Substance Use among API MSM

1
Substance Use among API MSM

• Don Operario
• Center for AIDS Prevention Studies (CAPS)
  University of California, San Francisco, San
  Francisco

UC
SF
University of California San Francisco
2
Presentation Outline

• Background
• Research Findings Asian Counseling and Testing
  (ACT) study
• Implications for Prevention and Treatment
• Directions for Future Research

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• Background Substance Use and U.S. APIs
• Few studies, many myths
• Prevalence may be on the rise
• West Coast and Hawaii
• Substance use prevalence may differ by
  demographic group

4

• Research Questions
• What is the prevalence of substance use among
  young API MSM?
• What are demographic and environmental correlates
  of substance use among young API MSM?
• 
  

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ACT Study
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Sample Characteristics (N496)

• Ethnicity ()
• Chinese 27
• Filipino 28
• Vietnamese 16
• Other 29
• Age
• 18-24 years 49
• 25-39 years 51
• US born 30
• Education
• no college 17
• some college 33
• college graduate 50

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Gay Social Network Characteristics

• Sexual Orientation ()
• Gay 82
• Bisexual 13
• Other 5
• Degree of outness
• not out to anyone 4
• lt half people you know 40
• gt half people you know 56
• Frequency of clubbing
• Once a month or less 11
• 2-3 times a month 26
• Once a week or more 47
• Ever attended a circuit party 20

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Sexual Behaviors, 6 mos. () Number
of sex partners 0 6 1 31 2-3 26 4
-10 29 11 or more 7 Any unprotected anal
sex 47
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• Substance Use Behaviors, Lifetime
• ()
• Alcohol 94
• Marijuana 62
• Ecstasy 59
• Hallucinogens 28
• Poppers 29
• Crystal 29
• Cocaine/Crack 20
• Special K 26
• GHB 22
• Any illicit drug 78
• Any IDU 2

10
Substance Use Behaviors, 6 mos. Once a More
than once a Any() Month () Month ()
Alcohol 100 13 62 Marijuana 44 12 32 Ecs
tasy 48 16 39 Hallucinogens 14 9 9 Poppe
rs 16 15 16 Crystal 21 11 34 Cocaine/Crac
k 10 10 16 Special K 20 10 25 GHB 21 23
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Correlates of Frequent Illicit Drug Use

• Nativity (OR, 95 CI)
• U.S. born 2.03 (1.21, 3.41)
• Foreign born reference
• Education
• no college 2.91 (1.43, 5.96)
• some college 2.22 (1.22, 4.04)
• college graduate reference
• Degree of outness
• less than half reference
• more than half 2.26 (1.31, 3.90)

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Correlates of Party Drug Use

• Nativity (OR, 95 CI)
• U.S. born 1.90 (1.17, 3.08)
• Foreign born reference
• Frequency of clubbing, 6 mos
• once month or less reference
• more than once a month 1.58 (1.01, 2.49)
• Ever attended a circuit party
• yes 3.06 (1.65, 5.65)
• no reference
• Multiple sex partners, 6 mos
• yes 2.04 (1.35, 3.08)
• no reference

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Correlates of Polydrug Use

• Nativity (OR, 95 CI)
• U.S. born 1.76 (1.11, 2.79)
• Foreign born reference
• Degree of outness
• less than half reference
• more than half 1.71 (1.13, 2.58)
• Frequency of clubbing, 6 mos
• once month or less reference
• more than once a month 2.44 (1.13, 2.58)
• Ever attended a circuit party
• yes 3.20 (1.88, 5.46)
• no reference
• Multiple sex partners, 6 mos
• yes 2.22 (1.44, 3.42)
• no reference
• Any Unprotected anal sex, 6 mos
• yes 2.03 (1.35, 3.04)
• no reference

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Summary

• High prevalence of substance use
• Associations between party/poly drug use and
  HIV-related sexual risk
• Correlates of substance use suggest directions
  for outreach and prevention

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Program Implications

• Incorporate gay/MSM topics into treatment
• Target venues, subgroups

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Directions for Future Research

• Descriptive studies
• Motivations for using
• Patterns of use (frequent/casual, social settings
  and networks)
• Treatment intervention and effectiveness studies
• Incentives and barriers for seeking treatment

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Closing

• HIV prevalence among API MSM is low
• High levels of risk behavior, compounded by low
  rates of testing
• If complacency continues, strong potential for
  rapid spread of HIV epidemic among API MSM