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Journal of Urban Health : Bulletin of the New York Academy of Medicine logoLink to Journal of Urban Health : Bulletin of the New York Academy of Medicine
. 2005 Dec;82(4):601–609. doi: 10.1093/jurban/jti122

Risky sexual behaviors associated with recreational drug use among men who have sex with men in an international resort area: Challenges and opportunities

William W Darrow 1,✉, Susan Biersteker 1, Trina Geiss 1, Kelly Chevalier 1, Jodi Clark 1, Yamile Marrero 1, Vanessa Mills 1, Kenneth Obiaja 1
PMCID: PMC3456688  PMID: 16221920

Abstract

South Florida is home to a highly transient population of approximately 145,000 men who have sex with men (MSM) and annually hosts over 1.8 million gay and bisexual visitors. To develop more effective interventions for HIV/sexually transmitted infections (STI) prevention in this setting, we conducted a cross-sectional study of recreational drug use and risky sexual behaviors among MSM. A standardized, selfadministered questionnaire, reviewed and approved by a university Institutional Review Board, was offered to men 18 years of age and older who reported ever having sex with a man. Men were approached on weekends in five diverse locations in Miami-Dade County and five in Broward County in winter 2004. An honorarium of $10 was offered to those who completed and returned a questionnaire. Of 407 participants, 115 men (28%) lived in Miami-Dade, 147 (36%) lived in Broward, 46 (11%) lived in another county in south Florida, and 99 (24%) lived elsewhere. Overall, 32% reported using one or more “club drugs” in the past year. Club drug use was highly associated with unprotected anal intercourse (UAI) (P<.001). MSM residing outside of south Florida were more likely than local residents to report using cocaine and ketamine and engaging in unprotected receptive anal intercourse (URAI) in the past month (P=.03). Tourists may be even more likely than residents to engage in risky sexual behaviors and use certain recreational drugs. Interventions must be developed, implemented, and evaluated that take into account the unique characteristics of international resort areas.

Keywords: HIV prevalence, International travel, Men who have sex with men, Recreational drug use, Sexual behavior, Substance abuse

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Footnotes

An earlier version was presented in Miami Beach on August 27, 2004, at the conference, “Opportunities, Challenges, and Successes of International Research,” cosponsored by the Drug Abuse and AIDS Research Center (DAARC) of the University of Miami and the National Institute on Drug Abuse (NIDA). Drs. Darrow, Biersteker, Geiss, Chevalier, Clark, Marrero, Mills, and Obiaja are with the Robert R. Stempel School of Public Health, Florida International University, Miami, Florida. Ana Adasme, Lenworth Anglin, Veronica Francis, Lynda Humaran, Maria Norasco-Warren, Lisa Quammie, and Nalinie Samlal also contributed to this report.

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