Findings from within-subjects comparisons of drug use and sexual risk behaviour in men who have sex with men in England

• Published in: International journal of STD & AIDS Vol. 28; no. 3; p. 250
• Main Authors: Melendez-Torres, G J, Hickson, Ford, Reid, David, Weatherburn, Peter, Bonell, Chris
• Format: Journal Article
• Language: English
• Published: England 01.03.2017
• Subjects: Adolescent; Adult; Aged; England - epidemiology; Homosexuality, Male; Humans; Longitudinal Studies; Male; Middle Aged; Risk; Risk-Taking; Sexual and Gender Minorities - psychology; Sexual and Gender Minorities - statistics & numerical data; Sexual Partners; Substance-Related Disorders - epidemiology; Surveys and Questionnaires; Unsafe Sex - psychology; Unsafe Sex - statistics & numerical data; Young Adult; homosexual; high-risk behaviour; Epidemiology; sexual behaviour
• DOI: 10.1177/0956462416642125

Epidemiological evidence for the encounter-level association between sexualised drug use and unprotected anal intercourse in men who have sex with men is unclear and has not examined men who have sex with men in England. To estimate this association, we compared dyadic sexual encounters within respondents. We used encounter-level data from a longitudinal online survey of men who have sex with men living in England and multilevel models to test univariate and multivariate associations between any respondent or partner drug use, specific respondent drug use, additional situational characteristics and unprotected anal intercourse. Based on 6742 encounters from 2142 men who have sex with men, respondent drug use and respondent use of certain specific drugs were associated with increased unprotected anal intercourse odds. In univariate models, partner drug use was associated with increased unprotected anal intercourse odds, but in multivariate models, only non-specific knowledge of partner drug use was associated with the same. Encounters with non-regular-and-steady partners or that were not HIV-seroconcordant were associated with decreased unprotected anal intercourse odds. This is the first within-subjects comparison of drug use and unprotected anal intercourse conducted on a sample from England, and the largest of its kind. Findings are consistent with other studies, though associations between drug use and unprotected anal intercourse are shaped by social contexts that may change over time.