Club drug use and unprotected anal intercourse among HIV-seronegative men who have sex with men seeking HIV/STD testing at a local STD clinic in Houston

Objective. To explore (1) the association between "club drug" use and unprotected anal intercourse (UAI) and (2) the association between binge drug use and UAI among HIV seronegative men who have sex with men (MSM) seeking HIV/STD testing at a local clinic in Houston. ^ Study design. A sub-sample of 297 HIV seronegative MSM from a cross-sectional study of drug and sexual behavior in Houston was conducted in 2006. Patients who were seeking HIV/STD testing at a local MSM-identified STD clinic were recruited for an anonymous computer-assisted interview. Analysis of identified secondary data consisted of self-reported information about demographic characteristics, use of drugs, and sexual behaviors. ^ Results. With new and casual sex partners, there was a strong and statistically significant association between use of "club drugs" and UAI. No association between binge drug use and UAI was evident. Men aware of HIV seropositivity or unaware of the HIV serostatus of their primary partner were less likely to report UAI. ^ Conclusion. These data suggest that in the Houston area, HIV-negative MSM club drug users, particularly multiple drug users, are at higher risk of UAI than comparable MSMs who do not use club drugs. Episode-level data regarding binge use of these and other drugs, and UAI should be collected in future studies to explore their relationship. The 'new partner' category should be added to sex partner types to measure sex and drug use behaviors in future studies.^ Keywords. HIV-negative MSM; club drugs; unprotected anal intercourse; binge drug use. ^

Public service use by residents of Jackson Hinds Gardens before and after enrollment

Homelessness is associated with high use of public services such as health care and criminal justice services. Intervention designs to reverse homelessness have broadly fallen into two categories: either standard care which employs requisitely addressing the causes of homelessness, or housing first, which emphasizes provision of permanent housing without requisitely addressing the causes of homelessness. Multiple cities have recently commenced housing first interventions. Locally, Houston’s first housing first development is the Jackson Hinds Gardens project. The purpose of this study is to analyze the public service use of residents of housing first in Houston. Residents of Jackson Hinds Gardens who have been enrolled for at least 6 months were evaluated for public service use for an equal amount of time preceding and during their residence at Jackson Hinds. Resident interactions with county health services and criminal justice entities were determined by electronic database searches; these data were supplemented by life experience interview data. Service usage values pre- and post-enrollment at Jackson Hinds Gardens were compared by paired t-test analyses. We found that ER and inpatient usage decreased following enrollment in Jackson Hinds, although these reductions were not significant. In contrast, outpatient care and number of medications significantly increased following enrollment. These analyses inform on the effects of housing first in another major city, as well as informing the ethical considerations regarding housing first versus standard care. ^