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Substance Use among API MSM. Don Operario Center for AIDS Prevention Studies (CAPS) University of California, San Francisco, San Francisco. UC. SF. University of California San Francisco. Presentation Outline. Background Research Findings: Asian Counseling and Testing ( ACT ) study
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Substance Use among API MSM Don Operario Center for AIDS Prevention Studies (CAPS)University of California, San Francisco, San Francisco UC SF University of California San Francisco
Presentation Outline • Background • Research Findings: Asian Counseling and Testing (ACT) study • Implications for Prevention and Treatment • Directions for Future Research
Background: Substance Use and U.S. APIs • Few studies, many myths • Prevalence may be on the rise • West Coast and Hawaii • Substance use prevalence may differ by demographic group
Research Questions • What is the prevalence of substance use among young API MSM? • What are demographic and environmental correlates of substance use among young API MSM?
Ethnicity (%) Chinese 27 Filipino 28 Vietnamese 16 Other 29 Age 18-24 years 49 25-39 years 51 US born 30 Education no college 17 some college 33 college graduate 50 Sample Characteristics (N=496)
Gay Social Network Characteristics Sexual Orientation (%) Gay82 Bisexual 13 Other 5 Degree of “outness” not out to anyone 4 < half people you know 40 > half people you know 56 Frequency of clubbing Once a month or less 11 2-3 times a month 26 Once a week or more 47 Ever attended a circuit party 20
Sexual Behaviors, 6 mos. (%) Number of sex partners 0 6 1 31 2-3 26 4-10 29 11 or more7 Any unprotected anal sex 47
Substance Use Behaviors, Lifetime • (%) • Alcohol 94 • Marijuana 62 • Ecstasy 59 • Hallucinogens 28 • Poppers 29 • Crystal 29 • Cocaine/Crack 20 • Special K 26 • GHB 22 • Any illicit drug 78 • Any IDU 2
Substance Use Behaviors, 6 mos. Once a More than once a Any(%) Month (%)Month (%) Alcohol 100 13 62 Marijuana 44 12 32 Ecstasy 48 16 39 Hallucinogens 14 9 9 Poppers 16 15 16 Crystal 21 11 34 Cocaine/Crack 10 10 16 Special K 20 10 25 GHB 21 23 23
Correlates of Frequent Illicit Drug Use Nativity(OR, 95% CI) U.S. born 2.03 (1.21, 3.41) Foreign born reference Education no college 2.91 (1.43, 5.96) some college 2.22 (1.22, 4.04) college graduate reference Degree of outness less than half reference more than half 2.26 (1.31, 3.90)
Correlates of Party Drug Use Nativity (OR, 95% CI) U.S. born 1.90 (1.17, 3.08) Foreign born reference Frequency of clubbing, 6 mos once month or less reference more than once a month 1.58 (1.01, 2.49) Ever attended a circuit party yes 3.06 (1.65, 5.65) no reference Multiple sex partners, 6 mos yes 2.04 (1.35, 3.08) no reference
Correlates of Polydrug Use Nativity (OR, 95% CI) U.S. born 1.76 (1.11, 2.79) Foreign born reference Degree of outness less than half reference more than half 1.71 (1.13, 2.58) Frequency of clubbing, 6 mos once month or less reference more than once a month 2.44 (1.13, 2.58) Ever attended a circuit party yes 3.20 (1.88, 5.46) no reference Multiple sex partners, 6 mos yes 2.22 (1.44, 3.42) no reference Any Unprotected anal sex, 6 mos yes 2.03 (1.35, 3.04) no reference
Summary: • High prevalence of substance use • Associations between party/poly drug use and HIV-related sexual risk • Correlates of substance use suggest directions for outreach and prevention
Program Implications • Incorporate gay/MSM topics into treatment • Target venues, subgroups
Directions for Future Research • Descriptive studies • Motivations for using • Patterns of use (frequent/casual, social settings and networks) • Treatment intervention and effectiveness studies • Incentives and barriers for seeking treatment
Closing • HIV prevalence among API MSM is low • High levels of risk behavior, compounded by low rates of testing • If complacency continues, strong potential for rapid spread of HIV epidemic among API MSM