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Published in: Journal of Community Health 1/2013

01-02-2013 | Original Paper

Substance Use and Sexual Risk Mediated by Social Support Among Black Men

Authors: Mance E. Buttram, Steven P. Kurtz, Hilary L. Surratt

Published in: Journal of Community Health | Issue 1/2013

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Abstract

Health and social disparities are widespread among men who have sex with men (MSM). Although literature indicates that Black MSM (BMSM) are no more likely than other MSM to report sexual risk behaviors, such as unprotected anal intercourse, studies have reported that buying and trading sex appear to be important risk factors for BMSM. Substance use generally is not significantly greater among BMSM than other MSM, studies have found that BMSM report more powder and crack cocaine use than other MSM. The lack of adequate coping skills and social support for BMSM has also been documented. This paper examines differences in substance use, sexual risk behaviors and social support among Black and non-black MSM, in a sample of 515 men participating in a randomized intervention trial. BMSM reported higher rates of substance dependence (72.2 vs. 59.5 %, P = .015) and buying sex (49.1 vs. 17.4 %, P < .000) than non-Black MSM. BMSM also reported lower levels of social support than other MSM on all measures included in the study; e.g., getting help and emotional support from others (38.0 vs. 52.8 %, P < .006). Mediation analyses showed that BMSM’s higher rates of substance dependence and buying sex are partially mediated by lower levels of social support. Our data appear to show that lack of social support is an important influence on risk behaviors among BMSM. Qualitative data also supported these findings. Sexual risk and substance use prevention interventions should address BMSM’s capacity to build adequate and supportive relationships.
Literature
1.
go back to reference Bruce, D., Harper, G. W., & Adolescent Medicine Trials Network for HIV/AIDS. (2011). Operating without a safety net: Gay male adolescents and emerging adults’ experiences of marginalization and migration, and implications for theory of syndemic production of health disparities. Health Education & Behavior, 38(4), 367–378.CrossRef Bruce, D., Harper, G. W., & Adolescent Medicine Trials Network for HIV/AIDS. (2011). Operating without a safety net: Gay male adolescents and emerging adults’ experiences of marginalization and migration, and implications for theory of syndemic production of health disparities. Health Education & Behavior, 38(4), 367–378.CrossRef
2.
go back to reference Stall, R., Friedman, M., & Catania, J. A. (2008). Interacting epidemics and gay men’s health: A theory of syndemic production among urban gay men. In R. J. Wolitski, R. Stall, & R. O. Valiserri (Eds.), Unequal opportunity: Health disparities affecting gay and bisexual men in the United States (pp. 251–274). New York, NY: Oxford University Press. Stall, R., Friedman, M., & Catania, J. A. (2008). Interacting epidemics and gay men’s health: A theory of syndemic production among urban gay men. In R. J. Wolitski, R. Stall, & R. O. Valiserri (Eds.), Unequal opportunity: Health disparities affecting gay and bisexual men in the United States (pp. 251–274). New York, NY: Oxford University Press.
4.
go back to reference Cochran, S. D., & Mays, V. M. (2008). Prevalence of primary mental health morbidity and suicide symptoms among gay and bisexual men. In R. J. Wolitski, R. Stall, & R. O. Valiserri (Eds.), Unequal opportunity: Health disparities affecting gay and bisexual men in the United States. New York, NY: Oxford University Press. Cochran, S. D., & Mays, V. M. (2008). Prevalence of primary mental health morbidity and suicide symptoms among gay and bisexual men. In R. J. Wolitski, R. Stall, & R. O. Valiserri (Eds.), Unequal opportunity: Health disparities affecting gay and bisexual men in the United States. New York, NY: Oxford University Press.
5.
go back to reference Garofalo, R., Mustanski, B., Johnson, A., & Emerson, E. (2010). Exploring factors that underlie racial/ethnic disparities in HIV risk among young men who have sex with men. Journal of Urban Health, 87(2), 318–323.PubMedCrossRef Garofalo, R., Mustanski, B., Johnson, A., & Emerson, E. (2010). Exploring factors that underlie racial/ethnic disparities in HIV risk among young men who have sex with men. Journal of Urban Health, 87(2), 318–323.PubMedCrossRef
6.
go back to reference Wolitski, R. J., Valiserri, R. O., & Stall, R. (2008). Health disparities affecting gay and bisexual men in the United States: An introduction. In R. J. Wolitski, R. Stall, & R. O. Valiserri (Eds.), Unequal opportunity: Health disparities affecting gay and bisexual men in the United States (pp. 3–32). New York, NY: Oxford University Press. Wolitski, R. J., Valiserri, R. O., & Stall, R. (2008). Health disparities affecting gay and bisexual men in the United States: An introduction. In R. J. Wolitski, R. Stall, & R. O. Valiserri (Eds.), Unequal opportunity: Health disparities affecting gay and bisexual men in the United States (pp. 3–32). New York, NY: Oxford University Press.
7.
go back to reference Alvy, L. M. M., David, J., Mansergh, G., et al. (2011). Depression is associated with sexual risk among men who have sex with men, but is mediated by cognitive escape and self-efficacy. AIDS and Behavior, 15, 1171–1179.PubMedCrossRef Alvy, L. M. M., David, J., Mansergh, G., et al. (2011). Depression is associated with sexual risk among men who have sex with men, but is mediated by cognitive escape and self-efficacy. AIDS and Behavior, 15, 1171–1179.PubMedCrossRef
8.
go back to reference Mays, V. M., Cochran, S. D., & Zamudio, A. (2004). HIV prevention research: Are we meeting the needs of African American men who have sex with men? Journal of Black Psychology, 30(1), 78–105.PubMedCrossRef Mays, V. M., Cochran, S. D., & Zamudio, A. (2004). HIV prevention research: Are we meeting the needs of African American men who have sex with men? Journal of Black Psychology, 30(1), 78–105.PubMedCrossRef
9.
go back to reference Centers for Disease Control and Prevention. (2009). HIV/AIDS Surveillance Report, 2007, Vol. 19. Centers for Disease Control and Prevention. (2009). HIV/AIDS Surveillance Report, 2007, Vol. 19.
10.
go back to reference Millett, G. A., Peterson, J. L., Wolitski, R. J., & Stall, R. (2006). Greater risk for HIV infection of Black men who have sex with men: A critical literature review. American Journal of Public Health, 96(9), 1007–1019.PubMedCrossRef Millett, G. A., Peterson, J. L., Wolitski, R. J., & Stall, R. (2006). Greater risk for HIV infection of Black men who have sex with men: A critical literature review. American Journal of Public Health, 96(9), 1007–1019.PubMedCrossRef
11.
go back to reference Semple, S. J., Strathdee, S. A., Zians, J., & Patterson, T. L. (2010). Social and behavioral characteristics of HIV-positive MSM who trade sex for methamphetamine. American Journal of Drug and Alcohol Abuse, 36, 325–331.PubMedCrossRef Semple, S. J., Strathdee, S. A., Zians, J., & Patterson, T. L. (2010). Social and behavioral characteristics of HIV-positive MSM who trade sex for methamphetamine. American Journal of Drug and Alcohol Abuse, 36, 325–331.PubMedCrossRef
12.
go back to reference Miller, M., Serner, M., & Wagner, M. (2005). Sexual diversity among Black men who have sex with men in an inner-city community. Journal of Urban Health, 82(1, Supplement 1), i26–i34. Miller, M., Serner, M., & Wagner, M. (2005). Sexual diversity among Black men who have sex with men in an inner-city community. Journal of Urban Health, 82(1, Supplement 1), i26–i34.
13.
go back to reference Shoptaw, S., Weiss, R. E., Munjas, B., Hucks-Ortiz, C., Young, S. D., Larkins, S., et al. (2009). Homonegativity, substance use, sexual risk behaviors, and HIV status in poor and ethnic men who have sex with men in Los Angeles. Journal of Urban Health, 86(1), S77–S92.CrossRef Shoptaw, S., Weiss, R. E., Munjas, B., Hucks-Ortiz, C., Young, S. D., Larkins, S., et al. (2009). Homonegativity, substance use, sexual risk behaviors, and HIV status in poor and ethnic men who have sex with men in Los Angeles. Journal of Urban Health, 86(1), S77–S92.CrossRef
14.
go back to reference Hatfield, L. A., Horvath, K. J., Jacoby, S. M., & Rosser, B. R. (2009). Comparison of substance use and risky sexual behavior among a diverse sample of urban, HIV-positive men who have sex with men. Journal of Addictive Diseases, 28(3), 208–218.PubMedCrossRef Hatfield, L. A., Horvath, K. J., Jacoby, S. M., & Rosser, B. R. (2009). Comparison of substance use and risky sexual behavior among a diverse sample of urban, HIV-positive men who have sex with men. Journal of Addictive Diseases, 28(3), 208–218.PubMedCrossRef
15.
go back to reference Tobin, K. E., German, D., Spikes, P., Patterson, J. & Latkin, C. (2011). A comparison of the social and sexual networks of crack-using and non-crack using African American men who have sex with men. Journal of Urban Health [Epub Ahead of Print]. Tobin, K. E., German, D., Spikes, P., Patterson, J. & Latkin, C. (2011). A comparison of the social and sexual networks of crack-using and non-crack using African American men who have sex with men. Journal of Urban Health [Epub Ahead of Print].
16.
go back to reference Harawa, N. T., Williams, J. K., Ramamurthi, H. C., Manago, C., Avina, S., & Jones, M. (2008). Sexual behavior, sexual identity, and substance abuse among low-income bisexual and non-gay-identifying African American men who have sex with men. Archives of Sex Behavior, 37(5), 748–762.CrossRef Harawa, N. T., Williams, J. K., Ramamurthi, H. C., Manago, C., Avina, S., & Jones, M. (2008). Sexual behavior, sexual identity, and substance abuse among low-income bisexual and non-gay-identifying African American men who have sex with men. Archives of Sex Behavior, 37(5), 748–762.CrossRef
17.
go back to reference Kraft, J. M., Beeker, C., Stokes, J. P., & Peterson, J. L. (2000). Finding the “community” in community-level HIV/AIDS interventions: Formative research with young African American men who have sex with men. Health Education & Behavior, 27(4), 430–441.CrossRef Kraft, J. M., Beeker, C., Stokes, J. P., & Peterson, J. L. (2000). Finding the “community” in community-level HIV/AIDS interventions: Formative research with young African American men who have sex with men. Health Education & Behavior, 27(4), 430–441.CrossRef
18.
go back to reference Glick, S. N., & Golden, M. R. (2010). Persistence of racial differences in attitudes toward homosexuality in the United States. Journal of Acquired Immune Deficiency Syndrome, 55(4), 516–523.CrossRef Glick, S. N., & Golden, M. R. (2010). Persistence of racial differences in attitudes toward homosexuality in the United States. Journal of Acquired Immune Deficiency Syndrome, 55(4), 516–523.CrossRef
19.
go back to reference McKirnan, D. J., Vanable, P. A., Ostrow, D. G., & Hope, B. (2001). Expectancies of sexual ‘escape’ and sexual risk among drug and alcohol-involved gay and bisexual men. Journal of Substance Abuse, 13(1–2), 137–154.PubMedCrossRef McKirnan, D. J., Vanable, P. A., Ostrow, D. G., & Hope, B. (2001). Expectancies of sexual ‘escape’ and sexual risk among drug and alcohol-involved gay and bisexual men. Journal of Substance Abuse, 13(1–2), 137–154.PubMedCrossRef
20.
go back to reference Wolin, S., & Wolin, S. (1995). Resilience among youth growing up in substance-abusing families. Pediatric Clinics of North America, 42(2), 415–429.PubMed Wolin, S., & Wolin, S. (1995). Resilience among youth growing up in substance-abusing families. Pediatric Clinics of North America, 42(2), 415–429.PubMed
21.
go back to reference Smith, D. M., & Gates, G. (2001). Gay and lesbian families in the United States: Same-sex unmarried partner households: a preliminary analysis of 2000 United States Census data, a human rights campaign report. Washington, DC: Human Rights Campaign. Smith, D. M., & Gates, G. (2001). Gay and lesbian families in the United States: Same-sex unmarried partner households: a preliminary analysis of 2000 United States Census data, a human rights campaign report. Washington, DC: Human Rights Campaign.
23.
go back to reference Sarason, I. G., Levine, H. M., Basham, R. B., & Sarason, B. R. (1983). Assessing social support: The social support questionnaire. Journal of Personality and Social Psychology, 44(1), 127–139.CrossRef Sarason, I. G., Levine, H. M., Basham, R. B., & Sarason, B. R. (1983). Assessing social support: The social support questionnaire. Journal of Personality and Social Psychology, 44(1), 127–139.CrossRef
24.
go back to reference West, D. J. (1992). Male prostitution. New York City, NY: The Haworth Press. West, D. J. (1992). Male prostitution. New York City, NY: The Haworth Press.
25.
go back to reference Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.PubMedCrossRef Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.PubMedCrossRef
26.
go back to reference Glaser, B. G., & Strauss, A. L. (1967). Discovery of grounded theory: Strategies for qualitative research. Hawthorne, NY: Walter de Guyter. Glaser, B. G., & Strauss, A. L. (1967). Discovery of grounded theory: Strategies for qualitative research. Hawthorne, NY: Walter de Guyter.
27.
go back to reference Mimiaga, M. J., Reisner, S. L., Cranston, D. I., Bright, D., Daffin, G., Bland, S., et al. (2009). Sexual mixing patterns and partner characteristics of Black MSM in Massachusetts at increased risk for HIV infection and transmission. Journal of Urban Health, 86(4), 602–623.PubMedCrossRef Mimiaga, M. J., Reisner, S. L., Cranston, D. I., Bright, D., Daffin, G., Bland, S., et al. (2009). Sexual mixing patterns and partner characteristics of Black MSM in Massachusetts at increased risk for HIV infection and transmission. Journal of Urban Health, 86(4), 602–623.PubMedCrossRef
28.
go back to reference Carlos, J. A., Bingham, T. A., Stueve, A., Lauby, J., Ayala, G., Millett, G. A., et al. (2010). The role of peer support on condom use among black and Latino MSM in three urban areas. AIDS Education and Prevention, 22(5), 430–444.PubMedCrossRef Carlos, J. A., Bingham, T. A., Stueve, A., Lauby, J., Ayala, G., Millett, G. A., et al. (2010). The role of peer support on condom use among black and Latino MSM in three urban areas. AIDS Education and Prevention, 22(5), 430–444.PubMedCrossRef
Metadata
Title
Substance Use and Sexual Risk Mediated by Social Support Among Black Men
Authors
Mance E. Buttram
Steven P. Kurtz
Hilary L. Surratt
Publication date
01-02-2013
Publisher
Springer US
Published in
Journal of Community Health / Issue 1/2013
Print ISSN: 0094-5145
Electronic ISSN: 1573-3610
DOI
https://doi.org/10.1007/s10900-012-9582-8

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