Drug Use and Sexual Risk Behavior Among Gay and Bisexual Men Who Attend Circuit Parties: A Venue-Based Comparison

Some previous studies suggest that risk behavior among gay/bisexual men is increasing. There is increasing concern in the public health field that sexual and drug use behavior may be high at circuit parties (CPs), which are events where mainly gay men congregate for social activities and dancing. The term "circuit" refers to the phenomenon of many gay/bisexual men traveling on an annual basis to attend parties in US and international cities. The typical CP involves a weekend-long series of social events, culminating in a main dance event in which thousands of men may dance and socialize for 24 continuous hours or longer. The events include smaller dance or after-hours parties where sexual risk behavior and drug use may be particularly high.

In this cross-sectional study, the researchers describe the sexual and drug use behavior among a sample of gay/bisexual men who reported attending CPs during the previous 12 months. The researchers compared risk behaviors reported during CP weekends with those reported during other weekends to determine whether risk behaviors were more commonly practiced during CP weekends, and tested for associations between high-risk sexual activity and HIV serostatus and drug use. Study subjects were 295 gay/bisexual men from the San Francisco Bay Area. The researchers asked each participant about his drug use and sexual risk behavior during his most recent San Francisco (SF) CP weekend; his most recent CP weekend in another geographic area; his most recent weekend attending a dance club but not a CP; and his most recent weekend attending neither a dance club nor a CP.

Drug use was highly prevalent and markedly elevated during CP weekends compared to non-CP weekends, with the exception of alcohol and marijuana use. During their most recent distant CP weekend, 80 percent of participants used methylenedioxymethamphetamine (ecstasy), 66 percent used ketamine, 43 percent used crystal methamphetamines, 29 percent used gamma-hydroxybutyrate or gamma-butyrolactone (GHB/GBL), 14 percent used sildenafil (Viagra), and 12 percent used amyl nitrites (poppers). Fifty-three percent used four or more drugs. Compared with drug use during distant CP weekends, ketamine, crystal methamphetamines and cocaine were used significantly less frequently during SF CP weekends, and fewer participants reported using four or more drugs. Significantly fewer participants reported using drugs (with the exception of alcohol) during dance club weekends compared to SF CP weekends. In contrast to overall high rates of drug use during CP or dance club weekends, drug use prevalence was generally low during nonevent weekends.

In general, HIV-positive participants reported higher rates of sexual activity than HIV-negative participants. Prevalence of anal sex was high, with between one-third and one-half of participants reporting anal sex during each type of weekend. Unprotected anal sex with partners of unknown or opposite HIV serostatus was most prevalent during distant CP weekends, reported by 21 percent of HIV-positive and 9 percent of HIV-negative participants. In multivariate analysis, predictors of unprotected anal sex with opposite or unknown HIV serostatus partners included being HIV-positive (odds ratio [OR] 3.2; 95 percent confidence interval [CI] 1.4-7.5), and weekend use of crystal methamphetamines (OR 2.4; 95 percent CI, 1.1-4.9), sildenafil (OR 3.8; 95 percent CI, 2.0-7.3), and amyl nitrites (OR, 2.2; 95 percent CI, 1.3-4.0).

"Risk-reduction strategies that directly address the needs of men who attend CPs should be designed and tested," the authors concluded. "The increased risk behaviors at distant compared with SF CPs suggest that programs may also be needed to help CP participants maintain safe practices outside of their local communities. Prevention programs should educate gay/bisexual men who attend CPs about the risks of drug use and associated high-risk sexual behavior and should particularly focus on HIV-positive men, with the goal of reducing their behaviors that place others at risk for HIV."

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