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BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Gender-specific differences in high-risk sexual behaviors among methamphetamine users in Myanmar-China border city, Muse, Myanmar: who is at risk?

Authors: Yu Mon Saw, Thu Nandar Saw, Nyein Chan, Su Myat Cho, Masamine Jimba

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

Methamphetamine (MA) use is a significant public health concern due to its negative effects on health. However, to date, no epidemiological research has examined high-risk sexual behaviors (inconsistent condom use, having multiple sexual partners and having a history of sexually transmitted infections) among MA users. This topic is particularly important in Myanmar, which is recognized as one of the key MA production countries in the Southeast Asia region. Therefore, this study examined factors associated with high-risk sexual behaviors among MA users in Muse city, Myanmar.

Methods

A community-based cross-sectional study was conducted from January to March 2013 in Muse city, Northern Shan State, Myanmar. In total, 1183 MA users (772 male; 411 female) were recruited using respondent-driven sampling and a computer assisted self-interviewing method. Generalized estimating equation models were used to examine factors associated with high-risk sexual behaviors.

Results

A large proportion of MA users engaged in high-risk sexual behaviors (inconsistent condom use: males, 90.7%, females, 85.2%; multiple sexual partners: males, 94.2%, females, 47.2%; and history of STIs: males, 55.7%, females, 56.0%). Among males, being a multiple stimulants drug user (adjusted odds ratio [AOR] =1.77; 95% confidence interval [CI] =1.30–2.41) and being a client of sex workers (AOR = 1.41; 95% CI = 1.08–1.83) were risk factors for engaging in high-risk sexual behaviors. Among females, being a migrant worker (AOR = 2.70; 95% CI = 1.86–3.93) and being employed (AOR = 1.57; 95% CI = 1.13–2.18) were risk factors for engaging in high-risk sexual behaviors as well.

Conclusions

High-risk sexual behaviors were particularly pronounced among both male and female MA users. MA prevention programs that reflect gender considerations should be developed to pay more attention to vulnerable populations such as migrants, clients of sex workers, and less educated female MA users.
Literature
1.
Thompson PM, Hayashi KM, Simon SL, Geaga JA, Hong MS, Sui Y, Lee JY, Toga AW, Ling W, London ED. Structural abnormalities in the brains of human subjects who use methamphetamine. J Neurosci. 2004;24:6028–36.CrossRefPubMed
2.
3.
Rawson RA, Washton A, Domier CP, Reiber C. Drugs and sexual effects: role of drug type and gender. J Subst Abus Treat. 2002;22:103–8.CrossRef
4.
Steinberg JK, Grella CE, Boudov MR, Kerndt PR, Kadrnka CM. Methamphetamine use and high-risk sexual behaviors among incarcerated female adolescents with a diagnosed STD. J Urban Health. 2011;88:352–64.CrossRefPubMedPubMedCentral
5.
6.
Semple SJ, Zians J, Grant I, Patterson TL. Sexual compulsivity in a sample of HIV-positive methamphetamine-using gay and bisexual men. AIDS Behav. 2006;10:587–98.CrossRefPubMed
7.
Molitor F, Truax SR, Ruiz JD, Sun RK. Association of methamphetamine use during sex with risky sexual behaviors and HIV infection among non-injection drug users. West J Med. 1998;168:93–7.PubMedPubMedCentral
8.
Saw YM, Saw TN, Wai KM, Poudel KC, Win HH. Correlates of sex trading among male non-injecting drug users in Myanmar: a cross-sectional study. Harm Reduct J. 2016;13:34.CrossRefPubMedPubMedCentral
9.
Sattah MV, Supawitkul S, Dondero TJ, Kilmarx PH, Young NL, Mastro TD, Chaikummao S, Manopaiboon C, Griensven F. Prevalence of and risk factors for methamphetamine use in northern Thai youth: results of an audio-computer-assisted self-interviewing survey with urine testing. Addiction. 2002;97:801–8.CrossRefPubMed
10.
Browne DC, Clubb PA, Wang Y, Wagner F. Drug use and high-risk sexual behaviors among african american men who have sex with men and men who have sex with women. Am J Public Health. 2009;99:1062–6.CrossRefPubMedPubMedCentral
11.
12.
Zapata LB, Hillis SD, Marchbanks PA, Curtis KM, Lowry R. Methamphetamine use is independently associated with recent risky sexual behaviors and adolescent pregnancy. J Sch Health. 2008;78:641–8.CrossRefPubMed
13.
Halkitis PN, Parsons JT, Stirratt MJ. A double epidemic: crystal methamphetamine drug use in relation to HIV transmission among gay men. J Homosex. 2001;41:17–35.CrossRefPubMed
14.
Frohmader KS, Lehman MN, Laviolette SR, Coolen LM. Concurrent exposure to methamphetamine and sexual behavior enhances subsequent drug reward and causes compulsive sexual behavior in male rats. J Neurosci. 2011;31:16473–82.CrossRefPubMed
15.
Fisher DG, Reynolds GL, Ware MR, Napper LE. Methamphetamine and Viagra use: relationship to sexual risk behaviors. Arch Sex Behav. 2011;40:273–9.CrossRefPubMed
16.
Mansergh G, Shouse RL, Marks G, Guzman R, Rader M, Buchbinder S, Colfax GN. Methamphetamine and sildenafil (Viagra) use are linked to unprotected receptive and insertive anal sex, respectively, in a sample of men who have sex with men. Sex Transm Infect. 2006;82:131–4.CrossRefPubMedPubMedCentral
17.
Semple SJ, Strathdee SA, Zians J, Patterson TL. Correlates of trading sex for methamphetamine in a sample of HIV-negative heterosexual methamphetamine users. J Psychoactive Drugs. 2011;43:79–88.CrossRefPubMedPubMedCentral
18.
McKetin R, Kozel N, Douglas J, Ali R, Vicknasingam B, Lund J, Li JH. The rise of methamphetamine in southeast and East Asia. Drug Alcohol Rev. 2008;27:220–8.CrossRefPubMed
19.
Shain RN, Perdue ST, Piper JM, Holden AE, Champion JD, Newton ER, Korte JE. Behaviors changed by intervention are associated with reduced STD recurrence: the importance of context in measurement. Sex Transm Dis. 2002;29:520–9.CrossRefPubMed
20.
Wellings K, Collumbien M, Slaymaker E, Singh S, Hodges Z, Patel D, Bajos N. Sexual behaviour in context: a global perspective. Lancet. 2006;368:1706–28.CrossRefPubMed
21.
22.
Barr AM, Panenka WJ, MacEwan GW, Thornton AE, Lang DJ, Honer WG, Lecomte T. The need for speed: an update on methamphetamine addiction. J Psychiatry Neurosci. 2006;31:301–13.PubMedPubMedCentral
23.
MOH/NAP: Progress Report 2010. National Strategic Plan for HIV/AIDS in Myanmar. In. National AIDS Programme, Ministry of Health, Myanmar. 2009.
24.
MOH/NAP: Global AIDS Response Progress Report Myanmar. In. National AIDS Programme, Ministry of Health and Sports, Myanmar. 2015.
25.
Yen CF. Relationship between methamphetamine use and risky sexual behavior in adolescents. Kaohsiung J Med Sci. 2004;20:160–5.CrossRefPubMed
26.
Springer AE, Peters RJ, Shegog R, White DL, Kelder SH. Methamphetamine use and sexual risk behaviors in U.S. high school students: findings from a national risk behavior survey. Prev Sci. 2007;8:103–13.CrossRefPubMed
27.
Paz-Bailey G, Jacobson JO, Guardado ME, Hernandez FM, Nieto AI, Estrada M, Creswell J. How many men who have sex with men and female sex workers live in El Salvador? Using respondent-driven sampling and capture-recapture to estimate population sizes. Sex Transm Infect. 2011;87:279–82.CrossRefPubMed
28.
29.
Metzger DS, Koblin B, Turner C, Navaline H, Valenti F, Holte S, Gross M, Sheon A, Miller H, Cooley P, et al. Randomized controlled trial of audio computer-assisted self-interviewing: utility and acceptability in longitudinal studies. HIVNET Vaccine Preparedness Study Protocol Team Am J Epidemiol. 2000;152:99–106.PubMed
30.
Bangsberg DR, Bronstone A, Chesney MA, Hecht FM. Computer-assisted self-interviewing (CASI) to improve provider assessment of adherence in routine clinical practice. J Acquir Immune Defic Syndr. 2002;31(Suppl 3):S107–11.CrossRefPubMed
31.
Ghanem KG, Hutton HE, Zenilman JM, Zimba R, Erbelding EJ. Audio computer assisted self interview and face to face interview modes in assessing response bias among STD clinic patients. Sex Transm Infect. 2005;81:421–5.CrossRefPubMedPubMedCentral
32.
Saw YM, Yasuoka J, Saw TN, Poudel KC, Tun S, Jimba M. What are the factors associated with HIV testing among male injecting and non-injecting drug users in Lashio, Myanmar: a cross-sectional study. BMJ Open. 2013;3:e002747.CrossRefPubMedPubMedCentral
33.
Saw YM, Saw TN, Yasuoka J, Chan N, Kham NPE, Khine W, Cho SM, Jimba M. Gender difference in early initiation of methamphetamine use among current methamphetamine users in muse, northern Shan State, Myanmar. Harm Reduct J. 2017;14:21.CrossRefPubMedPubMedCentral
34.
Johnston LG, Sabin K, Mai TH, Pham TH. Assessment of respondent driven sampling for recruiting female sex workers in two Vietnamese cities: reaching the unseen sex worker. J Urban Health. 2006;83:16–28.CrossRefPubMedCentral
35.
Simic M, Johnston LG, Platt L, Baros S, Andjelkovic V, Novotny T, Rhodes T. Exploring barriers to ‘respondent driven sampling’ in sex worker and drug-injecting sex worker populations in Eastern Europe. J Urban Health. 2006;83:6–15.CrossRefPubMedCentral
36.
Platt L, Wall M, Rhodes T, Judd A, Hickman M, Johnston LG, Renton A, Bobrova N, Sarang A. Methods to recruit hard-to-reach groups: comparing two chain referral sampling methods of recruiting injecting drug users across nine studies in Russia and Estonia. J Urban Health. 2006;83:39–53.CrossRefPubMedCentral
37.
Saw YM, Poudel KC, Kham NP, Chan N, Cope JE, Wai KM, Tun S, Saw TN. Assessment of HIV testing among young methamphetamine users in muse, northern Shan State, Myanmar. BMC Public Health. 2014;14:735.CrossRefPubMedPubMedCentral
38.
Martins SS, Ghandour LA, Chilcoat HD. Profile of dependence symptoms among extramedical opioid analgesic users. Addict Behav. 2007;32:2003–19.CrossRefPubMed
39.
Semple SJ, Patterson TL, Grant I. Motivations associated with methamphetamine use among HIV+ men who have sex with men. J Subst Abus Treat. 2002;22:149–56.CrossRef
40.
Schilder AJ, Lampinen TM, Miller ML, Hogg RS. Crystal methamphetamine and ecstasy differ in relation to unsafe sex among young gay men. Can J Public Health. 2005;96:340–3.PubMed
41.
Green AI, Halkitis PN. Crystal methamphetamine and sexual sociality in an urban gay subculture: an elective affinity. Cult Health Sex. 2006;8:317–33.CrossRefPubMed
42.
Moon MW, Binson D, Page-Shafer K, Diaz R. Correlates of HIV risk in a random sample of street youths in San Francisco. J Assoc Nurses AIDS Care. 2001;12:18–27.CrossRefPubMed
43.
Couture MC, Evans JL, Sothy NS, Stein ES, Sichan K, Maher L, Page K. Correlates of amphetamine-type stimulant use and associations with HIV-related risks among young women engaged in sex work in Phnom Penh, Cambodia. Drug Alcohol Depend. 2012;120:119–26.CrossRefPubMed
44.
CDC. Methamphetamine Use and HIV risk behaviors among heterosexual men --- preliminary results from five northern California counties, December 2001--November 2003. MMWR Morb Mortal Wkly Rep. 2006;55:273–7.
45.
Semple SJ, Patterson TL, Grant I. The context of sexual risk behavior among heterosexual methamphetamine users. Addict Behav. 2004;29:807–10.CrossRefPubMed
46.
Santos GM, Coffin PO, Das M, Matheson T, DeMicco E, Raiford JL, Vittinghoff E, Dilley JW, Colfax G, Herbst JH. Dose-response associations between number and frequency of substance use and high-risk sexual behaviors among HIV-negative substance-using men who have sex with men (SUMSM) in San Francisco. J Acquir Immune Defic Syndr. 2013;63:540–4.CrossRefPubMedPubMedCentral
47.
Colfax G, Coates TJ, Husnik MJ, Huang Y, Buchbinder S, Koblin B, Chesney M, Vittinghoff E, Team ES. Longitudinal patterns of methamphetamine, popper (amyl nitrite), and cocaine use and high-risk sexual behavior among a cohort of san francisco men who have sex with men. J Urban Health. 2005;82:62–70.CrossRef
48.
Allen ES, Atkins DC, Baucom DH, Snyder DK, Gordon KC, Glass SP. Intrapersonal, interpersonal, and contextual factors in engaging in and responding to extramarital involvement. Clin Psychol Sci Pract. 2005;12:101–30.CrossRef
49.
Atkins DC, Baucom DH, Jacobson NS. Understanding infidelity: correlates in a national random sample. J Fam Psychol. 2001;15:735–49.CrossRefPubMed
50.
Htun NSN, Phoolcharoen W, Perngparn U. HIV/AIDS risk behaviors among Myanmar migrants in Bangkok, Thailand. J Health Res. 2009;29(Suppl):B7–90.
51.
Pradhan B. HIV and Bangladeshi women migrant workers - an assessment of vulnerabilities and gaps in services. International organization for. Migration. 2012;
52.
Rajasingham R, Mimiaga MJ, White JM, Pinkston MM, Baden RP, Mitty JA. A systematic review of behavioral and treatment outcome studies among HIV-infected men who have sex with men who abuse crystal methamphetamine. AIDS Patient Care STDs. 2012;26:36–52.CrossRefPubMedPubMedCentral
53.
Darke S, Kaye S, McKetin R, Duflou J. Major physical and psychological harms of methamphetamine use. Drug Alcohol Rev. 2008;27:253–62.CrossRefPubMed
54.
Plankey MW, Ostrow DG, Stall R, Cox C, Li X, Peck JA, Jacobson LP. The relationship between methamphetamine and popper use and risk of HIV seroconversion in the multicenter AIDS cohort study. J Acquir Immune Defic Syndr. 2007;45:85–92.CrossRefPubMedPubMedCentral
55.
Semple SJ, Strathdee SA, Zians J, Patterson TL. Sexual risk behavior associated with co-administration of methamphetamine and other drugs in a sample of HIV-positive men who have sex with men. Am J Addict. 2009;18:65–72.CrossRefPubMedPubMedCentral
56.
Tibbits MK, Smith EA, Caldwell LL, Flisher AJ. Impact of HealthWise South. Africa on polydrug use and high-risk sexual behavior. Health Educ Res. 2011;26:653–63.CrossRefPubMedPubMedCentral
57.
Patterson TL, Semple SJ, Zians JK, Strathdee SA. Methamphetamine-using HIV. positive men who have sex with men: correlates of polydrug use. J Urban Health. 2005;82:i120–6.CrossRefPubMedPubMedCentral
58.
Mimiaga MJ, Reisner SL, Vanderwarker R, Gaucher MJ, O'Connor CA, Medeiros MS, Safren SA. Polysubstance use and HIV/STD risk behavior among. Massachusetts men who have sex with men accessing Department of Public.
59.
Semple SJ, Zians J, Strathdee SA, Patterson TL. Sexual marathons and methamphetamine use among HIV-positive men who have sex with men. Arch Sex Behav. 2009;38:583–90.CrossRefPubMed
60.
Adamczyk A, Greif M. Education and risky sex in Africa: unraveling the link between women’s education and reproductive health behaviors in Kenya. Soc Sci Res. 2011;40:654–66.CrossRef
61.
Lau JT, Tsui HY, Siah PC, Zhang KL. A study on female sex workers in southern China (Shenzhen): HIV-related knowledge, condom use and STD history. AIDS Care. 2002;14:219–33.CrossRefPubMed
62.
UNAIDS. A guide to monitoring and evaluation. Switzerland: Joint United Nations Programme on HIV/AIDS. Geneva; 2000.
63.
64.
Tang CS, Wong CY, Lee AM. Gender-related psychosocial and cultural factors. associated with condom use among Chinese married women. AIDS Educ Prev. 2001;13:329–42.CrossRefPubMed
65.
Worth D. Sexual decision-making and AIDS: why condom promotion among vulnerable women is likely to fail. Stuin Fam Plann. 1989;20:297–307.CrossRef
66.
Yang H, Li X, Stanton B, Fang X, Lin D, Mao R, Liu H, Chen X, Severson R. Workplace and HIV-related sexual behaviours and perceptions among female migrant workers. AIDS Care. 2005;17:819–33.CrossRefPubMedPubMedCentral
67.
Mgalla Z, Pool R. Sexual relationships, condom use and risk perception among female bar workers in north-west Tanzania. AIDS Care. 1997;9:407–16.CrossRefPubMed
68.
Hendershot CS, Stoner SA, George WH, Norris J. Alcohol use, expectancies, and sexual sensation seeking as correlates of HIV risk behavior in heterosexual young adults. Psychol Addict Behav. 2007;21:365–72.CrossRefPubMedPubMedCentral
69.
Compton WM, Thomas YF, Stinson FS, Grant BF. Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry. 2007;64:566–76.CrossRefPubMed
Metadata
Title
Gender-specific differences in high-risk sexual behaviors among methamphetamine users in Myanmar-China border city, Muse, Myanmar: who is at risk?
Authors
Yu Mon Saw
Thu Nandar Saw
Nyein Chan
Su Myat Cho
Masamine Jimba
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5113-6

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