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Background: The objectives of the study were to determine the prevalence of alcohol and drug use before or during sex among men who have sex with men MSM in Catalonia during , and to identify factors associated with variables of intensive alcohol and drug use. Methods: Cross-sectional study using self-administered questionnaires. Men were recruited in saunas, sex shops, bars and a public park and by mail to all the members of the Catalonia Gay Federation. Results: The multivariate analysis showed an association between having suffered discrimination and frequent alcohol and multidrug use. Being human immunodeficiency virus HIV -positive was associated with frequent use of drugs and multidrug use. Associations between substance use and sexual risk behaviour also emerged. A previous study carried out in Catalonia in revealed drug use before or during sex as one of the factors associated with unprotected anal intercourse among MSM. Prior research has put forward several potential explanations for this association. First, certain drugs are used to enhance sex among MSM, and their use during sex may increase the risk of engaging in unprotected sex due to pharmacological effects such as social disinhibition and prolonged intercourse. There is evidence that drug consumption is a risk factor for HIV infection. This risk increased to 2. Contrary to other countries, e. USA, where a high prevalence of alcohol and recreational drug use among MSM has been widely reported, 11 , 14 , 18 , 19 less data are available in Europe and most are secondary findings with little detail about the type of drug, drug combination or context of use. The lack of studies on drugs and MSM in Europe, and particularly in Spain, reinforces the need for a more in-depth analysis of drug and alcohol use in this group, since identifying the factors that determine the use of these substances will help us design specific strategies for the reduction of the risks and damage associated with their use. In this context, the objectives of our study were to determine the prevalence of alcohol and drug use before or during sex among MSM in Catalonia during and to identify the sociodemographic, psychosocial and behavioural factors associated with three specific variables of intensive alcohol and drug use. In the most recent , a convenience sample of MSM was recruited at saunas, sex shops, bars and a public park frequented by gay men. These sites were selected from a larger list of gay venues screened prior to the survey. Venues were chosen to represent a wide cross-section of MSM in Barcelona. All men present in the venue during a specific period were invited to participate. Of the men approached, The questionnaires were anonymous, self-administered and accompanied by a self-addressed stamped envelope that was to be sent to a post-office box; therefore, it was impossible to ascertain whether anyone had answered more than once. The distributed questionnaires were marked in order to identify the origin of the returned questionnaires. The return rate was The questionnaire used was adapted from a questionnaire developed and validated by the Lausanne University Institute of Social and Preventive, which investigated behavioural patterns over the last 12 months. The degree of internalized homophobia, that is the men ' s own negative attitude towards their homosexuality or bisexuality, was investigated using seven items on acceptance of homosexuality with responses ranging from 1 totally agree to 4 totally disagree. The questionnaire also collected variables on sex practices in the last 12 months with stable and casual partners and on the use of condoms, number of partners, self-reported HIV status and previous history of STI. A stable partner was defined as any person with whom the respondent had sexual relations and felt closer and more committed. Unprotected anal intercourse was defined as inconsistent use of a condom with a sexual partner during the last 12 months. The participant was asked about alcohol and drug use cannabis, heroin, cocaine, crack, ecstasy, amphetamines, poppers, LSD, Viagra, ketamine and methamphetamine before or during sex over the last 12 months and about the frequency of use for each substance always, frequently, occasionally or never. This information was used to construct the specific response variables for the intensive use of alcohol and drugs: i Frequent alcohol use , that is, the use of alcohol always or frequently before or during sex over the last 12 months; ii Frequent drug use , that is, the use of at least one drug always or frequently before or during sex over the last 12 months; iii Multidrug use , that is, the use of three or more different drugs before or during sex over the last 12 months. These variables were not mutually exclusive. The prevalence of drug or alcohol use during sex over the last 12 months was calculated for the descriptive analysis. Logistic regression was used to evaluate the sociodemographic, psychosocial and sexual behaviour variables associated with each of the specific response variables for the intensive use of alcohol and drugs. The calibrations of the models were assessed by the Hosmer—Lemeshow goodness-of-fit statistic. Statistical significance was set at 0. Of the men included in the study, These were the participants included in the analysis. Mean age was 41 years SD 9. Immigrants accounted for Most of the men identified themselves as homosexual As for sexual behaviour during the last 12 months, The self-reported prevalence of HIV was Sociodemographic, psychosocial and sexual behavior characteristics of a sample of MSM in Catalonia, Spain, More than half the participants said they had used alcohol and drugs at some time before or during sex Prevalence of alcohol and drug use before or during sex in a sample of MSM in Catalonia, Spain, last 12 months. Related the variables for the intensive use of alcohol or drugs before or during sex, The results of univariate and multivariate regression models are presented in tables 3 and 4 , respectively. Univariate analysis of the variables of intensive alcohol and drug use before or during sex last 12 months. Multivariate analysis of the variables of intensive alcohol and drug use before or during sex last 12 months a. In the final multivariate regression model adjusted for the recruitment site, men aged 25 years of less OR 1. Having a stable partner proved to be a protective factor against frequent alcohol use OR 0. Finally, men who said they had had unprotected sex with casual partners had a 1. Both variables of sexual risk behaviour were significantly associated with the variable frequent drug use before or during sex in the final multivariate model. Thus, men who said they had had more than 20 partners OR 1. According to the multivariate analysis, the younger responders OR 1. Furthermore, the number of partners OR 2. The results of this study reveal a high prevalence of alcohol and drug use before or during sex among MSM recruited in Catalonia, since more than half of those interviewed said that they had used alcohol and drugs during the last year. The prevalence of drug use by MSM is higher than in the general population, whereas that of alcohol use is similar. If we consider the prevalence of the more intensive use of these substances before or during sex, The multivariate analysis of factors related to intensive alcohol and drug use before or during sex showed an association between age and frequent alcohol and multidrug use. This result corroborates those of other studies that show a greater prevalence of use of these substances among young MSM. As in other studies undertaken in the USA and the UK, 8,12,19,27 a clear association was observed between being HIV-positive and frequent use of drugs and multidrug use. Some authors state that many HIV-infected men use these substances to handle the stress brought about by their illness or homophobia or societal prejudice. In this sense, working against the stigma and discrimination that these individuals face will benefit prevention programs. Of the three psychosocial variables analyzed, only having suffered discrimination due to sexual orientation showed a significant association, not only with frequent alcohol use, but also with multidrug use. This association has been observed elsewhere. Finally, and consistent with the results of other studies, 7 , 8 , 10 , 11 , 26 unprotected sex with casual partners was significantly associated with both frequent use of alcohol and drugs and with multidrug use. Furthermore, having a greater number of partners was associated with alcohol and drug use. This is consistent with the results of other studies 7 , 10 , 12 and confirms the use of substances such as poppers, ecstasy, and methamphetamine as aphrodisiacs. The present study has important limitations. First, the respondents were recruited from multiple venues and not from a probability sample; therefore, caution should be exercised in generalizing the findings to all MSM in Catalonia. However, we did try to diversify as much as possible the places, days, and times of our approach to participants in order to minimize this bias. Young people in general are underrepresented in samples recruited from gay venues. For instance, the mean age of MSM surveyed on-line in Spain in was Furthermore, we do not know the characteristics of the men who refused to participate in the study. Secondly, the return rate of the questionnaires was not high, but it was similar to previous surveys and higher than in other studies that used similar methods. Thirdly, we cannot exclude biases of memory and under-reporting of certain risk practices or of the self-reported results of HIV infection. However, the fact that the questionnaire was anonymous and self-administered may have helped reduce this type of risk. The present study is the first to analyse in depth the intensive use of alcohol and drug use before or during sex among MSM in our setting; therefore, our results can help to guide prevention programs in Catalonia. Finally, in order to be efficient, these programs must try to cover MSM-specific psychosocial aspects, tackle discrimination and include prevention and support groups for HIV-positive men. The results of this study reveal a high prevalence of alcohol and drug use before or during sex among MSM recruited in Catalonia. The multivariate analysis showed an association between variables of intensive alcohol and drug use and having suffered discrimination, being HIV-positive and sexual risk behaviour. Google Scholar. Google Preview. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Advertisement intended for healthcare professionals. Sign in through your institution. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. Journal Article. Correlates of intensive alcohol and drug use in men who have sex with men in Catalonia, Spain. Cinta Folch , Cinta Folch. Oxford Academic. Anna Esteve. Kati Zaragoza. Jordi Casabona. Select Format Select format. Permissions Icon Permissions. Abstract Background: The objectives of the study were to determine the prevalence of alcohol and drug use before or during sex among men who have sex with men MSM in Catalonia during , and to identify factors associated with variables of intensive alcohol and drug use. Table 1 Open in new tab. UAI, unprotected anal intercourse. Table 2 Open in new tab. Alcohol use sometimes Table 3 Open in new tab. Frequent alcohol use. Frequent drug use. Multidrug use. Table 4 Open in new tab. Frequent alcohol use b. Frequent drug use c. Multidrug use d. Key points. Technical document; Google Scholar Crossref. Search ADS. Factors associated with unprotected sexual intercourse with steady male, casual male, and female partners among men who have sex with men in Barcelona, Spain. Substance use, substance choice, and unprotected anal intercourse among young Asian American and Pacific Islander men who have sex with men. Unprotected anal intercourse and substance use among men who have sex with men with recent HIV infection. Substance use and sexual behaviours of Japanese men who have sex with men: a nationwide internet survey conducted in Japan. Prevalence and correlates of substance use among young Asian Pacific Islander men who have sex with men. Alcohol use, drug use and alcohol-related problems among men who have sex with men: the Urban Men's Health Study. Intertwining epidemics: A review of research on substance use among men who have sex with men and its connection to the AIDS epidemic. The relationship of substance use with sex to the use of condoms among young adults in two urban areas of Scotland. Google Scholar PubMed. No connection between alcohol use and unsafe sex among gay and bisexual men. Regional patterns and correlates of substance use among young men who have sex with men in 7 US urban areas. Factors associated with HIV seroconversion in gay men in England at the start of the 21st century. Recreational drug use and sexual risk practice among men who have sex with men in the United Kingdom. Correlates of internalized homophobia in a community sample of lesbian and gay men. Longitudinal patterns of methamphetamine, popper amyl nitrite , and cocaine use and high-risk sexual behavior among a cohort of San Francisco men who have sex with men. Sexual risk behavior among HIV-positive men who have sex with men: A literature review. Crystal methamphetamine, its analogues, and HIV infection: medical and psychiatric aspects of a new epidemic. Crystal methamphetamine use predicts incident STD infection among men who have sex with men recruited online: A nested case-control Study. Predictors of substance use over time among gay, lesbian, and bisexual youths: An examination of three hypotheses. All rights reserved. Issue Section:. Download all slides. Comments 0. Add comment Close comment form modal. I agree to the terms and conditions. You must accept the terms and conditions. Add comment Cancel. Submit a comment. Comment title. You have entered an invalid code. Submit Cancel. Thank you for submitting a comment on this article. Your comment will be reviewed and published at the journal's discretion. Please check for further notifications by email. Views More metrics information. Total Views Email alerts Article activity alert. Advance article alerts. New issue alert. Receive exclusive offers and updates from Oxford Academic. 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