Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

552 Abstracts ThPeE7854-ThPeE7857

XIV International AIDS Conference

adopted in administering close an open-ended questionnaire sets. Data were
analysed by descriptive statistics.
Results: Alcohol and tobacco were the most frequently (27%) advertised products, with beer and cigarette-related substances being the most conspicuously
displayed on billboards around home and school.96.3% of respondents reported
that the media had influence on their use of drugs and 69.4% reported increased
sexual activities due to media appeals. 64.5% and 67.3% had knowledge of
HIV/AIDS and its consequences, respectively. 51.5% of them reported being
aware of the implications of unprotected sex, but 73.6% never used condoms,
at least.
Conclusions: Media messages can be used to emphasise greater risks of unrelenting, unprotected sex than the temporary pleasures that ultimately bring permanent pains and sorrows of sex mediated by drug and alcohol consumption.
Presenting author: Sam Smah, Centre for Development studies, University of
Jos, Jos, Nigeria, Tel.: [phone], Fax: [phone], E-mail: samsmah
@yahoo.com
ThPeE7854 Sexual behaviour among South African
adolescents as it relates to drug use, exposure to
drug use and access to drugs
N.K. Morojele', J.S. Brook2, K.M. Moshia'. 'Medical Research Council,
Pretoria, South Africa; 2Mount Sinai School of Medicine, New York, United States
Background: There has been a paucity of research on possible implications for
adolescents' sexual behaviour of their exposure to drugs and to drug use by people within their social milieu. The aim of this study is to examine the relative importance of adolescents' own drug use, the drug use of family, partners and peers,
and their access to drugs in accounting for their sexual behaviour.
Methods: A community sample of 308 male and female adolescents in Durban,
South Africa participated in face-to-face interviews. Logistic regression was used
to determine the relationship between engagement in sexual intercourse and self
drug use, family members' and significant others' drug use, and access to drugs.
Results: While mother drug use was not significantly related to life time sexual
intercourse, the following factors were found to be associated with a significant
increase in the odds of having engaged in sexual intercourse: self drug use, father drug use, sibling drug use, partner drug use, friend drug use, and access to
drugs. After controlling for age, socio-economic status and delinquency (a marker
for unconventionality), significant relationships between engagement in sexual intercourse and self drug use, father drug use, and access to drugs were maintained.
Conclusions: The findings suggest that adolescents who use drugs, and are
from environments marked by high rates of drug use and in which drugs can
be easily obtained have an increased chance of engaging in sexual intercourse.
Decreasing the availability of drugs and the levels of drug use within a community may be among potentially useful strategies for reducing adolescent sexual
behaviour.
Presenting author: Neo Morojele, Medical Research Council, Private Bag X385,
Pretoria 0001, South Africa, Tel.: [phone], Fax: [phone], Email: neo.morojele @ mrc.ac.za
ThPeE7855 Substance use and unprotected anal intercourse
among urban young men who have sex with men:
Baseline results from the C.I.T.Y. U.S. multisite HIV
prevention trial
A. Stueve, T. Community Intervention Trial for Youth Study Team2,
G. Agronick2, R. Duran2, L. O'Donnell2, A. San Doval2. 'Mailman School of
Public Health, Columbia University, Joseph L. Mailman School of Public Health,
Division of Epidemiology, 600 W 168th Street, PH-18, New York, NY, United
Background: Two decades into the AIDS epidemic in the US, adolescent and
young adult males who have sex with men (YMSM) remain at high risk of HIV
infection. Risky sexual behaviors have been identified, yet the role of substance
use prior to and during sex remains controversial. This study assesses the extent
to which urban YMSM report being "high" on drugs or alcohol during sex and the
association between being "high" and unprotected anal intercourse (UAI).
Methods: During summer 2000, a brief interview was administered to 3075 men,
15-25 years, who reported sexual contact with a male in the past year. Men were
recruited in randomly selected venues in 13 urban areas using time-space sampling. Participants were asked about their last sexual contact with main and nonmain partners, including whether they engaged in anal intercourse, used a condom, and were "high on drugs or alcohol". Logistic regression was used to assess
the relationship between being high and UAI.
Results: Of the 1590 men with a main partner during the past 3 months, 18.6%
reported being high during their last sexual encounter and 25.0% reported UAI.
Of 1667 men with a nonmain partner, 29.3% reported being high the last time

they had sex, and 12.3% reported UAI. Being high was not a significant risk factor for UAI with main partners. However, it was associated with UAI with nonmain
partners (OR=1.82, 95% CI=1.32, 2.52), increasing risk for unprotected insertive
(OR=1.65, 95% CI=1.07, 2.54) and receptive (OR=1.84, 95% CI=1.23, 2.76) AI.
Men who were high on drugs or alcohol with their last partner were also more
likely to report recent sex with females and to trade sex for drugs, money or other
valuables.

Discussion: Being high increases the likelihood YMSM will engage in UAI with
nonmain partners. HIV prevention must include messages about the potential
dangers of drinking and drug use in situations where sexual encounters with nonmain partners may occur.
Presenting author: Ann Stueve, Joseph L. Mailman School of Public Health, Division of Epidemiology, 600 W. 168th Street, PH-18, New York, NY, United States,
Tel.: [phone], Fax: [phone], E-mail: casl 1 @columbia.edu
ThPeE7856I Adherence to HIV medications and club drug use
among gay and bisexual men
P.N. Halkitis', A.H. Kutnick2, T Borkowski3, J.T Parsons4. 'New York University,
New York, NY; 2CHEST New York, NY; 3Columbia University New York, NY;
'Hunter College, CUNY, New York, NY, United States
Background: Substance use/abuse is highly related to adherence to HIV medications, and this impact is further exacerbated by the use of a specific set of
substances known as club drugs.
Methods: A community sample of HIV seropositive gay/bisexual men who are on
a protease inhibitor HAART regimen completed quantitative assessments using
A-CASI to assess adherence, which were validated using qualitative, calendarbased, technological (MEMS caps) and biological (viral load) assessments. Data
were collected over a two-month period to assess the relationship between substance use and adherence.
Results: Data were collected on a sample of 300 gay/bisexual men (mean age=
42), 67% of whom were men of color. Of these, 51.9% reported missing at least
one dose of their PI in the two-month period prior to assessment, and 47.5%
in the last two weeks. Based on the Drug Abuse Screening Test, substance
users/abusers reported more doses missed in the last two months (F(1,283) =
3.93, p <.05) than non-drug users. Those reporting the use of substances known
as "club drugs" (e.g., methamphetamine, MDMA, ketamine, etc.) reported less
adherence than those reporting no substance use (p =.002) and those reporting
the use of substances not categorized as "club drugs" (p =.008). Users of hallucinogens (F(1,232) = 25.93, p < 0.001), methamphetamine (F(1,232) = 11.02, p
= 0.001), inhalant nitrates (F(1,232) = 6.71, p = <.01) and ketamine (F (1,232) =
30.50, p < 0.001), MDMA (F(1,232) = 9.69, p =.002) reported more missed doses
than those reporting no use of each of these.
Conclusions: Special attention should be paid to the class of substances known
as club drugs as use of these is more likely to impact adherence to HAART, perhaps due to the greater disinhibition caused by use of club drugs as well as the
contexts in which these substances are used. The use of club drugs, besides
impacting adherence, also has biomedical implications for those on protease inhibitors.
Presenting author: Perry N. Halkitis, 239 Greene Street, East Building, 537G,
New York, NY 10003, United States, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeE7857 Methamphetamine use among men who have sex
with men in Boston and New York City: Emerging
drug? Emerging risks?
J.E. Egan', P. Case', M.C. Clatts2, R.F. Narvaez', T.L. Geraty'. 'Harvard
Medical School, Department of Social Medicine, Boston, MA, United States;
2Columbia University New York City United States
Introduction: Methamphetamine use (MU) has been associated with increased
risk for HIV infection among men who have sex with men (MSM). Much of the
available data about MU among MSM is confined to research in West Coast cities
with major production centers and large MSM populations. MU is emerging on the
East Coast where little data exists.
Methods: As part of an ongoing ethnographic study of "club drugs" among MSM
in Boston and NYC, we interviewed 68 men who self-reported sex with a man
within the last 12 months and used ketamine, MDMA, methamphetamine, GHB,
and/or inhaled nitrates within 3 months of interview.
Results: Half (54%) reported MU within 3 months of the interview, with all but one
using multiple drugs. 16% used methamphetamine in a single mixture with other
powdered drugs such as ketamine, cocaine, or MDMA. Commonly known as "Trail
Mix," little is known about the range, quality, or relative ratios of drugs in these
homemade mixtures. Each constituent drug has different effects for different periods of time, complicating self-regulation and dosing. Users may be exposed to
excessive levels of particular parts of the mixture, leading to overdose or may
contribute to cognitive and neurological effects. In this early phase of emergence,
inhalation and smoking are primary modes of administration, although as evident
elsewhere, strong potential for transitions to injection exists. Participants reported
high levels of sexual activity in various venues. The relationship between MU,
sexual risk taking, and HIV risk varies between social and drug-using networks.
Conclusion: Prevention and treatment services need to provide MSM with information about the potential risks associated with MU and combination drugs such

as Trail Mix. Education and assessment models targeted to MSM, which have
historically focused on sexual risk, should include greater attention to drug and
injection risks.
Presenting author: James E Egan, Department of Social Medicine, Harvard
Medical School, 641 Huntington Ave, Boston, MA 02115, United States, Tel.:
[phone], Fax: [phone], E-mail: JamesEgan @ hms.harvard.edu