Increased High Risk Sexual Behavior After September 11 in Men Who Have Sex with Men: An Internet Survey

Abstract

Numerous studies on the mental health effects of terrorist attacks have been published, with some reporting increases in smoking and drug and alcohol use. None have reported on changes in sexual behavior. To investigate the impact of the September 11 attacks on sexual and drug- and alcohol-using behaviors of men who have sex with men (MSM), an anonymous Internet survey was conducted to obtain information retrospectively on behavior during three month periods before and after the attacks. A total of 2,915 MSM from all 50 U.S. states completed the survey. Men who were exposed to the attacks were not differentially targeted for the survey since the online banner ad used to recruit did not mention September 11. Exposure to the attacks varied: 11.4% lost a friend or relative; 5% witnessed the attacks in person; and nearly all saw the attacks on television within one hour of their occurrence. Nearly equal proportions of men reported increases and decreases in the number of sex partners following September 11. Small, statistically significant increases in unprotected anal intercourse and alcohol use, but not illicit drug use, were found when behavior after September 11 was compared to that before the attacks. Men who lost a friend or relative in the attacks were significantly more likely to report unprotected anal intercourse, an increased number of sex partners, and increased alcohol use after September 11 than those who did not. Counseling about substance abuse and risky sexual behavior should be incorporated into trauma-related programs for adolescents and adults.

Mental Health Consequences of September 11: A Five-Year Review of the Behavioral Sciences Literature

“…Gay men who lost a relative or friend in the terrorist attacks reported using unprotected intercourse, an increase in sexual partners and drinking more alcohol than those who did not lose a relative or friend. Findings show that exposure to traumatic events has the potential for changing sexual behavior (Chiasson et al 2005).…”

Substance use and misuse in the aftermath of terrorism. A Bayesian meta‐analysis

“…North (1999) [3] Association of alcohol use with terrorism Pfefferbaum (2001) [32] Increased alcohol use MMWR (2002) [71] Increased alcohol use/increased smoking Factor (2002) [6] Association of alcohol use with terrorism North (2002) [14] Increased alcohol use Tucker (2002) [17] Increased alcohol use Vlahov (2002) [8] Increased alcohol use/increased smoking Gibson (2003) [35] Increased alcohol use/increased smoking Grieger (2003) [36] Increased alcohol use [20] Association of alcohol use with terrorism Rosenheck (2003b) [37] Association of alcohol use with terrorism Zywiak (2003) [38] Increased alcohol use/association of alcohol use with terrorism Gould (2004) [39] Association of alcohol use with terrorism Jordan (2004) [40] Increased alcohol use Stein (2004) [43] Mixed drug use Vlahov (2004) [7] Increased alcohol use/increased smoking Bleich (2005) [45] Mixed drug use Chiasson (2005) [46] Increased alcohol use/association of alcohol Use with terrorism/mixed drug use Forman-Hoffman (2005) [47] Association of alcohol use with terrorism Knudson (2005) [72] Association of alcohol use with terrorism Simons (2005) [16] Increased alcohol use [50] Increased alcohol use Dewart (2006) [51] Mixed drug use Ford (2006) [52] Increased alcohol use/increased smoking Schiff (2006) [53] Increased alcohol use Wu (2006) [54] Increased alcohol use/increased smoking Hasin (2007) [55] Increased alcohol use MMWR: Morbidity and Mortality Weekly Reports.…”

Recruiting a US National Sample of HIV-Negative Gay and Bisexual Men to Complete at-Home Self-Administered HIV/STI Testing and Surveys: Challenges and Opportunities

“…This includes using the Internet to identify and enroll participants for facilitated assessments (Bauermeister, Carballo-Dieguez, Ventuneac, & Dolezal, 2009; Carballo-Diéguez et al, 2011; Grov, Agyemang, Ventuneac, & Breslow, 2013; Grov, Rendina, & Parsons, 2014; Hernandez-Romieu et al., 2014; Hightow-Weidman et al, 2015; Hirshfield, Remien, Humberstone, Walavalkar, & Chiasson, 2004; Lelutiu-Weinberger et al, 2014; Mitchell & Petroll, 2013; Pachankis, Rendina, Ventuneac, Grov, & Parsons, 2014; Parsons, Vial, Starks, & Golub, 2013; Vial, Starks, & Parsons, 2014, 2015), identify and enroll participants for facilitated interventions (Adam et al, 2011; Khosropour, Johnson, Ricca, & Sullivan, 2013; Martinez et al, 2014; Parsons et al., 2013; Whiteley et al, 2012), conducting fully online studies (i.e. assessments and recruitment) (Adam et al, 2011; Bull, Lloyd, Rietmeijer, & McFarlane, 2004; Carpenter, Stoner, Mikko, Dhanak, & Parsons, 2009; Chiasson et al, 2005; Chiasson, Shuchat Shaw, Humberstone, Hirshfield, & Hartel, 2009; Christensen et al, 2013; Coleman et al, 2010; Gass, Hoff, Stephenson, & Sullivan, 2012; Greacen et al, 2013; Grov, Rendina, Breslow, et al, 2014; Grov, Rendina, Ventuneac, & Parsons, 2013; Grov, Rodriguez-Diaz, Ditmore, Restar, & Parsons, 2014; Hirshfield et al, 2010; Hirshfield, Grov, Parsons, Anderson, & Chiasson, 2015; Hirshfield et al, 2008; Holloway, Rice, et al, 2014; Jain & Ross, 2008; Marcus, Hickson, Weatherburn, & Schmidt, 2013; Matthews, Stephenson, & Sullivan, 2012; Mitchell & Petroll, 2012; Mustanski, Greene, Ryan, & Whitton, 2015; Mustanski, Rendina, Greene, Sullivan, & Parsons, 2014; Navejas, Neaigus, Torian, & Murrill, 2012; Oldenburg et al, 2015; Reece et al, 2010; Rendina, Breslow, et al, 2014; Rendina, Jimenez, Grov, Ventuneac, & Parsons, 2014; Rosenberg, Rothenberg, Kleinbaum, Stephenson, & Sullivan, 2013; Rosenmann & Safir, 2007; Rosser et al, 2009; Rosser et al, 2010; Sharma, Sullivan, & Khosropour, 2011; Siegler, Sullivan, Khosropour, & Rosenberg, 2013; Sineath et al, 2013; …”