The Context of HIV Risk Among Drug Users and Their Sexual Partners

Using the same interview questions as the Chicago MACS, but
employing a random household survey of unmarried males living in the
San Francisco neighborhoods with the highest rates of reported AIDS
cases, Stall and Wiley (1988) reported on the NMPD use patterns of
1,034 men aged 25 to 54, of whom 286 said they were exclusively
heterosexual and 748 were gay or bisexual. Using a somewhat different
definition of heavy drinking (5 or more drinks on 2 or more nights per
week), the San Francisco Men’s Health Study (SFMHS) sample had rates
of 19 percent and 11 percent heavy drinkers among the gay/bisexual and
heterosexual subsamples, respectively, compared to rates of 28 percent
and 19 percent at the first two baseline assessments of the gay/bisexual
men in the Chicago MACS/CCS. Except for the oldest group
(45 to 54 years) in the SFMHS sample, gay/bisexual men did not differ
from heterosexual men in terms of alcohol use patterns.
In terms of NMPD use prevalence, however, the SFMHS data for
gay/bisexual men is similar to what was found in the Chicago
MACS/CCS at baseline and significantly higher than in the San Francisco
heterosexual male subgroup. Stall and Wiley (1988) reported 25 percent
and 18 percent prevalence use rates for downers and hallucinogens in
their gay/bisexual sample, which compares to the 19 percent and
18 percent rates in the Chicago cohort and 9 percent and 12 percent rates
for downers and hallucinogen use by the San Francisco heterosexual male
sample. The SFMHS gay/bisexual subgroup did report somewhat higher
baseline rates of reported use of cocaine (52 percent), opiates (4 percent),
and uppers (28 percent) than did the Chicago sample. Conversely,
popper use was reported by 58 percent of SFMHS respondents and MDA
use by 9 percent, compared to initial rates of use of 71 percent and
15 percent, respectively, by the Chicago MACS/CCS sample.
The third relevant sample is the diverse community-based sample of
746 New York City (NYC) gay/bisexual men recruited by Martin and
Dean in early 1985 (Martin et al. 1989). In three yearly interviews of
their cohort, the investigators determined both prevalence of NMPD use
and alcohol abuse/dependence disorder. They reported a 12 percent rate
of alcohol abuse or dependence in 1986, which dropped to 9 percent in
1987. In terms of NMPD use, Martin and Dean’s NYC cohort appears
similar to the Chicago MACS/CCS cohort during the period 1984-1987,
with the exception of inhaled nitrites, which were reportedly used by
45 percent of the NYC cohort in 1984/1985 and approximately
25 percent of the men in 1986/1987.
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