Substance use and sexual risk behavior:: Understanding their association among four ethnic groups of Latino men who have sex with men

Purpose: To explore the association between substance use in conjunction with sex and unprotected anal sex among Colombian, Dominican, Mexican, and Puerto Rican men who have sex with men (MSSM), considering ethnicity, acculturation, and mediating variables. Methods: A New York City convenience sample of 307 men provided information on past year's sexual behavior; substance use, acculturation, attendance at bars, discos, and parties, self-worth, machismo, and sensation seeking. Results: Alcohol use and drug use were positively associated with unprotected anal sex, particularly with casual partners. Different rates of substance use among the four ethnic groups were found, but were not significant when adjusting for acculturation. Among men who engaged in both unprotected and protected anal sex, substance use was not more common on unprotected occasions than on protected occasions. Attendance at bars, clubs, etc. was not associated with unprotected anal sex. Sensation seeking, self-worth, and machismo were related to substance use and unprotected anal sex. In multivariate analyses, the substance use/unprotected sex association remained when adjusting for ethnicity, acculturation, partner type, attendance at bars, and personality variables. Implications: Substance use and unprotected sex are associated among these Latino MSM. However there does not appear to be a simple causal relationship between the variables. Several other vriables co-vary with these factors but did not statistically explain their association.