Pathways to HIV risk and vulnerability among lesbian, gay, bisexual, and transgendered methamphetamine users: a multi-cohort gender-based analysis

BMC Public Health

Research Article

Julio SG Montaner¹  Thomas Kerr¹  Evan Wood¹  Brandon DL Marshall²  Thomas L Patterson³  Jean A Shoveller⁴ 

[1] British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, V6Z 1Y6, Vancouver, BC, Canada;Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, V6Z 1Y6, Vancouver, BC, Canada;British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, V6Z 1Y6, Vancouver, BC, Canada;School of Population and Public Health, University of British Columbia, 2206 East Mall, V6T 1Z3, Vancouver, BC, Canada;Department of Psychiatry, University of California, 9500 Gilman Drive, 92093-0680, La Jolla, California, USA;School of Population and Public Health, University of British Columbia, 2206 East Mall, V6T 1Z3, Vancouver, BC, Canada;

关键词: Methamphetamine;    Sexual Minority;    Unprotected Intercourse;    Sexual Minority Woman;    Aboriginal Ancestry;   

DOI  :  10.1186/1471-2458-11-20

 received in 2010-07-28, accepted in 2011-01-07,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundMethamphetamine (MA) use continues to be a major public health concern in many urban settings. We sought to assess potential relationships between MA use and individual, social, and structural HIV vulnerabilities among sexual minority (lesbian, gay, bisexual or transgendered) drug users.MethodsBeginning in 2005 and ending in 2008, 2109 drug users were enroled into one of three cohort studies in Vancouver, Canada. We analysed longitudinal data from all self-identified sexual minority participants (n = 248). Logistic regression using generalized estimating equations (GEE) was used to examine the independent correlates of MA use over time. All analyses were stratified by biological sex at birth.ResultsAt baseline, 104 (7.5%) males and 144 (20.4%) females reported sexual minority status, among whom 64 (62.1%) and 58 (40.3%) reported MA use in the past six months, respectively. Compared to heterosexual participants, sexual minority males (odds ratio [OR] = 3.74, p < 0.001) and females (OR = 1.80, p = 0.003) were more likely to report recent MA use. In multivariate analysis, MA use among sexual minority males was associated with younger age (adjusted odds ratio [AOR] = 0.93 per year older, p = 0.011), Aboriginal ancestry (AOR = 2.59, p = 0.019), injection drug use (AOR = 3.98, p < 0.001), having a legal order or area restriction (i.e., "no-go zone") impact access to services or influence where drugs are used or purchased (AOR = 4.18, p = 0.008), unprotected intercourse (AOR = 1.62, p = 0.048), and increased depressive symptoms (AOR = 1.67, p = 0.044). Among females, MA use was associated with injection drug use (AOR = 2.49, p = 0.002), Downtown South residency (i.e., an area known for drug use) (AOR = 1.60, p = 0.047), and unprotected intercourse with sex trade clients (AOR = 2.62, p = 0.027).ConclusionsMethamphetamine use was more prevalent among sexual minority males and females and was associated with different sets of HIV risks and vulnerabilities. Our findings suggest that interventions addressing MA-related harms may need to be informed by more nuanced understandings of the intersection between drug use patterns, social and structural HIV vulnerabilities, and gender/sexual identities. In particular, MA-focused prevention and treatment programs tailored to disenfranchised male and female sexual minority youth are recommended.

【 授权许可】

Unknown   
© Marshall et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.