AIDS and Behavior

, Volume 22, Issue 4, pp 1373–1382 | Cite as

High Substance Use and HIV Risk Behavior Among Young Argentine Men Who Have Sex with Men

  • Iván C. Balán
  • Timothy Frasca
  • María A. Pando
  • Rubén O. Marone
  • Victoria Barreda
  • Curtis Dolezal
  • Alex Carballo-Diéguez
  • María M. Ávila
Original Paper

Abstract

In the United States young men who have sex with men have higher rates of substance use, higher HIV incidence, and less frequent HIV testing than their heterosexual counterparts and older MSM. Less is known about comparable populations in Latin America. As part of an epidemiological study, MSM were recruited through Respondent Driven Sampling in the metropolitan area of Buenos Aires, Argentina and answered a computerized behavioral survey. From the total of 500 MSM enrolled, a sub-sample of 233 aged 18–25 was analyzed. The sample was concentrated among lower socioeconomic strata, and only 16% identified as gay. Nearly half reported male, female, and transvestite sexual partners. Reported substance use was widespread ranging from 61% for marijuana to 20% for pasta base (cocaine sulfate). Seventy percent of the sample had never been tested for HIV infection; 3% tested positive for HIV and 8% for syphilis during the study.

Keywords

MSM YMSM HIV Substance use Sexual risk Argentina 

Resumen

En los Estados Unidos, los hombres jóvenes que tienen sexo con hombres (JHSH) tienen tasas de uso de sustancias más altas de los HSH de mayor edad y de sus pares heterosexuales, además de una mayor incidencia del VIH y menor frecuencia de hacerse el examen del VIH. De las poblaciones comparables en América Latina, se conoce menos. Como parte de un estudio epidemiológico, 500 HSH fueron reclutados a través del método de Muestreo Dirigido por los Participantes (en inglés RDS) en el área metropolitano de Buenos Aires, Argentina y contestaron una encuesta conductual computarizada. Una submuestra de 233 hombres de 18 a 25 años de edad fue analisada. Se concentró en estratos socioeconómicos más bajos y sólo el 16% se identificaron como gay. Casi la mitad de la submuestra reportó haber tenido parejas sexuales masculinas, femeninas y travestíes. El uso de sustancias fue común, desde 61% consumidores de marihuana hasta 20% sulfato de cocaína (pasta base). El 70% de la muestra nunca se había hecho una prueba para el VIH: 3% resultaron positivos para VIH y 8% para sífilis en el transcurso del estudio.

Notes

Acknowledgements

This research was supported by Grant No. R01 MH073410 from the National Institute of Mental Health (NIMH) to Alex Carballo-Diéguez (principal investigator). Additional support came from the NIMH to the HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University (Grant No. P30-MH43520, principal investigators Anke A. Ehrhardt and Robert H. Remien). We thank the research assistants Miguel Zapatela and Miguel Verón as well as the the participants who volunteered their time and candidly expressed their opinions on very intimate topics.

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. The authors declare no conflicts of interest.

References

  1. 1.
    Kipke MD, Weiss G, Ramirez M, et al. Club drug use in Los Angeles among young men who have sex with men. Subst Use Misuse. 2007;42(11):1723–43.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Stall R, Purcell DW. Intertwining epidemics: a review of research on substance use among men who have sex with men and its connection to the AIDS epidemic. AIDS Behav. 2000;4(2):181–91.CrossRefGoogle Scholar
  3. 3.
    Wolitski R, Valdiserri RO, Denning PH, Levine WC. Are we headed for a resurgence of the HIV epidemic among men who have sex with men? Am J Public Health. 2001;91(6):883–8.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Marshal MP, Friedman MS, Stall R, et al. Sexual orientation and adolescent substance use: a meta-analysis and methodological review. Addiction. 2008;103:546–56.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Corliss HL, Rosario M, Wypij D, et al. Sexual orientation disparities in longitudinal alcohol use patterns among adolescents: findings from the growing up today study. Arch Pediatr Adolesc Med. 2008;162(11):1071–8.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Marshal MP, Friedman MS, Stall R, Thompson AL. Individual trajectories of substance use in lesbian, gay and bisexual youth and heterosexual youth. Addiction. 2009;104(6):974–81.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Salomon EA, Mimiaga MJ, Husnik MJ, et al. Depressive symptoms, utilization of mental health care, substance use and sexual risk among young men who have sex with men in EXPLORE: implications for age-specific interventions. AIDS Behav. 2009;13(4):811–21.CrossRefPubMedGoogle Scholar
  8. 8.
    Thiede H, Valleroy LA, MacKellar DA, et al. Regional patterns and correlates of substance use among young men who have sex with men in 7 U.S. urban areas. Am J Public Health. 2003;93(11):1916–21.CrossRefGoogle Scholar
  9. 9.
    Newcomb ME, Birkett M, Corliss HL, Mustanski B. Sexual orientation, gender, and racial differences in illicit drug use in a sample of US high school students. Am J Public Health. 2014;104(2):304–10.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Kecojevic A, Wong CF, Corliss HL, Lankenau SE. Risk factors for high levels of prescription drug misuse and illicit drug use among substance-using young men who have sex with men (YMSM). Drug Alcohol Dep. 2015;150:156–63.CrossRefGoogle Scholar
  11. 11.
    Clatts MC, Goldsamt LA, Yi H. Club drug use among young men who have sex with men in NYC: a preliminary epidemiological profile. Subst Use Misuse. 2005;40(9–10):1317–30.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Lelutiu-Weinberger C, Gamarel KE, Golub SA, Parsons JT. Race-based differentials in the impact of mental health and stigma on HIV risk among young men who have sex with men. Health Psychol. 2015;34(8):847–56.CrossRefPubMedGoogle Scholar
  13. 13.
    Kuerbis A, Mereish EH, Hayes M, Davis CM, Shao S, Morgenstern J. Testing cross-sectional and prospective mediators of internalized heterosexism on heavy drinking, alcohol problems, and psychological distress among heavy drinking men who have sex with men. J Stud Alcohol Drugs. 2017;78(1):113–23.CrossRefPubMedGoogle Scholar
  14. 14.
    Torres HL, Gore-Felton C. Compulsivity, substance use, and loneliness: the loneliness and sexual risk model (LSRM). Sex Addict Compulsivity. 2007;14(1):63–75.CrossRefGoogle Scholar
  15. 15.
    Halkitis PN, Siconolfi D, Fumerton M, Barlup KA. Risk bases in childhood and adolescence among HIV-negative young adult gay and bisexual male barebackers. J Gay Lesbian Soc Serv. 2008;20(4):288–314.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Halkitis PN, Parsons JT, Stirratt MJ. A double epidemic: crystal methamphetamine drug use in relation to HIV transmission among gay men. J Homosex. 2001;41(2):17–35.CrossRefPubMedGoogle Scholar
  17. 17.
    Balaji AB, Bowles KE, Le BC, et al. High HIV incidence and prevalence and associated factors among young MSM, 2008. AIDS. 2013;27(2):269–78.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Celentano DD, Valleroy LA, Sifakis F, et al. Associations between substance use and sexual risk taking among very young men who have sex with men. Sex Transm Dis. 2006;33(4):265–71.PubMedGoogle Scholar
  19. 19.
    Colfax G, Vittinghoff E, Husnik MJ, et al. Substance use and sexual risk: a participant and episode-level analysis among a cohort of men who have sex with men. Am J Epidemiol. 2004;159(10):1002–12.CrossRefPubMedGoogle Scholar
  20. 20.
    Deiss RG, Clark JL, Konda KA, et al. Problem drinking is associated with increased prevalence of sexual risk behaviors among men who have sex with men (MSM) in Lima, Peru. Drug Alcohol Depend. 2013;132:134–9.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Koblin BA, Husnik MJ, Colfax G, et al. Risk factors for HIV infection among men who have sex with men. AIDS. 2006;20(5):731–9.CrossRefPubMedGoogle Scholar
  22. 22.
    Moeller RW, Palamar JJ, Halkitis PN, Siconolfi DE. An episodic analysis of substance use and risky sexual behavior in a racially diverse sample of young men who have sex with men. J Gay Lesbian Soc Serv. 2014;26(2):168–85.CrossRefGoogle Scholar
  23. 23.
    Ruiz J, Face M, Sun RK. Risk factors for human immunodeficiency virus infection and unprotected anal intercourse among young men who have sex with men. Sex Transm Dis. 1998;25(2):100–7.CrossRefPubMedGoogle Scholar
  24. 24.
    Stueve A, O’Donnell L, Duran R, San Doval A. Being high and taking sexual risks: findings from a multisite survey of urban young men who have sex with men. AIDS Educ Prev. 2002;14(6):482–95.CrossRefPubMedGoogle Scholar
  25. 25.
    Pathela P, Jamison K, Braunstein SL, et al. Incidence and correlates of HIV infection among men who have sex with men attending public sexually transmitted disease clinics, New York City, 2007–2012. AIDS Behav. 2016;21(5):1444–51.CrossRefGoogle Scholar
  26. 26.
    MacKellar DA, Valleroy LA, Anderson JE, et al. Recent HIV testing among young men who have sex with men: correlates, contexts, and HIV seroconversion. Sex Transm Dis. 2006;33(3):183–92.CrossRefPubMedGoogle Scholar
  27. 27.
    Oster AM, Johnson CH, Le BC, et al. Trends in HIV prevalence and HIV testing among young MSM: five United States cities, 1994–2011. AIDS Behav. 2014;18(suppl 3):S237–47.CrossRefPubMedGoogle Scholar
  28. 28.
    Sumartojo E, Lyles C, Choi K, et al. Prevalence and correlates of HIV testing in a multi-site sample of young men who have sex with men. AIDS Care. 2008;20(1):1–14.CrossRefPubMedGoogle Scholar
  29. 29.
    Dong Z, Xu J, Zhang H, et al. HIV incidence and risk factors in Chinese young men who have sex with men: a prospective cohort study. PloSOne. 2014;9(5):e97527.CrossRefGoogle Scholar
  30. 30.
    Wei S, Zhang H, Wang J, et al. HIV and syphilis prevalence and associated factors among young men who have sex with men in 4 cities in China. AIDS Behav. 2013;17(3):1151–8.CrossRefPubMedGoogle Scholar
  31. 31.
    Amirkhanian YA, Kelly JA, Kirsanova AV, et al. HIV risk behaviour patterns, predictors, and sexually transmitted disease prevalence in the social networks of young men who have sex with men in St Petersburg, Russia. Int J STD AIDS. 2006;17(1):50–6.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Jacobson JO, Alonso-Gonzalez M, Ramachandran D, et al. Regional HIV surveillance of youth MSM through multilevel analysis of RDS studies in Latin America. Sex Transm Infect. 2011;87(S1):A29.CrossRefGoogle Scholar
  33. 33.
    Johnston LG, Steinhaus MC, Sass J, et al. Recent HIV testing among young men who have sex with men in Bangkok and Chiang Mai: HIV testing and prevention strategies must be enhanced in Thailand. AIDS Behav. 2016;20(9):2023–32.CrossRefPubMedGoogle Scholar
  34. 34.
    Ministerio de Salud, Presidencia de la Nación, 2016. Boletín sobre el VIH/sida en la Argentina. 2016;19(33).Google Scholar
  35. 35.
    Centers for Disease Control and Prevention (CDC). Rapid HIV test distribution—United States, 2003–2005. MMWR 2006;55(24):673.Google Scholar
  36. 36.
    Plate DK, The Rapid HIV Test Evaluation Working Group. Evaluation and implementation of rapid HIV tests: the experience in 11 African countries. AIDS Res Hum Retrov. 2007;23(12):1491–8.CrossRefGoogle Scholar
  37. 37.
    Carballo-Diéguez A, Balán IC, Marone R, et al. Use of Respondent Driven Sampling (RDS) generates a very diverse sample of men who have sex with men (MSM) in Buenos Aires, Argentina. PLoS ONE. 2011;6(11):e27447.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Underwood B, Froming WJ. The mood survey: a personality measure of happy and sad moods. J Pers Assess. 1980;44(4):404–14.CrossRefGoogle Scholar
  39. 39.
    Russell DW. UCLA Loneliness Scale (Version 3): reliability, validity, and factor structure. J Pers Assess. 1996;66(1):20–40.CrossRefPubMedGoogle Scholar
  40. 40.
    Pando MA, Balán IC, Marone R, et al. HIV and other sexually transmitted infections among men who have sex with men recruited by RDS in Buenos Aires, Argentina: high HIV and HPV infection. PLoS ONE. 2012;7(6):e39834.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Volz E, Heckathorn DD. Probability based estimation theory for respondent driven sampling. J Off Stat. 2008;24(1):79–97.Google Scholar
  42. 42.
    Salganik MJ. Variance estimation, design effects, and sample size calculations for respondent-driven sampling. J Urban Health. 2006;83(S1):98–112.CrossRefPubMedCentralGoogle Scholar
  43. 43.
    Montealegre JR, Johnston LG, Murrill C, Monterroso E. Respondent-driven sampling for HIV biological and behavioral surveillance in Latin America and the Caribbean. AIDS Behav. 2013;17(7):2313–40.CrossRefPubMedGoogle Scholar
  44. 44.
    Heckathorn D. Respondent-driven sampling: a new approach to the study of hidden populations. Soc Probl. 1997;44(2):174–99.CrossRefGoogle Scholar
  45. 45.
    Heckathorn D. Respondent-driven sampling II: deriving valid population estimates from chain-referral samples of hidden populations. Soc Probl. 2002;49(1):11–34.CrossRefGoogle Scholar
  46. 46.
    Suthar AB, Ford N, Bachanas PJ, et al. Towards universal voluntary HIV testing and counselling: a systematic review and meta-analysis of community-based approaches. PLoS Med. 2013;10(8):e1001496.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Pando MA, Balán IC, Dolezal C, et al. Increasing HIV testing for prevention: acceptability of a rapid HIV test available over-the-counter for self testing among MSM from Buenos Aires, Argentina (poster). AIDS Vacc. 2013;29(11):109.Google Scholar
  48. 48.
    McCabe SE, Hughes TL, Bostwick WB, et al. Sexual orientation, substance use behaviors and substance dependence in the United States. Addiction. 2009;104(8):1333–45.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Dolezal C, Carballo-Diéguez A, Nieves-Rosa LE, Diaz F. Substance use and sexual risk behavior: understanding their association among four ethnic groups of Latino men who have sex with men. J Subst Abuse. 2000;11(4):323–6.CrossRefPubMedGoogle Scholar
  50. 50.
    Bertholet N, Daeppen JB, Wietlisbach V, Fleming M, Burnand B. Reduction of alcohol consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Arch Intern Med. 2005;165(9):986–95.CrossRefPubMedGoogle Scholar
  51. 51.
    D’onofrio G, Pantalon MV, Degutis LC, et al. Brief intervention for hazardous and harmful drinkers in the emergency department. Ann Emerg Med. 2008;51(6):742–50.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Madras BK, Compton WM, Avula D, Stegbauer T, Stein JB, Clark HW. Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: comparison at intake and 6 months later. Drug Alcohol Depend. 2009;99(1):280–95.CrossRefPubMedGoogle Scholar
  53. 53.
    Gryczynski J, Mitchell SG, Peterson TR, Gonzales A, Moseley A, Schwartz RP. The relationship between services delivered and substance use outcomes in New Mexico’s Screening, Brief Intervention, Referral and Treatment (SBIRT) Initiative. Drug Alcohol Depend. 2011;118(2):152–7.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Yu J, Appel P, Rogers M, et al. Integrating intervention for substance use disorder in a healthcare setting: practice and outcomes in New York City STD clinics. Am J Drug Alcohol Abuse. 2016;42(1):32–8.CrossRefPubMedGoogle Scholar
  55. 55.
    Rogers M, Johnson K, Yu J, Cuoco L, Blank S. Impact of a brief intervention for substance use on acquisition of sexually transmitted diseases including HIV: findings from an urban sexually transmitted disease clinic population. Sex Transm Dis. 2015;42(10):569–74.CrossRefPubMedGoogle Scholar
  56. 56.
    Muller FJ. Psychotherapy in Argentina: theoretical orientation and clinical practice. J Psychother Integr. 2008;18(4):410–20.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Iván C. Balán
    • 1
    • 4
  • Timothy Frasca
    • 1
  • María A. Pando
    • 2
  • Rubén O. Marone
    • 3
  • Victoria Barreda
    • 3
  • Curtis Dolezal
    • 1
    • 4
  • Alex Carballo-Diéguez
    • 1
    • 4
  • María M. Ávila
    • 2
  1. 1.HIV Center for Clinical & Behavioral StudiesNew York State Psychiatric InstituteNew YorkUSA
  2. 2.Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS)Universidad de Buenos Aires-CONICETBuenos AiresArgentina
  3. 3.Nexo Asociación CivilBuenos AiresArgentina
  4. 4.Columbia UniversityNew YorkUSA

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