Substance Use and Cognitive Function as Drivers of Condomless Anal Sex Among HIV-Positive Gay, Bisexual, and Other Men Who Have Sex with Men Aged 50 and Older: The Gold Studies

(1) Background: Condomless anal sex and substance use are associated with STI risk among gay, bisexual, and other men who have sex with men (gbMSM). Our first study objective was to describe event-level sexual risk and substance use trends among gbMSM. Our second study objective was to describe substances associated with event-level sexual risk. (2) Methods: Data come from the Momentum Health Study in Vancouver, British Columbia and participants were recruited from 2012–2015, with follow-up until 2018. Stratified by self-reported HIV status, we used generalized estimating equations to assess trends of sexual event-level substance use and assessed interactions between substance use and time period on event-level higher risk sex defined as condomless anal sex with an HIV serodifferent or unknown status partner. (3) Results: Event-level higher risk anal sex increased across the study period among HIV-negative/unknown (baseline prevalence: 13% vs. study end prevalence: 29%) and HIV-positive gbMSM (baseline prevalence: 16% vs. study end prevalence: 38%). Among HIV-negative/unknown gbMSM, event-level erectile drug use increased, while alcohol use decreased over the study period. Overall, interactions between substance use and time on higher risk anal sex were not statistically significant, regardless of serostatus. However, we found a number of time-specific significant interactions for erectile drugs, poppers, Gamma-hydroxybutyrate (GHB), crystal methamphetamine and ecstasy/MDMA use among HIV-negative/unknown gbMSM. (4) Conclusion: Significant differences in substance use trends and associated risks exist and are varied among gbMSM by serostatus. These findings provide a more comprehensive understanding of the effects of event-level substance use on sexual risk through longitudinal follow-up of nearly six years.

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HIV-Related Attitudes and Intentions for High-Risk, Substance-Using Men Who Have Sex With Men: Associations and Clinical Implications for HIV-Positive and HIV-Negative MSM

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.24.4.281 ◽

2010 ◽

Vol 24 (4) ◽

pp. 281-293 ◽

Cited By ~ 6

Author(s):

Gordon Mansergh ◽

David J. McKirnan ◽

Stephen A. Flores ◽

Sharon M. Hudson ◽

Beryl A. Koblin ◽

...

Keyword(s):

Substance Use ◽

Risk Behavior ◽

Self Efficacy ◽

Safer Sex ◽

Hiv Positive ◽

Hiv Status ◽

Anal Sex ◽

Sex With Men ◽

Hiv Negative ◽

Hiv Positive Men

This study compared HIV-related attitudes and intentions by respondent HIV-status in a large sample of substance-using men who have sex with men (MSM) in the United States. Attitudes and intentions included self-efficacy for safer sex; difficulty communicating with sex partners about safer sex; intent to use condoms consistently and to not use substances before sex in the next 3 months; and less concern for HIV given effective antiviral treatments. Differences were found for behavior during the most recent anal sex encounter by HIV-status, including (a) insertive and (b) receptive anal sex risk behavior, and (c) substance use before or during the encounter. Self-efficacy for safer sex was associated with less risk behavior among HIV-negative men but not among HIV-positive men, suggesting that self-efficacy for safer sex continues to be a relevant issue to address in counseling uninfected MSM. HIV-positive men who reported less concern for HIV given treatments were more likely to report receptive risk behavior, as were HIV-negative men who reported difficulty communicating about safer sex. Implications are discussed for potentially heightened client desire and therapeutic opportunity to reduce future substance use during sex for clients who report recent substance use during sex.

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The Predominant Relationship Between Sexual Environment Characteristics and HIV-Serodiscordant Condomless Anal Sex Among HIV-Positive Men Who Have Sex with Men (MSM)

AIDS and Behavior ◽

10.1007/s10461-015-1202-z ◽

2015 ◽

Vol 20 (6) ◽

pp. 1228-1235 ◽

Cited By ~ 10

Author(s):

Nicholas S. Perry ◽

S. Wade Taylor ◽

Steven Elsesser ◽

Steven A. Safren ◽

Conall O’Cleirigh

Keyword(s):

Hiv Positive ◽

Anal Sex ◽

Condomless Anal Sex ◽

Sex With Men ◽

Hiv Positive Men

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Condomless Anal Sex Among HIV-Positive Men Who Have Sex with Men: Biomedical Context Matters

AIDS and Behavior ◽

10.1007/s10461-017-1852-0 ◽

2017 ◽

Vol 21 (10) ◽

pp. 2886-2894 ◽

Cited By ~ 3

Author(s):

Alison J. Hughes ◽

Yea-Hung Chen ◽

Susan Scheer

Keyword(s):

Hiv Positive ◽

Anal Sex ◽

Condomless Anal Sex ◽

Sex With Men ◽

Hiv Positive Men

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Affective differences in Iowa Gambling Task performance associated with sexual risk taking and substance use among HIV-positive and HIV-negative men who have sex with men

Journal of Clinical and Experimental Neuropsychology ◽

10.1080/13803395.2015.1085495 ◽

2016 ◽

Vol 38 (2) ◽

pp. 141-157 ◽

Cited By ~ 3

Author(s):

Sarit A. Golub ◽

Louisa I. Thompson ◽

William J. Kowalczyk

Keyword(s):

Substance Use ◽

Task Performance ◽

Sexual Risk ◽

Risk Taking ◽

Iowa Gambling Task ◽

Hiv Positive ◽

Sexual Risk Taking ◽

Gambling Task ◽

Sex With Men ◽

Hiv Negative

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Pilot Trial of a Sexual Health Counseling Intervention for HIV-Positive Gay and Bisexual Men Who Report Anal Sex without Condoms

10.32920/14640234.v1 ◽

2021 ◽

Author(s):

Trevor A. Hart ◽

Natalie Stratton ◽

Todd A. Coleman ◽

Holly A. Wilson ◽

Scott H. Simpson ◽

...

Keyword(s):

Sexual Transmission ◽

Psychosocial Outcomes ◽

Gay And Bisexual Men ◽

Sexual Compulsivity ◽

Hiv Positive ◽

Bisexual Men ◽

Anal Sex ◽

Counseling Intervention ◽

And Bisexual ◽

Sex With Men

Background Even in the presence of promising biomedical treatment as prevention, HIV incidence among men who have sex with men has not always decreased. Counseling interventions, therefore, continue to play an important role in reducing HIV sexual transmission behaviors among gay and bisexual men and other men who have sex with men. The present study evaluated effects of a small-group counseling intervention on psychosocial outcomes and HIV sexual risk behavior. Method HIV-positive (HIV+) peer counselors administered seven 2-hour counseling sessions to groups of 5 to 8 HIV+ gay and bisexual men. The intervention employed information provision, motivational interviewing, and behavioral skills building to reduce sexual transmission risk behaviors. Results There was a significant reduction in condomless anal sex (CAS) with HIV-negative and unknown HIV-status partners, from 50.0% at baseline to 28.9% of the sample at 3-month follow-up. Findings were robust even when controlling for whether the participant had an undetectable viral load at baseline. Significant reductions were also found in the two secondary psychosocial outcomes, loneliness and sexual compulsivity. Conclusions The findings provide preliminary evidence that this intervention may offer an efficient way of concurrently reducing CAS and mental health problems, such as sexual compulsivity and loneliness, for HIV+ gay and bisexual men. Trial Registration ClinicalTrials.gov NCT02546271

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