnership among young adult male drug users, particularly Black/Hispanic MSM. Research is needed among this population to further inform a timely and innovative structural intervention that incorporates the social context of physical violence and risky partnership to help reduce the high HIV reservoir, and HIV-related risk behavior and social circumstances.