Beliefs and Behaviors Regarding Substance Use and HIV Risk among Men Who Have Sex with Men (MSM) in a Mid-Sized U.S. Community

Abstract

This paper explores the beliefs and behaviors surrounding substance use and HIV risk among a convenience sample of 98 men who have sex with men (MSM) in a mid-sized community located in the central United States. Several interesting patterns were identified in the descriptive analyses. Multivariate analysis identified two variables—belief that recreational drug use made sexual experiences better and reports that most MSM friends drank alcohol or took recreational drugs—that were significant predictors of engagement in substance using behavior. Models accounted for 24% of the variance in drinking behavior and 15% of the variance in drug using behavior. Suggestions for HIV/AIDS prevention and intervention and implications for future research are given.

KEYWORDS:

• alcohol
• club drugs
• HIV/AIDS
• MSM

The assistance of the STOP Program, Volunteers of America, Kentucky, and the study participants is gratefully acknowledged.

Notes

^a The full correlation matrix can be requested from the first author.

∗p ≤ .01.

Norms as used in this context draws heavily on the Theory of Reasoned Action (TRA; Ajzen & Fishbein, 1980; Fishbein & Ajzen, 1975) and research examining the TRA and HIV prevention/intervention. According to the TRA, norms are a person's perception of what specific categories of “others” (i.e., important groups of people in a person's life such as family, friends, coworkers, etc.) think about a given action—such as condom use—and how motivated the person is to comply with what the “others” think.

The term “MSM” was used during the course of this research; no other label options were available for participants to select (in terms of self-identifying). This wording/requirement was a function of CDC grant monies and the accompanying mandates that outreach funds must be directed toward “MSM.” The term “MSM” was deemed as appropriate for use by the outreach workers, consultants, and the CDC. The term “MSM” as used in this study describes behavior, not sexual orientation.

The questionnaire originally contained 12 variables. Initial examination of the data indicated that two of the variables—number of days in the week a respondent reports going to a bar and number of days in the week a respondent reports drinking—were highly correlated (0.749; p ≥ .001). Moreover, the pattern and magnitude of correlations between these two variable and the remaining indicators were identical. Based on this, a single variable reflecting the mean number of days per week a respondent reported going to a bar and the mean number of days per week the respondent reporting drinking alcohol was created.

While this research specifically sought to examine club drug use and HIV risk among MSM, the term “recreational drug use” was used within the questionnaire in lieu of “club drugs.” This terminology was recommended by CDC to indicate the possibility of the use of these particular drugs (i.e., methamphetamine, ecstasy, ketamine, poppers, and GHB) beyond time spent in bars.

Both these interventions—the Mpowerment Project and d-up: Defend Yourself!—are available through the Diffusion of Effective Behavioral Interventions project (DEBI). The DEBI project is a national-level strategy to provide high quality training and on-going technical assistance on selected evidence-based HIV/STD/viral hepatitis prevention interventions to state and community HIV/STD program staff. More information can be found at the following web address: http://www.effectiveinterventions.org/.