Sex hustling, injection drug use, and non-gay identification by men who have sex with men. Associations with high-risk sexual behaviors and condom use
Rietmeijer, C.A.; Wolitski, R.J.; Fishbein, M.; Corby, N.H.; Cohn, D.L.
Sexually Transmitted Diseases 25(7): 353-360
1998
ISSN/ISBN: 0148-5717 PMID: 9713915 DOI: 10.1097/00007435-199808000-00006Document Number: 277464
With HIV incidence rates as high as 0.7-2.4% per year, men who have sex with men (MSM) accounted for half of all AIDS cases and 43% of non-AIDS HIV cases among men reported to the US Centers for Disease Control and Prevention in 1996. Subgroups of MSM who are at particular risk of HIV infection, such as MSM who inject drugs, MSM who have sex in exchange for money or drugs (hustlers), and non-gay-identified MSM, may be less likely to be reached by HIV/AIDS prevention messages targeted at the broader MSM community. Sex behavior-related data were collected from 1290 MSM recruited in Denver and Long Beach from gay bars and bath houses, adult video arcades, and outdoor cruising areas between September 1993 and June 1994. The 531 MSM sampled in Denver and 759 in Long Beach reported having had sex with a man during the preceding year. 417 (32%) were non-gay-identified, 86 (7%) had injected drugs in the past 6 months, and 117 (9%) had exchanged sex for drugs or money. 10% of non-gay-identified men identified themselves as being straight. Of drug-injecting MSM and hustlers, 19% and 13%, respectively, were straight-identified. Detailed information on HIV testing and serostatus, number of partners, and sex practices, including condom use, was available for the 482 men who had reported anal or oral sex with a man or who had injected drugs in the past 30 days. 55% of drug-injecting MSM reported sex hustling and 40% of hustlers reported IV drug use. Hustling was associated with a higher number of sex partners, more frequent anal sex with men and women, and less frequent condom use during anal sex with occasional male partners. Hustlers and drug-injecting MSM used condoms less consistently during vaginal intercourse with female partners than did other MSM.