Gender-specific differences in high-risk sexual behaviors among methamphetamine users in Myanmar-China border city, Muse, Myanmar: who is at risk?

Abstract

BackgroundMethamphetamine (MA) use is a significant public health concern due to its negative effects on health. However, to date, no epidemiological research has examined high-risk sexual behaviors (inconsistent condom use, having multiple sexual partners and having a history of sexually transmitted infections) among MA users. This topic is particularly important in Myanmar, which is recognized as one of the key MA production countries in the Southeast Asia region. Therefore, this study examined factors associated with high-risk sexual behaviors among MA users in Muse city, Myanmar.MethodsA community-based cross-sectional study was conducted from January to March 2013 in Muse city, Northern Shan State, Myanmar. In total, 1183 MA users (772 male; 411 female) were recruited using respondent-driven sampling and a computer assisted self-interviewing method. Generalized estimating equation models were used to examine factors associated with high-risk sexual behaviors.ResultsA large proportion of MA users engaged in high-risk sexual behaviors (inconsistent condom use: males, 90.7%, females, 85.2%; multiple sexual partners: males, 94.2%, females, 47.2%; and history of STIs: males, 55.7%, females, 56.0%). Among males, being a multiple stimulants drug user (adjusted odds ratio [AOR] =1.77; 95% confidence interval [CI] =1.30–2.41) and being a client of sex workers (AOR = 1.41; 95% CI = 1.08–1.83) were risk factors for engaging in high-risk sexual behaviors. Among females, being a migrant worker (AOR = 2.70; 95% CI = 1.86–3.93) and being employed (AOR = 1.57; 95% CI = 1.13–2.18) were risk factors for engaging in high-risk sexual behaviors as well.ConclusionsHigh-risk sexual behaviors were particularly pronounced among both male and female MA users. MA prevention programs that reflect gender considerations should be developed to pay more attention to vulnerable populations such as migrants, clients of sex workers, and less educated female MA users.

Do sexual expectancies and inhibitions predict high-risk sexual behaviours? Evidence from a cross-sectional survey among young psychoactive substance users in the informal settlements of Kampala, Uganda

“…Psychoactive substance use is a risk factor for high-risk sexual behaviours such as multiple sexual partnerships and unprotected sexual intercourse (1)(2)(3)(4). The theoretical point of departure in this study is enshrined in alcohol myopia, cognitive escape, and expectancy theories.…”

Gender Differences in the Relationship between Methamphetamine Use and High-risk Sexual Behavior among Prisoners: A Nationwide, Cross-sectional Survey in Japan

“…The risk of contracting infectious diseases such as viral hepatitis and HIV infection is one of the health problems related to MA use. Studies from Myanmar and China have revealed that a large proportion of MA users engaged in high-risk sexual behaviors such as inconsistent condom use (Saw et al 2018), multiple sexual partners (Liu et al 2013;Saw et al 2018), and exchange of sexual partners during MA use (Liu et al 2013). Regarding gender, a study from China reported that male users were more likely to have had multiple sex partners (male 96.9%, female 77.3%) and exchanged sex partners during MA use (male 72.9%, female 46.4%) than female users (Liu et al 2013).…”

“…In previous studies, inconsistent condom use and multiple sexual partners were used as direct measures, and STD history was used as an indirect measure (Browne et al 2009;Saw et al 2018). We added "trading sex for drugs" to these three indicators because previous studies had shown that MA users, particularly female MA users, traded sex for drugs or money (Lion et al 2017;Molitor et al 1998;Semple et al 2011).…”

“…MA use-related variables were selected based on a previous study, which included age at MA initiation (Saw et al 2017), length of MA use (Liu et al 2013), reasons for MA use (Cheng et al 2009), frequency of MA use (Saw et al 2018), MA use during sex (Saw et al 2018), sharing MA injection (Lorvick et al 2006), and having partners who used MA (Liu et al 2013), DAST-20 and AUDIT (Trenz et al 2016).…”

Enhancement of Drug Seeking Following Drug Taking in a Sexual Context Requires Anterior Cingulate Cortex Activity in Male Rats

“…Drugs are often used in a social or sexual context, with commonly abused drugs including psychostimulants known to robustly increase sexual arousal and pleasure, whereas sexual enjoyment is diminished during drug abstinence (Lorvick et al, 2012 ; Safi et al, 2016 ; Kuiper and Coolen, 2018 ). Users identify increased sexual pleasure as a reason for drug use and relapse (Saw et al, 2018 ). Moreover, drug addiction is highly comorbid with compulsive sexual behavior, suggesting a shared neural basis for drug and non-drug addictions (Frohmader et al, 2010b ; Tull et al, 2011 ; Ahmadi et al, 2017 ; Berry and Johnson, 2018 ; Kuiper and Coolen, 2018 ; Kuiper et al, 2019 ).…”