International Journal of Drug Policy - 2014

Volume 25 Issue 3 May 2014

Issue link: http://digitalreprints.elsevier.com/i/364061

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International Journal of Drug Policy 25 (2014) 591–597 Contents lists available at ScienceDirect International Journal of Drug Policy j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / d r u g p o Research paper An examination of places where African American men who have sex with men (MSM) use drugs/drink alcohol: A focus on social and spatial characteristics Karin E. Tobin a,∗ , Carl A. Latkin a,1 , Frank C. Curriero b,c,2 a Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 2213 McElderry Street, Second Floor, Baltimore, MD 21205, USA b Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltmore, MD 21205, USA c Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltmore, MD 21205, USA a r t i c l e i n f o Article history: Received 23 April 2013 Received in revised form 13 September 2013 Accepted 6 December 2013 Keywords: African American men who have sex with men (AA MSM) Spatial intensity Social networks Substance abuse Inventory a b s t r a c t Background: Drug and alcohol use are risk factors for HIV transmission. Much of the HIV behavioural research has focused on risk without consideration of the social and spatial context of the behaviour. Yet, risk may be specific or unique to place. The purpose of this study was to examine the social and spatial characteristics of places where African American men who have sex with men (AA MSM) use drugs and/or alcohol. Specifically, we examined spatial intensity and clustering of drug/alcohol places and characteristics of their social networks at these places. Methods: Participants were recruited using outreach, on-line advertisements and word-of-mouth refer- rals. Inclusion criteria were: age 18 or older and sex with a man in the prior 90 days. Participants (n = 51) completed a socio-spatial inventory in which they provided addresses of n = 187 places where they most recently used drugs and/or drank alcohol. Participants described characteristics of people who were at these places. Results: The mean age of participants was 36.5 years (SD = 10.9). Half (51%) identified as gay, 31% bisexual, 4% heterosexual and 10% as not sure/questioning and 27% self-reported HIV positive status. Drug/alcohol places were spatially concentrated in the inner part of the city and evidence of clustering by participant characteristics was present. Of n = 187 places named where the participant drank alcohol or used drugs, 68% were described as a residence (participants or "someone one else's house"), 20% were bars/clubs or restaurants, 8% were outside places and 4% were miscellaneous (e.g. on the bus/car). There were dif- ferences in the characteristics of social network members by place-type. At residential places, a greater proportion of networks listed were sex partners or kin, compared to other place-types. A greater propor- tion of networks listed at bars/clubs/restaurants were gay, knew that the participant had sex with men, and were younger compared to other place-types. Conclusion: AA MSM drink alcohol and use drugs in a variety of place-types and with various social net- work members. Little research has been done on factors that shape the geography of AA MSM substance use. Future research is needed to explore these complex associations. © 2014 Elsevier B.V. All rights reserved. Introduction It is well established that drug and alcohol use are contribut- ing factors to HIV risk among men who have sex with men (MSM) (Harawa et al., 2008; Mansergh et al., 2008; Mayer et al., ∗ Corresponding author. Tel.: +1 410 502 5386; fax: +1 410 502 5385. E-mail addresses: ktobin@jhsph.edu (K.E. Tobin), clatkin@jhsph.edu (C.A. Latkin), fcurrier@jhsph.edu (F.C. Curriero). 1 Tel.: +1 410 502 5386; fax: +1 410 502 5385. 2 Tel.: +1 410 614 5817; fax: +1 410 955 9334. 2010; Mimiaga et al., 2010; Parsons, Kutnick, Halkitis, Punzalan, & Carbonari, 2005; Skeer et al., 2012; Stall et al., 2001). Substance- using MSM are at especially elevated risk for HIV, attributable to having sex under the influence of drugs (Catania et al., 2001; Celentano et al., 2006; Harawa et al., 2008; Koblin et al., 2006; Mansergh et al., 2008; McKirnan, Vanable, Ostrow, & Hope, 2001; Mimiaga et al., 2010), as well as exchanging sex for money or drugs, and lower condom use (Bachmann et al., 2009; Colfax et al., 2005; Crosby, Stall, Paul, Barrett, & Midanik, 1996; Garfein, Metzner, Cuevas, Bousman, & Patterson, 2010; Gorbach, Murphy, Weiss, Hucks-Ortiz, & Shoptaw, 2009; Reisner et al., 2010; Rhodes et al., 1999; Semple, Strathdee, Zians, & Patterson, 2010; Stall et al., 2003). 0955-3959/$ – see front matter © 2014 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.drugpo.2013.12.006

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