Annie Ristuccia1, Caleb LoSchiavo2, Perry N Halkitis3, Farzana Kapadia4. 1. Center for Health, Identity, Behavior and Prevention Studies, 665 Broadway #800, New York, NY 10012, USA. Electronic address: annie.ristuccia@nyu.edu. 2. Center for Health, Identity, Behavior and Prevention Studies, 665 Broadway #800, New York, NY 10012, USA; Department of Biostatistics and Social and Behavioral Sciences, School of Public Health, Rutgers University, 684 Hoes Lane West, Piscataway, NJ 08854, USA. Electronic address: closchiavo@nyu.edu. 3. Center for Health, Identity, Behavior and Prevention Studies, 665 Broadway #800, New York, NY 10012, USA; Department of Biostatistics and Social and Behavioral Sciences, School of Public Health, Rutgers University, 684 Hoes Lane West, Piscataway, NJ 08854, USA; Graduate School of Applied and Professional Psychology, Rutgers University, 152 Frelinghuysen Rd, Piscataway Township, NJ 08854, USA; Robert Wood Johnson School of Medicine, Rutgers University, 675 Hoes Lane West, Piscataway Township, NJ 08854, USA; School of Public Affairs and Administration, Rutgers University, 111 Washington Street, Newark, NJ 07102, USA. Electronic address: perry.halkitis@rutgers.edu. 4. Center for Health, Identity, Behavior and Prevention Studies, 665 Broadway #800, New York, NY 10012, USA; Department of Epidemiology, College of Global Public Health, New York University, 715 Broadway, New York, NY 10003, USA; Department of Population Health, School of Medicine, New York University, 227 East 30th Street, New York, NY 10016, USA. Electronic address: farzana.kapadia@nyu.edu.
Abstract
BACKGROUND: Substance use and condomless sexual behaviours are both well studied in sexual minority men, but few researchers have used event-level data collection to examine sexualised drug use in sexual and gender minority young adults. The aim of this study is to describe the co-occurrence of sex under the influence of substances and condomless sexual behaviours, using nuanced event-level data, in a racially/ethnically and socioeconomically diverse sample in New York City. METHODS: Data from one wave of a cohort of sexual and gender minority young adults who were assigned male at birth (n = 500) were used to characterise co-occurrence of sex under the influence of drugs and condomless sexual behaviours (oral receptive, anal insertive, and anal receptive sex), in the last 30 days. Logistic regression models were constructed to assess associations between sex while high and condomless sexual behaviours, controlling for sociodemographic factors. RESULTS: Preliminary analyses indicated significant associations between engaging in sex while high and condomless sexual behaviours. In unadjusted regression models, sexualised and non-sexualised drug use were both significantly associated with increased odds of condomless sexual behaviours. In adjusted models, sexualised drug use remained significantly associated with condomless anal insertive sex (AOR = 3.57) and condomless anal receptive sex (AOR = 4.98). Having multiple sexual partners was also significantly associated with greater odds of condomless sexual activity in all three adjusted models. CONCLUSION: Multivariable analyses indicated that engaging in sex while high on any drug was associated with increased condomless sexual behaviour, but that sexualised drug use was associated with particularly elevated condomless anal sex. These findings provide insight for understanding the co-occurrence of substance use and condomless sex, and suggest a need for HIV/STI risk reduction strategies that address the role of sexualised drug use.
BACKGROUND: Substance use and condomless sexual behaviours are both well studied in sexual minority men, but few researchers have used event-level data collection to examine sexualised drug use in sexual and gender minority young adults. The aim of this study is to describe the co-occurrence of sex under the influence of substances and condomless sexual behaviours, using nuanced event-level data, in a racially/ethnically and socioeconomically diverse sample in New York City. METHODS: Data from one wave of a cohort of sexual and gender minority young adults who were assigned male at birth (n = 500) were used to characterise co-occurrence of sex under the influence of drugs and condomless sexual behaviours (oral receptive, anal insertive, and anal receptive sex), in the last 30 days. Logistic regression models were constructed to assess associations between sex while high and condomless sexual behaviours, controlling for sociodemographic factors. RESULTS: Preliminary analyses indicated significant associations between engaging in sex while high and condomless sexual behaviours. In unadjusted regression models, sexualised and non-sexualised drug use were both significantly associated with increased odds of condomless sexual behaviours. In adjusted models, sexualised drug use remained significantly associated with condomless anal insertive sex (AOR = 3.57) and condomless anal receptive sex (AOR = 4.98). Having multiple sexual partners was also significantly associated with greater odds of condomless sexual activity in all three adjusted models. CONCLUSION: Multivariable analyses indicated that engaging in sex while high on any drug was associated with increased condomless sexual behaviour, but that sexualised drug use was associated with particularly elevated condomless anal sex. These findings provide insight for understanding the co-occurrence of substance use and condomless sex, and suggest a need for HIV/STI risk reduction strategies that address the role of sexualised drug use.
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