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Biomedical subjects

John Hylton

Publications and source records attributed to John Hylton.

7 recordsLinked to original sources

Associations between substance use and sexual risk among very young men who have sex with men.

OBJECTIVE: To determine if an association exists in young men who have sex with men (MSM) between being under the influence of alcohol or drugs during sex and participation in sexual behaviors which increase the risk of human immunodeficiency virus (HIV). STUDY DESIGN: A total of 3492 young MSM were interviewed through the Young Men's Survey, an anonymous, cross-sectional, multisite, venue-based survey conducted from 1994 through 1998 at 194 public venues frequented by MSM aged 15 to 22 years in 7 US cities. RESULTS: The majority of young MSM reported both receptive and insertive anal intercourse, and of these, approximately half reported not using condoms. Report of unprotected receptive anal intercourse at least once in the prior 6 months was associated with being under the influence of alcohol (adjusted odds ratio [AOR]=1.5; 95% confidence interval [CI]=1.2-1.8), cocaine (AOR=1.6; 95% CI=1.1-2.2), amphetamines (AOR=1.5; 95% CI=1.1-2.0) or marijuana during sex (AOR=1.3; 95% CI=1.1-1.6). Report of unprotected insertive anal intercourse at least once in the prior 6 months was associated with being under the influence of alcohol (AOR=1.2; 95% CI=1.0-1.5), cocaine (AOR=1.5; 95% CI=1.1-2.0) or amphetamines (AOR=1.9; 95% CI=1.4-2.6). CONCLUSIONS: HIV prevention strategies for young MSM need to incorporate substance use risk reduction.

Adolescent↗

Race/ethnic differences in HIV prevalence and risks among adolescent and young adult men who have sex with men.

The prevalence of HIV infection is disproportionately higher in both racial/ethnic minority men who have sex with men (MSM) and in men under the age of 25, where the leading exposure category is homosexual contact. Less is known, however, about patterns of HIV prevalence in young racial/ethnic minority MSM. We analyzed data from the Young Men's Survey (YMS), an anonymous, cross-sectional survey of 351 MSM in Baltimore and 529 MSM in New York City, aged 15-22, to determine whether race/ethnicity differences exist in the prevalence of HIV infection and associated risk factors. Potential participants were selected systematically at MSM-identified public venues. Venues and associated time periods for subject selection were selected randomly on a monthly basis. Eligible and willing subjects provided informed consent and underwent an interview, HIV pretest counseling, and a blood draw for HIV antibody testing. In multivariate analysis, adjusted for city of recruitment and age, HIV seroprevalence was highest for African Americans [adjusted odds ratio (AOR) = 12.5], intermediate for those of "other/mixed" race/ethnicity (AOR = 8.6), and moderately elevated for Hispanics (AOR = 4.6) as compared to whites. Stratified analysis showed different risk factors for HIV prevalence in each ethnic group: for African Americans, these were history of sexually transmitted diseases (STDs) and not being in school; for Hispanics, risk factors were being aged 20-22, greater number of male partners and use of recreational drugs; and for those of "other/mixed" race/ethnicity, risk factors included injection drug use and (marginally) STDs. These findings suggest the need for HIV prevention and testing programs which target young racial/ethnic minority MSM and highlight identified risk factors and behaviors.

Adolescent↗