1. Patterns of frequent drug use among HIV positive & negative aging men who have sex with men in the Multicenter AIDS Cohort study (MACS) J.G. Burke 1, S.H. Lim 1, M.P. Marshal 1, A.J. Silvestre 1, S.M. Albert 1, D.G. Ostrow 2, R.D. Stall 1 1 University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA 2 The Chicago MACS and David Ostrow & Associates, Chicago, IL, USA The “Patterns of Substance Use Among HIV Positive and Negative Aging MSM” study (R03 DA025952 02) was funded by the National Institute on Drug Abuse

2. Project Goal – To examine the patterns of drug use over time among aging HIV positive and HIV negative men who have sex with men (MSM) participating in the longitudinal Multicenter AIDS Cohort Study (MACS). Sample – 10 years of MACS data – MSM age > 50 years of age – N= 1,378 Data Analysis – Identified distinct patterns (trajectories) using Group- based Modeling – Examined pattern group differences Background

3. Results 6.5% (n=90) High Use 7.0% (n=96)Midlife Use 7.2% (n=99) Decreasing Use 79.3% (n=1093)Low Use Age in years Probability of frequent drug use in the past 6 months Frequent drug use = daily or weekly use of poppers (nitrites inhalants) or crack cocaine, or other forms of cocaine, or methamphetamines, or ecstasy.

4. Results Bi-variate differences were found between the patterns of frequent drug use – HIV status – Socioeconomic status – Binge drinking – Unprotected Anal Insertive Intercourse – Emotional well-being – Depressive Symptoms – Use of mental health services Low (n=1 093) Decr easin g (n=9 9) Mid life (n= 96) High (n=9 0) p Non white % 12.817.2 10. 4 10.0 N. S. HIV negative % 57.333.3 39. 6 47.8 <0. 00 1 Low socioeconomi c status % 33.744.5 25. 0 28.9 0.0 16 Any binge drinking % 16.922.2 22. 9 33.3 0.0 01 Number of Unprotected Anal Insertive Intercourse (NUAII) partners,mean 0.471.58 3.1 5 3.81 <0. 00 1 Number of Unprotected Anal Receptive Intercourse (NUARI) partners, mean 1.014.33 2.7 8 2.95 N. S. Emotional well-being, (SF-36), mean 75.970.5 72. 5 74.5 0.0 07 Any depressive symptoms (CES-D≥16) % 50.563.6 57. 3 60.0 0.0 22 Any use of mental health service % 47.164.7 50. 0 54.4 0.0 06

5. Next Steps Qualitative interviews to collect in-depth information from aging MSM on their drug use experiences over time, factors that contributed to increase, decrease, or stable drug use as well as their insights on drug use prevention and cessation for aging MSM.