Transcript The Sexual Practices of Combined Methamphetamine and

The Sexual Practices of
Combined Methamphetamine
and Nitrate Users
Michael T. Maurer, Ph.D., M.H.A.
Methamphetamine (crystal, tina)
• Synthetic drug with marked cocaine like
effects but are longer-acting than cocaine
• stimulates the CNS
• produces euphoria (a sense of well being)
• used to stave off sleepiness, “diet drugs”,
antidepressants
• tolerance creates does escalation
• Swallowed in water, dabbed on tongue,
smoked, snorted, injected, anally
• hyperactivity, paranoid thinking, violent
behavior, psychotic symptoms
• physically addicting to some people
• affects self image
• high sexual stimulation
Inhalant Nitrates (amyl nitrate)
• Aromatic stimulant
• produces many of the effects of alochol
intoxication
• CNS depressant
• relaxes anal muscles
• headache, blurred vision, vertigo, nausea,
weakness, confusion, vomiting, neuritis
Links between SU & risk-taking
behaviors
• “disinhibition”
• “personality”
• “aphrodisiac”
“Disinhibition”
• Drug use results in the elimination of
inhibitors that normally keep risk-taking
behavior in check
“Personality”
• Drug use and risk taking are related to each
other through a third variable involving the
personal characteristic(s) of an individual
“Aphrodisiac”
• Drug use enhances the pleasure of sexual
encounters, thereby increasing the
likelihood that all sexual activities will take
place, including those involving high risk
disease transmission
Social Cognition Model
• Social cognitive factors (e.g., attitudes and
beliefs), which frequently mediate the
effects of other individual differences (e.g.,
demographics, mental health, identity)
Seropositive Urban Men’s Study
(SUMS)
• Qualitative interviews and Quantitative
surveys
• 225 HIV+ sexually active MSM
• 29% A-A, 29% L, 33% E-A, 9%
other/mixed
Methamphetamine Data (SUMS)
• 11% injected,
inhaled/swallowed
• 7.4% usage rate in
NYC
• 16.5% usage rate in
SF
• 77.8% >twice a week
• 3.7% daily
• 5.8 HIV- & 30.5 HIV
UK in last 3 months
• 2.3 acts of non-p anal I
• 3.5 acts of non-p oral I
HIV• 9.8 acts of non-p oral I
HIV UK
• 44% vs. 26% non-p
anal I
Sums Data
• Non-p anal R (t=2.29,
p=0.23)
• attend sex parties
(p=.002)
• bath houses (p=.05)
• Higher levels of
sensation seeking
(p=.05)
• higher levels of
depression (p=.10)
Street Survey
• Brief survey to 202
men of whom 14.9%
were HIV+
• crystal use in last 3
months 10.4%
• 7.4% less than once a
week
• 2.4% twice a week
• 0.5% more than twice
• 0.5% daily
• 25% reported first
time use in past 3
months
Street Crystal Data
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20% HIV+ non-p a I
50% non-p a R
33% non-p o I
43% non-p o R
more common among
those frequenting
mainstream gay
venues (x2 (1)=5.79,
p=.01)
• 22 crystal out of 202
• 15 E-A, 4 L, 1 AsianA, 1 A-A
• used alcohol,
marijuana, inhalant
nitrates, cocaine
Street Nitrate Data
• 59 (29.9%) of 202
men in last 3 months
• HIV+ more use than
HIV- (t(187)=3.18,
p=.02)
• public sex
environment
(t(142)=5.77, p<.001)
• Non-p o I, o R, a I, a R
(t (141)=4.57, p<.01)
• single best predictor
for non-p o R (66.7%)
• non-p a I 73.7%
Street Crystal & Nitrates
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202 respondents
20 (9.9%) crystal
59 (29.2%) inhalant nitrates
14 (8.1%) both crystal & nitrates
used both 28.6% less than once, 35.7% once
or twice, 35.7% more than twice a week
Crystal & Nitrates Combined
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54.3% orally receptive
16.5% oral insertive
16.5% anally insertive
64.3% anally receptive