Syed W Noor1, Trevor A Hart2, Chukwuemeka N Okafor3, Deanna Ware4, Kara W Chew5, Gypsyamber D'Souza6, Ken Ho7, M Reuel Friedman8, Michael Plankey4. 1. Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada; Department of Kinesiology and Health Science, Louisiana State University Shreveport, One University Place, Shreveport, LA, 71115, USA. Electronic address: swnoor@ryerson.ca. 2. Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada. 3. Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, 1311 S 5th St, Waco, TX, 76706, USA. 4. Georgetown University Medical Center, Department of Medicine, 3800 Reservoir Road, NW PHC-5Washington, DC, 20007, USA. 5. David Geffen School of Medicine at UCLA, 11075 Santa Monica Blvd, Suite 100, Los Angeles, CA, 90025, USA. 6. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA. 7. Division of Infectious Diseases, University of Pittsburgh, 3520 Fifth Avenue, Suite 533, Pittsburgh, PA, 15213, USA. 8. Department of Infectious Diseases and Microbiology, University of Pittsburgh, 130 De Soto St, Pittsburgh, PA, 15261, USA.
Abstract
BACKGROUND: Studies have examined patterns of substance use among Men who have Sex with Men (MSM), but few have examined factors predicting transitioning from one substance use pattern to another. We investigated transitioning from one substance use pattern to another over a 12-year period (2004-2016) among the Multicenter AIDS Cohort Study participants. METHOD: Alcohol, marijuana, heroin, cocaine, poppers, uppers (e.g., methamphetamines) and erectile dysfunction(ED) medications use in the last 6 months from 3568 US MSM was dichotomized (no/yes) to classify participants into substance use classes at each follow up visit. We fit latent transition models to calculate transition probabilities of moving from one substance use class to another over a 3, 4 and 6-year time period. Then fit regression models to identify factors associated with the probability of each participant staying in or moving from the same substance use class. RESULTS: Overall, cocaine and ED medication use declined but marijuana and heroin use increased over 2004-2016. We observed most participants (84.6 %-100 %) stayed in the same class. Increased age was associated with transition from the Minimal-use class to the Alcohol-only class (aOR = 1.06,95 %CI:1.01-1.13;p < 0.01) and non-White MSM reported lower odds of moving from the Alcohol-only class to the Alcohol-Popper class (aOR = 0.50,95 %CI:0.30-0.82;p <0.01). There were no difference in the transition probabilities by HIV-status. CONCLUSION: Despite decline in substance use in general, participants are highly stable in their choice of substances. However, treating MSM as a homogeneous group can lead to an under-appreciation of the diversity of prevention needs and treatment of substance using MSM.
BACKGROUND: Studies have examined patterns of substance use among Men who have Sex with Men (MSM), but few have examined factors predicting transitioning from one substance use pattern to another. We investigated transitioning from one substance use pattern to another over a 12-year period (2004-2016) among the Multicenter AIDS Cohort Study participants. METHOD: Alcohol, marijuana, heroin, cocaine, poppers, uppers (e.g., methamphetamines) and erectile dysfunction(ED) medications use in the last 6 months from 3568 US MSM was dichotomized (no/yes) to classify participants into substance use classes at each follow up visit. We fit latent transition models to calculate transition probabilities of moving from one substance use class to another over a 3, 4 and 6-year time period. Then fit regression models to identify factors associated with the probability of each participant staying in or moving from the same substance use class. RESULTS: Overall, cocaine and ED medication use declined but marijuana and heroin use increased over 2004-2016. We observed most participants (84.6 %-100 %) stayed in the same class. Increased age was associated with transition from the Minimal-use class to the Alcohol-only class (aOR = 1.06,95 %CI:1.01-1.13;p < 0.01) and non-White MSM reported lower odds of moving from the Alcohol-only class to the Alcohol-Popper class (aOR = 0.50,95 %CI:0.30-0.82;p <0.01). There were no difference in the transition probabilities by HIV-status. CONCLUSION: Despite decline in substance use in general, participants are highly stable in their choice of substances. However, treating MSM as a homogeneous group can lead to an under-appreciation of the diversity of prevention needs and treatment of substance using MSM.
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