Marseille 2007
| Abstract #448 - Drug Use Prior to and Following Seroconversion: A Longitudinal Analysis Among a Cohort of MSM. | ||||
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Session: 41.5: Drugs Alcohol and Potions (Parallel) on Tuesday @ 16.30-18.30 in 3 Chaired by Jeffrey Weiss, Biljana Ristic Authors: Presenting Author: Dr Ted Myers - University of Toronto, Canada |
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| Additional Authors: Dr Liviana Calzavara, Dr Janet Raboud, Ms Maia Lesosky, Ms Ann Burchell, Mr Dan Allman, | ||||
| Aim: To describe recreational drug use prior to seroconversion, and evolution in use following seroconversion among a group MSM. | ||||
| Method / Issue: Interview data on drug use among MSM from the Polaris HIV Seroconversion Study, a longitudinal open-cohort of documented recent seroconverters and HIV negative controls, were analysed to examine reported use and change in use over time. This analysis included 118 HIV positive men and 210 negative controls. Data were collected retrospectively for the time period prior to seroconversion, and at 9 six-month follow-up periods. Alcohol, cannabis, cocaine and poppers were analysed separately, and other drugs were placed in two categories: uppers or party drugs and downers. Crude changes in patterns of use between pairs of visits for all men combined were examined using McNemar tests. A typology of users was created based on pattern of use (non-user, always user, changed user stopped or started use). Logistic regression models tested the effect of time and variation by HIV status. GEE models accounted for the dependence within individual observations. | ||||
| Results / Comments: As HIV positive and HIV negative control respondents were matched, these groups were similar on most sociodemographic characteristics. Prior to seroconversion a significantly greater percent of HIV positive men reported heavy (5 or more drinks on one occasion) alcohol use (p=.0008); and a higher frequency of alcohol use (p=.008). Seroconverters were significantly more likely to report use of uppers (p=.03), and poppers (p=.02) than HIV negative men. There was no significant difference between groups in use of cannabis (use/no-use; frequency of use), cocaine or downers. The modeling over time showed trends toward cessation in the entire study group in use of poppers, cocaine, uppers and downers. There was no consistency in either uptake or cessation in use of alcohol, heavy drinking or cannabis. For most drugs the greatest change was reported between induction and the 1st follow-up. A greater proportion of HIV positive men consistently used drugs over all time periods compared to HIV negative men. The greatest change over time was observed in the proportions using poppers, cocaine, cannabis and uppers. HIV positive individuals were more likely to stop using poppers than HIV negative (15% vs 5%); a small but greater percent of HIV negative started using cannabis (6% vs 3%). | ||||
| Discussion: While a significantly greater proportion of HIV positive men reported heavy alcohol consumption, and use of poppers and uppers prior to seroconversion than did HIV negative men in the comparable time period, we lack evidence on actual use in the event when infection occurred. Concerning change, engagement in the cohort appears to influence use over time for both groups of men. Although the percent of HIV positive men who changed their drug use was generally greater than HIV negative, overall the percent of HIV positive men consistently using drugs over time was greater than for HIV negative. Further research and understanding of drug use in risk events, and of the role of continued use among HIV positive men, and the health consequences of use is required. | ||||
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