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Use of club drugs ( Klitzman et al., 2000 Patterson, Semple, Zians, & Strathdee, 2005) and powder cocaine or crack cocaine ( Campsmith, Nakashima, & Jones, 2000 de Souza, Diaz, Sutmoller, & Bastos, 2002 Maranda, Han, & Rainone, 2004) has been associated with increased risky sexual behaviors among MSM.
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Certain drugs, such as amphetamines and its derivatives, methylenedioxymeth-amphetamine (ecstasy) and crystal methamphetamine (crystal or ice), as well as ketamine (“special K”), gamma-hydroxbutyrate (GHB), and lysergic acid diethylamide (LSD), have been labeled party or club drugs and their use has increased greatly in the past 10 years ( Klitzman, Pope, & Hudson, 2000). Over the past few decades, illicit drug use among men who have sex with men(MSM) 1 has become a popular area of research, as it is an important factor associated with high-risk sexual activity ( Halkitis, Parsons, & Stirratt, 2001 Heredia, 2003 National Institute on Drug Abuse, 2002 Seidman, Sterk-Elifson, & Aral,1994 Webster et al., 2003). Future research should examine interrelated dynamics of sexual activity, identity, and drug use as they evolve within individual African American MSM/MSMW and compare the frequency with which sex, condom use, and substance use co-occur with male versus female partners. Service providers and policy-makers may be guided by these findings toward building cultural competency among direct service staff. Because successful engagement of non-gay-identifying African American MSM/MSMW is essential to the reduction of HIV transmission and substance abuse in Black communities, findings call for drug treatment approaches that acknowledge and accept diverse sexuality in clients.
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Some of those in treatment for substance abuse indicated that a readiness to admit their same-sex activity and come to terms with their homosexuality/bisexuality was necessary for recovery. Participants described alcohol use and drug transactions, use, and addiction as motivating sex with men, allowing and rationalizing same-sex activity and unprotected sex, and facilitating access to male sex partners. Drug use was identified as playing a central role in same-sex sexuality for many African American MSM/MSMW. Alcohol, crack cocaine, and crystal methamphetamine were the primary drugs mentioned by participants. Focus group transcripts were analyzed using consensual qualitative research techniques. A total of 29 men self-identified as HIV-infected and 17 self-identified as uninfected. Between July 2005 and February 2006, we conducted seven focus groups with 46 predominately low socioeconomic status African American MSM/MSMW. We examined the role of drug use and addiction in same-sex sexuality among non-gay-identifying African American men who have sex with men or with both men and women (MSM/MSMW).