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

interaction and education than men continuing to use poppers. In
contrast, men lapsing to popper use were at higher anal sex risk levels,
perceived themselves to be at higher risk of AIDS, and had experienced
more adverse major life events (stressors) than men who consistently
abstained from popper use. While not a controlled intervention study,
these results indicate the potential for significant differences in sexual
behavior risk in conjunction with stopping or starting the use of poppers.
DISCUSSION
The studies reviewed above indicate that NMPD use is variably
associated with high-risk sex among gay/bisexual men. Important
variables that may affect the degree of consistency of these associations
include the extent of an individual’s NMPD use; sexual context of
NMPD use; intentions regarding changes in sexual behavior; the type of
outcome measurements obtained; geographic variables; and legal
constraints.
The extent of NMPD use, in terms of number, duration, and frequency of
the drugs used, and whether use is habitual or occasional, are important
considerations.
It should be ascertained whether the NMPD use is nonspecific or specific
for sexual contexts. For example, some NMPDs (such as poppers and
ecstasy) are sold primarily in settings where high-risk sexual activities
can take place with multiple partners (such as pornographic bookstores,
bars with backrooms, and gay bathouses), and are therefore more likely to
be associated with unprotected or multiple partnered sexual encounters if
studied only in terms of their global associations.
Measurement should be made regarding the stage of the individual’s
sexual behavior change effort—whether it is precontemplation, initiation
of change, consolidation of change, or maintenance/relapse—that is under
investigation (Peterson et al. 1992b). Temporary lapses to suppressed
high-risk sexual activities that were previously preferred may be
particularly susceptible to the disinhibiting effects of alcohol and
NMPDs.
Another variable to be considered is the nature of the outcome
measurements, i.e., whether they are self-reported sexual behaviors or
actual HIV infections, and whether they are cross-sectional, retrospective,
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