Symposia
Health Psychology / Behavioral Medicine - Adult
Trevor A. Hart, Ph.D.
Professor and Director, HIV Prevention Lab
Ryerson University
Toronto, Ontario, Canada
Syed Noor, PhD
Assistant Professor
Louisiana State University -Shreveport
Shreveport, Louisiana
Graham W. Berlin, PhD
Clinical Psychology Graduate Student
Ryerson University
Toronto, ON, Canada
Shayna Skakoon-Sparling, Ph.D.
Post-Doctoral Fellow
Ryerson University
Toronto, ON, Canada
Farideh Tavangar, MSc
Biostatistician
Ryerson University
Toronto, Ontario, Canada
Darrell H.S. Tan, MD, PhD.
Clinician Scientist
St. Michael's Hospital
Toronto, Ontario, Canada
Nathan Lachowsky, PhD
Associate Professor
University of Victoria
Victoria, BC, Canada
Jody Jollimore, MPP
Executive Director
Community Based Research Centre
Vancouver, British Columbia, Canada
Jordan M. Sang, PhD
Postdoctoral Fellow
BC Centre for Excellence in HIV/AIDS
Vancouver, British Columbia, Canada
Abbie Parlette, BA
Site Manager
Ryerson University
Toronto, Ontario, Canada
Herak Apelian, MS
Engage Montreal Research Coordinator
McGill University Health Centre
Montreal, QC, Canada
Gilles Lambert, MD
Medical Consultant
Direction regionale de sante publique
Montreal, QC, Canada
David M. Moore, MD, MPH
Research Scientist
BC Centre for Excellence in HIV/AIDS
Vancouver, British Columbia, Canada
Joseph Cox, MD
Associate Professor
McGill University
Montreal, QC, Canada
Introduction: While crystal methamphetamine use by gay, bisexual, and other men who have sex with men (GBM) is associated with sexually transmitted infection (STI) transmission, less is understood about the pathways by which this may occur. We examined crystal methamphetamine (CM) use and subsequent diagnosed bacterial STIs among GBM. We also examined whether this association is mediated by two types of beliefs (negative attitudes toward condoms and use of substances to escape stress), and sexual behavior,
Methods: Sexually-active GBM, aged ≥16, were recruited through respondent-driven sampling from February 2017-August 2019 in Toronto, Montreal, and Vancouver, Canada. We fit a structural mediation model on the association between baseline CM use and bacterial STI diagnosis at 1-year study follow-up. We estimated indirect paths from CM use to bacterial STIs via: 1) escape motives, 2) negative attitudes toward condoms, and 3) sexual behaviors (condomless anal sex [CAS], number of sex partners, and oral sex), adjusting for demographic variables (age, race, and HIV status).
Results: Among 2,449 GBM, analyses revealed a non-significant direct effect from baseline CM use to STIs at 1-year follow-up in the mediated model (β=.05; 95%CI, -0.06-0.16; p=.38). There were two significant indirect paths from CM use to STI: CM use to negative attitudes toward condoms to CAS to STIs (β=.01; 95%CI, .002-.02; p=.04) and CM use to number of sex partners to CAS to STIs (β=.02; 95%CI, .004-.04; p=.046) were observed. The model fit the data well (weighted root mean square residual=.035).
Discussion: CM use seems to predict subsequent bacterial STIs via negative attitudes toward condoms and via number of sex partners, which, in turn, are associated with CAS. CBT and other behavioral interventions to reduce STIs among CM-using GBM should attend to negative attitudes toward condoms. The data extend syndemic models focusing on substance use and HIV to bacterial STIs. There is a need to better integrate substance use services with STI/sexual health clinics for GBM.