In a household-based survey, MSM who reported heavy alcohol consumption were 2.5 times more likely to be HIV-positive [14]. Consumption of illicit drugs is also a risk factor for HIV infection among MSM. Various longitudinal studies have demonstrated the relevance of illicit drug use as a factor in HIV seroconversion of initially HIV-negative MSM [8, 22-25]. Use of stimulants, amyl nitrite and erectile dysfunction medication (such as sildenafil) were independent predictors of unprotected anal intercourse. The relative risk ratio for new infections rose by as much as
eightfold when substances were consumed in combination [26, 27]. MSM who take erectile dysfunction medication regularly are more likely to have unprotected anal intercourse and multiple partners [28-30]. A target population for interventions Dinaciclib research buy to reduce sexual risk behaviour in HIV-positive MSM is patients in specialized medical care. Although numerous studies have been learn more carried out on substance use and sexual risk behaviour in MSM in general, only a few studies have focused on this target population. In the Healthy Living Project [31], 1910 HIV-positive MSM in specialized medical care were included in an analysis of different predictors of sexual risk behaviour. The rate of unprotected anal intercourse with a negative or serostatus-unknown partner was relatively low (12%). Illicit drug taking, especially stimulant use, was
a significant predictor of unprotected anal intercourse. Alcohol use predicted unprotected sex with casual partners [32, 33]. Drumright et al. [34] examined MSM (n = 194) who had been diagnosed HIV-positive in the last 12 months. More than half of the subjects reported substance use in the context of sexual activity with at least one partner. In those cases, unprotected anal intercourse was more likely. Methamphetamine and cannabis were the strongest predictors for unprotected sex. Substance use increased the risk Exoribonuclease of HIV transmission to a sexual partner, especially in the context of a recent HIV infection, where infectiousness is high. In a sample of HIV-positive
MSM in specialized medical care, one-third reported unprotected anal intercourse with a serodiscordant or serostatus-unknown partner in the last 12 months. Unprotected anal intercourse was significantly correlated with consumption of cocaine, amyl nitrite, heroin and methamphetamine and taking of erectile dysfunction medication [35]. According to Morin et al. [36], stimulant use was a significant predictor of unprotected insertive sexual intercourse in a sample of HIV-positive patients [37]. In summary, only a few studies have been carried out on sexual risk behaviour and substance use in HIV-positive MSM in specialized medical care. In addition, these studies were carried out in the USA, and data from the USA may not be representative of the behaviour of MSM in Europe.