Crystal methamphetamine use and bacterial sexually transmitted infections (STIs) among gay, bisexual and other sexual minority men in Canada.

Autor:	Hart TA; Toronto Metropolitan University, Toronto, Canada; University of Toronto, Toronto, Canada. Electronic address: trevor.hart@ryerson.ca., Noor SW; Toronto Metropolitan University, Toronto, Canada; Louisiana State University Shreveport, Shreveport, LA, USA., Tavangar F; Centre for Urban Health Solutions, St. Michael's Hospital, Canada., Berlin GW; Toronto Metropolitan University, Toronto, Canada., Skakoon-Sparling S; Toronto Metropolitan University, Toronto, Canada., Tan DHS; Centre for Urban Health Solutions, St. Michael's Hospital, Canada; Unity Health, Toronto, Ontario, Canada., Lambert G; Institut national de santé publique du Québec, Montréal, QC, Canada; Direction régionale de santé publique - Montréal, Montréal, QC, Canada., Grace D; University of Toronto, Toronto, Canada., Jollimore J; Community-Based Research Centre for Gay Men's Health, Vancouver, BC, Canada., Sang JM; BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada., Kirschbaum AL; Toronto Metropolitan University, Toronto, Canada., Kanji R; Toronto Metropolitan University, Toronto, Canada., Apelian H; McGill University, Montreal, QC, Canada., Cox J; Direction régionale de santé publique - Montréal, Montréal, QC, Canada; McGill University, Montreal, QC, Canada., Moore DM; BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada., Lachowsky N; University of Victoria, Victoria, BC, Canada; Canadian Institute for Substance Use Research, Victoria, BC, Canada.
Jazyk:	angličtina
Zdroj:	Drug and alcohol dependence [Drug Alcohol Depend] 2023 Jan 01; Vol. 242, pp. 109718. Date of Electronic Publication: 2022 Dec 07.
DOI:	10.1016/j.drugalcdep.2022.109718
Abstrakt:	Objective: While crystal methamphetamine use by gay, bisexual, and other men who have sex with men (GBM) is associated with increased risk for sexually transmitted infection (STI) transmission, less is understood about the causal pathways between crystal methamphetamine use and STIs. We examined whether the association between greater crystal methamphetamine risk and prevalent bacterial STI diagnosis among GBM was mediated by two types of attitudinal variables: attitudes toward condoms, and sexual escape motives, defined as the use of substances to escape self-awareness during sex, and by sexual behaviors. Methods: We used computer-assisted self-interview questionnaires from 2449 sexually active GBM (18% living with HIV; median age = 33, interquartile range, 27-45) recruited via respondent-driven sampling in Vancouver, Toronto, and Montreal, Canada. Using the baseline data from the Engage cohort study, we fit a series of structural mediation models of the associations between greater crystal methamphetamine risk and bacterial STI (syphilis, gonorrhea, and chlamydia) diagnosis. We estimated indirect paths from greater crystal methamphetamine risk, attitudes toward condoms, sexual escape motives, and sexual risk behaviors, adjusting for self-reported demographic variables. Results: In the mediated model, the direct association between greater crystal methamphetamine risk and bacterial STI diagnosis was non-significant; however, five indirect paths were significant. Greater crystal methamphetamine risk was associated with bacterial STIs via condom use attitudes and escape motives, which in turn were associated with number of male anal sex partners, condomless anal sex, and oral sex. Discussion: Public health and counselling interventions for GBM who use crystal methamphetamine and who are at higher risk for STIs should target evidence-based causal paths that consider sexual attitudes and sexual practices. Competing Interests: Conflicts of Interest Joseph Cox and Gilles Lambert report nonfinancial support from the Direction r é gionale de santé publique, Centre intégré universitaire de santé et de services sociaux Centre-Sud-de-l’Ile-de-Montréal. Joseph Cox reports grants and personal fees from ViiV Healthcare and Gilead Sciences Canada, and personal fees from Merck Canada, outside the submitted work. David Moore reports a grant from the Michael Smith Foundation for Health Research. Nathan Lachowsky reports grants from the Canadian Institutes of Health Research, the Michael Smith Foundation for Health Research, Canadian Blood Services, the Vancouver Island Health Authority, the Canadian Foundation for AIDS Research, Gilead Sciences Canada, the Vancouver Foundation, the Public Health Agency of Canada, the University of Victoria and Mitacs, outside the submitted work. Darrell Tan reports a grant from the Canada Research Chairs Program; and grants from AbbVie and Gilead Sciences, outside the submitted work. He has been a site principal investigator for clinical trials sponsored by GlaxoSmithKline. Daniel Grace and Trevor Hart report grants from the Canadian Institutes of Health Research, Canadian Blood Services, and the Ontario HIV Treatment Network, outside the submitted work. Trevor Hart also reports editorial fees from the American Psychological Association, outside the submitted work. (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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