Alcohol, Drug Use, and Sexual Risk Behavior among a Divese Sample of Men Who Have Sex With Men in Buenos Aires, Argentina.

BALAN I; CARBALLO DIEGUEZ A; MARONE R; DOLEZAL C; PANDO MA; BARREDA V; AVILA MM

Atlanta, Georgia

Encuentro; 34th Annual Meeting of the Research Society on Alcoholism; 2011

This study assesses how alcohol and drug use is associated with HIV risk behavior among men who have sex with men (MSM) in Buenos Aires, Argentina. Respondent driven sampling was used to recruit 500 MSM, who completed a self-administered web-based survey inquiring about using alcohol or specific recreational drugs during the prior two months. Data were weighted using the Respondent Driven Sampling Analysis Tool (RDSAT version 5.6.0) based on the network size of the participant. The mean participant age was 30.5 (SD=11.5) and 66% had less than complete high school level of education. Only 25.6% of participants identified as gay; 37.8% as bisexual, 22.5% as heterosexual, and 13.7% were grouped as “other”. Over two-thirds of the sample reported having unprotected sex during the prior two months, with 88% of participants reporting more than one sexual partner, with a median of 5.8 (standard deviation [SD]=13.13) occasions of unprotected anal or vaginal intercourse (range 0-200). Over half of the heterosexual-identified men reported having had sex with men, women, and male-to-female transgender individuals. The substances most frequently used during the prior two months were alcohol (81.8%), marijuana (49.7%), cocaine (33.5%), "paco," locally produced cocaine sulfate (17.7%), and sedatives (17.5%).  One-third of the sample reported drinking alcohol at least 2-6 times per week; 18% reported usually drinking to the point of "feeling drunk" or "passing out."  The frequency of both alcohol and drug use was significantly lower among the gay-identified men in the sample. While the frequency of drug use among the whole sample was significantly correlated with the number of sexual partners (r [492]=.145, p=.001) and unprotected anal or vaginal intercourse (r [488]=.165, p=.000), the frequency of alcohol use was not associated with number of sexual partners (r [479]=.045, p=.319) or unprotected intercourse (r [498]=.070, p=.129). However, there were differences in these associations based on the participants’ sexual identity.  For example, while within the gay identified subsample there were no significant correlations between alcohol or drug use and number of sex partners or unprotected intercourse, among the bisexually identified sample, alcohol was  correlated with unprotected intercourse with women (r [165]=.179, p=.021), and inversely with unprotected intercourse with men (r [171]=-.177, p=.020) and drugs were correlated with increased sexual partners (r [178]=.205, p=.006) and unprotected intercourse with women (r [168]=.295, p=.000).  Among heterosexually identified participants, alcohol was inversely correlated with number of sexual partners (r [99]=-.208, p=.037), and with unprotected sex with men (r [97]=-.227, p=.024), while drug use was associated with unprotected sex with men (r [101]=.327, p=.001).  And, among men categorized as “other” alcohol use was not associated with number of sexual partners or unprotected intercourse, but drug use was associated with unprotected intercourse with transgenders (r [75]=.330, p=.003).  Among this diverse sample of MSM, there exists a high rate of problematic drinking. The associations between drug and alcohol use and unprotected sexual intercourse among the non-gay identified men is particularly concerning, given their position as a high-risk bridge population to broader segments of the Argentine population.