背景:先前的研究表明,使用药物的男男性行为者(MSM)的性传播感染(STI)和人类免疫缺陷病毒(HIV)的风险增加。通常,使用药物的MSM同时使用多种物质,研究表明某些物质更频繁地组合使用。作为弱势群体,重要的是要了解这些人群使用药物的各种方式来构建预防,减少危害,和满足他们需求的治疗方案。
方法:本分析的数据来自一组不同地域的美国国家男性性行为者样本(n=6111)。在评估样本中的药物使用率后,我们使用迭代潜在类别分析来确定10种物质的物质使用类别。选择模型后,在过去的3个月中,我们检查了班级分配与插入型和接受型无肛门性行为(CAS)伴侣的平均数量的相关性.
结果:最终模型显示了六个潜在类别:类别1=“大麻使用”(n=1,996),类2=“多样化使用”(n=299),第3类=“可卡因和吸入剂使用”(n=421),第4类=“甲基苯丙胺,GHB,和吸入剂的使用(n=345),第5类=\"nouse\"(n=2431),第6类=“镇静剂使用”(n=619)。年龄,种族,年收入,居住在EHE司法管辖区,过去无家可归的历史,过去的监禁史与某些班级的成员身份密切相关。在结果建模中,在前3个月中,最佳分配至4类的参与者的插入性(平均值=9.70,95%CI:5.92~13.47)和接受性(平均值=8.71,95%CI:6.75~10.66)无共管肛交(CAS)伴侣的平均数量最高.
结论:六个异构类可能表示与不同设置或活动相对应的使用行为的离散类型,它们本身可能因地区艾滋病毒发病率趋势和参与者人口统计学而有所不同。寻求解决MSM中物质使用问题的程序可以很好地适应这些不同的物质使用集群。
Prior research has shown that men who have sex with men (MSM) who use drugs are at increased risk of sexually transmitted infections (STI) and Human Immunodeficiency Virus (HIV). Often, MSM who use drugs use multiple substances at once and research has indicated that certain substances are used in combination more frequently. As a vulnerable population, it is important to understand the various ways in which this population uses drugs in order to structure prevention, harm reduction, and treatment programs to their needs.
Data for this analysis were taken from a cohort of geographically diverse U.S. national sample of cisgender men who have sex with men (n = 6111). After assessing prevalence of drug use in the sample, we used iterative latent class analysis to determine substance use classes for 10 substances. After a model was selected, class assignments were examined for association with mean number of insertive and receptive condomless anal sex (CAS) partners in the past three months.
The final model indicated six latent classes: class 1 = \"cannabis use\" (n = 1,996), class 2 = \"diverse use\" (n = 299), class 3 = \"cocaine and inhalant use\" (n = 421), class 4 = \"methamphetamine, GHB, and inhalant use\" (n = 345), class 5 = \"no use\" (n = 2431), class 6 = \"sedative use\" (n = 619). Age, race, annual income, residence in EHE jurisdictions, past history of houselessness, and past history of incarceration was significantly associated with membership in some classes. In outcome modeling, participants best assigned to Class 4 had the highest mean number of insertive (Mean = 9.70, 95% CI: 5.92 - 13.47) and receptive (Mean = 8.71, 95% CI: 6.75 - 10.66) condomless anal sex (CAS) partners in the prior three months.
The six heterogenous classes may indicate discrete typologies of use behavior corresponding to different settings or activities, which may themselves differ by regional HIV incidence trends and participant demographics. Programs seeking to address substance use among MSM may be well served to tailor toward these divergent clusters of substance use.