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Patterns of Substance Use Among a Large Urban Cohort of HIV-Infected Men Who Have Sex With Men in Primary Care

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Abstract

The present study sought to identify characteristics of HIV-infected MSM that are associated with the use of specific substances and substance abuse in general. Participants were 503 HIV-infected MSM who were receiving primary care. A self-assessment and medical records were used to obtain information about past 3-month alcohol and drug use and abuse, and demographics, HIV-disease stage and treatment, sexual risk, and mental health. Associations of these four domains with substance use and abuse outcomes were examined using hierarchical block-stepwise multivariable logistic regression. Substance use and abuse in the sample was high. Transmission risk behavior was significantly associated with over half of the outcomes. The associations of demographic and HIV-disease stage and treatment variables varied by substance, and mental health problems contributed differentially to almost every outcome. These findings should be considered for designing, implementing, and evaluating substance use programming for HIV-infected MSM.

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References

  1. Morin SF, Steward WT, Charlebois ED, et al. Predicting HIV transmission risk among HIV-infected men who have sex with men: findings from the healthy living project. J AIDS. 2005;40(2):226–35.

    Google Scholar 

  2. Parsons JT, Kutnick AH, Halkitis PN, Punzalan JC, Carbonari JP. Sexual risk behaviors and substance use among alcohol abusing HIV-positive men who have sex with men. J Psychoactive Drugs. 2005;37(1):27–36.

    Article  PubMed  Google Scholar 

  3. Vaudrey J, Raymond HF, Chen S, Hecht J, Ahrens K, McFarland W. Indicators of use of methamphetamine and other substances among men who have sex with men, San Francisco, 2003–2006. Drug Alcohol Depend. 2007;90(1):97–100.

    Article  PubMed  Google Scholar 

  4. Mayer KH, O’Cleirigh C, Skeer M, et al. Which HIV-infected men who have sex with men in care are engaging in risky sex and acquiring sexually transmitted infections: findings from a Boston community health centre. Sex Transm Infect. 2010;86:66–70.

    Article  PubMed  CAS  Google Scholar 

  5. Peck JA, Shoptaw S, Rotheram-Fuller E, Reback CJ, Bierman B. HIV-associated medical, behavioral, and psychiatric characteristics of treatment-seeking, methamphetamine-dependent men who have sex with men. J Addict Dis. 2005;24(3):115–32.

    Article  PubMed  Google Scholar 

  6. Halkitis PN, Kutnick AH, Slater S. The social realities of adherence to protease inhibitor regimens: substance use, health care and psychological states. J Health Psychol. 2005;10(4):545–58.

    Article  PubMed  Google Scholar 

  7. Fong IW, Read S, Wainberg MA, Chia WK, Major C. Alcoholism and rapid progression to AIDS after seroconversion. Clin Infect Dis. 1994;19(2):337–8.

    Article  PubMed  CAS  Google Scholar 

  8. Wang JY, Liang B, Watson RR. Alcohol consumption alters cytokine release during murine AIDS. Alcohol. 1997;14(2):155–9.

    Article  PubMed  CAS  Google Scholar 

  9. Chesney MA, Koblin BA, Barresi PJ, et al. An individually tailored intervention for HIV prevention: baseline data from the EXPLORE Study. Am J Public Health. 2003;93(6):933–8.

    Article  PubMed  Google Scholar 

  10. Koblin BA, Chesney MA, Husnik MJ, et al. High-risk behaviors among men who have sex with men in 6 US cities: baseline data from the EXPLORE study. Am J Public Health. 2003;93(6):926–32.

    Article  PubMed  Google Scholar 

  11. Mimiaga MJ, Fair AD, Mayer KH, et al. Experiences and sexual behaviors of HIV-infected MSM who acquired HIV in the context of crystal methamphetamine use. AIDS Educ Prev. 2008;20(1):30–41.

    Article  PubMed  Google Scholar 

  12. Stall R, Mills TC, Williamson J, et al. Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. Am J Public Health. 2003;93(6):939–42.

    Article  PubMed  Google Scholar 

  13. Stall R, Paul JP, Greenwood G, et al. Alcohol use, drug use and alcohol-related problems among men who have sex with men: the urban men’s health study. Addiction. 2001;96(11):1589–601.

    Article  PubMed  CAS  Google Scholar 

  14. Mimiaga MJ, Reisner SL, Vanderwarker R, et al. Polysubstance use and HIV/STD risk behavior among Massachusetts men who have sex with men accessing Department of Public Health mobile van services: implications for intervention development. AIDS Patient Care STDS. 2008;22(9):745–51.

    Article  PubMed  Google Scholar 

  15. CDC. Fact sheet: estimates of new HIV infections in the United States. Atlanta, GA: Centers for Disease Control and Prevention; 2008.

    Google Scholar 

  16. Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. JAMA. 1999;282(18):1737–44.

    Article  PubMed  CAS  Google Scholar 

  17. U.S. Department of Justice. Drugs of abuse. Washington, D.C.: Department of Justice, Drug Enforcement Administration; 2005.

  18. Parsons JT, Halkitis PN, Wolitski RJ, Gomez CA. Correlates of sexual risk behaviors among HIV-positive men who have sex with men. AIDS Educ Prev. 2003;15(5):383–400.

    Article  PubMed  Google Scholar 

  19. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.

    Article  PubMed  CAS  Google Scholar 

  20. Connor KM, Davidson JR, Churchill LE, Sherwood A, Foa E, Weisler RH. Psychometric properties of the social phobia inventory (SPIN). New self-rating scale. Br J Psychiatry. 2000;176:379–86.

    CAS  Google Scholar 

  21. Connor KM, Kobak KA, Churchill LE, Katzelnick D, Davidson JR. Mini-SPIN: a brief screening assessment for generalized social anxiety disorder. Depress Anxiety. 2001;14(2):137–40.

    Article  PubMed  CAS  Google Scholar 

  22. Meltzer-Brody S, Churchill E, Davidson JR. Derivation of the SPAN, a brief diagnostic screening test for post-traumatic stress disorder. Psychiatry Res. 1999;88(1):63–70.

    Article  PubMed  CAS  Google Scholar 

  23. Barkley RA. Attention deficit hyperactivity disorder: a handbook for diagnosis and treatment. 2nd ed. New York, NY: Guilford Press; 1998.

    Google Scholar 

  24. Fairies DE, Yalcin I, Harder D, Heiligenstein JH. Validation of the ADHD rating scale as a clinician administered and scored instrument. J Atten Disord. 2001;5:107–15.

    Article  Google Scholar 

  25. Finkelhor D. Sexually victimized children. New York: The Free Press; 1979.

    Google Scholar 

  26. Mimiaga MJ, Noonan E, Donnell D, et al. Childhood sexual abuse is highly associated with HIV risk-taking behavior and infection among MSM in the EXPLORE study. J AIDS 2009;51(3):340–8.

    Google Scholar 

  27. Massachusetts Department of Public Health. Men who have sex with men. Boston: Massachusetts Department of Public Health; 2007.

  28. O’Cleirigh C, Skeer M, Mayer KH, Safren SA. Functional impairment and health care utilization among HIV-infected men who have sex with men: the relationship with depression and post-traumatic stress. J Behav Med. 2009;32(5):466–77.

    Article  PubMed  Google Scholar 

  29. Cerda M, Sagdeo A, Galea S. Comorbid forms of psychopathology: key patterns and future research directions. Epidemiol Rev. 2008;30:155–77.

    Article  PubMed  Google Scholar 

  30. Hahesy AL, Wilens TE, Biederman J, Van Patten SL, Spencer T. Temporal association between childhood psychopathology and substance use disorders: findings from a sample of adults with opioid or alcohol dependency. Psychiatry Res. 2002;109(3):245–53.

    Article  PubMed  Google Scholar 

  31. Kuperman S, Schlosser SS, Kramer JR, et al. Developmental sequence from disruptive behavior diagnosis to adolescent alcohol dependence. Am J Psychiatry. 2001;158(12):2022–6.

    Article  PubMed  CAS  Google Scholar 

  32. Molnar BE, Buka SL, Kessler RC. Child sexual abuse and subsequent psychopathology: results from the national comorbidity survey. Am J Public Health. 2001;91(5):753–60.

    Article  PubMed  CAS  Google Scholar 

  33. Greenfield EA. Child abuse as a life-course social determinant of adult health. Maturitas. 2010;66(1):51–5.

    Article  PubMed  Google Scholar 

  34. Metzger DS, Koblin B, Turner C, et al. Randomized controlled trial of audio computer-assisted self-interviewing: utility and acceptability in longitudinal studies. HIVNET vaccine preparedness study protocol team. Am J Epidemiol. 2000;152(2):99–106.

    Article  PubMed  CAS  Google Scholar 

  35. Navaline HA, Snider EC, Petro CJ, et al. Preparations for AIDS vaccine trials. An automated version of the risk assessment battery (RAB): enhancing the assessment of risk behaviors. AIDS Res Hum Retroviruses. 1994;10(Suppl 2):S281–3.

    PubMed  Google Scholar 

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Acknowledgments

This study was supported by NIMH grant 5R01MH068746-05 and HRSA grant H97HA01293 awarded to Drs. Kenneth H. Mayer and Steven A. Safren.

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Authors and Affiliations

  1. The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA

    Margie R. Skeer, Matthew J. Mimiaga, Kenneth H. Mayer, Conall O’Cleirigh, Charles Covahey & Steven A. Safren

  2. Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA

    Margie R. Skeer

  3. Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Matthew J. Mimiaga, Conall O’Cleirigh & Steven A. Safren

  4. Miriam Hospital, Brown University, Providence, RI, USA

    Kenneth H. Mayer

Authors
  1. Margie R. Skeer
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  2. Matthew J. Mimiaga
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  3. Kenneth H. Mayer
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  4. Conall O’Cleirigh
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  5. Charles Covahey
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  6. Steven A. Safren
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Correspondence to Margie R. Skeer.

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Skeer, M.R., Mimiaga, M.J., Mayer, K.H. et al. Patterns of Substance Use Among a Large Urban Cohort of HIV-Infected Men Who Have Sex With Men in Primary Care. AIDS Behav 16, 676–689 (2012). https://doi.org/10.1007/s10461-011-9880-7

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  • DOI: https://doi.org/10.1007/s10461-011-9880-7

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