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Miles McNall, PhD; Gary Remafedi, MD, MPH

Arch Pediatr Adolesc Med. 1999;153:1130-1135.

Objectives  To analyze temporal trends in drug use and the relationship between drug use before or during sex and unprotected intercourse among a sample of young gay and bisexual men.

Methods  Data were obtained from cross-sectional surveys of 9 annual cohorts. Respondents were 877,13- to 21-year-old gay and bisexual male volunteers. Trends in the use of substances before or during sex were analyzed. Univariate and multivariate measures of the association between substance use before or during sex and unprotected anal intercourse were calculated.

Results  Between 1994 and 1997, the use of marijuana, cocaine, amphetamines, and mean scores on a measure of overall drug use severity increased significantly in a sample of young gay and bisexual men. Significant univariate associations were found between drug use before or during sex and unprotected anal intercourse for the following substances: alcohol, marijuana, cocaine, amphetamines, barbiturates, heroin, LSD, volatile nitrites, tranquilizers, and methaqualone. In multivariate analyses, however, only cocaine use predicted failure to use condoms during anal intercourse.

Conclusion  Although amphetamine and other drug use increased among young gay and bisexual men, only cocaine use was a significant, independent predictor of the failure to use condoms during anal intercourse.

From the Department of Pediatrics, University of Minnesota, Minneapolis.

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