Epi Profile Section 9 – Sex and Substance Use in PLWH
The Texas Medical Monitoring Project (MMP) uses interviews and medical record abstractions of a representative sample of Texans living with diagnosed HIV to better understand the experiences of PLWH. More information on the project is in the data sources and notes. This section provides information on condomless sex and on drug use among PLWH in Texas.
MSM Living with HIV
Nearly two-thirds of the sexually active MSM living with HIV in the sample reported having condomless anal sex with a male partner in the past 12 months (Table 23). However, more than 6 out of 10 of these men only had condomless sex with partners who were also living with HIV. Of the men who had condomless sex with partners who were not PLWH, almost 8 out of 10 had suppressed viral load.
More than a third of MSM living with HIV reported using non-injection or injection drugs in the past 12 months. Drug use decreases with age. Only a quarter of the MSM over the age of 55 years reported using injection or non-injection drugs compared to about half of those between the ages of 18-34 years. White and Black men were twice as likely to report drug use than were Hispanic men.
Men and Women Living with Heterosexually Acquired HIV
The patterns of condomless sex and substance use reported by heterosexual men and women were different. Almost half of this group reported condomless sex with a partner of the opposite sex in the previous 12 months, but around 7 out of 10 people who had condomless sex reported that they had condomless sex with only other PLWH. Two-thirds of the men and women who had condomless sex with partners who were not PLWH had suppressed viral load.
The proportion of people in the sample who reported injection or non-injection drug use increased with age, and White men and women were three times more likely to report using drugs than were Black and Hispanic men and women.
Table 23: Sexual activity and substance use in MSM living with HIV in Texas, MMP 2017-2018
|
Sexually Active MSM |
Average |
Had condomless anal sex with a male partner in the past 12 months |
Had condomless anal sex with a male partner whose HIV status was discordant or unknown in the past 12 months |
Used injection or non-injection drugs in the past 12 months |
||||
|---|---|---|---|---|---|---|---|---|
|
Number |
Number |
Number |
%* |
Number |
%* |
Number |
%* |
|
| Race/Ethnicity | ||||||||
| White |
35 |
8 |
28 |
82% |
12 |
36% |
16 |
48% |
|
Black |
41 |
3 |
22 |
54% |
14 |
31% |
14 |
40% |
|
Hispanic |
45 |
6 |
27 |
60% |
17 |
44% |
11 |
24% |
|
Total |
121 |
6 |
77 |
64% |
43 |
37% |
41 |
37% |
|
Age group (years) |
|
|
|
|
|
|
||
|
18-34 |
43 |
8 |
26 |
63% |
17 |
39% |
16 |
49% |
|
35-44 |
30 |
4 |
20 |
69% |
14 |
50% |
11 |
27% |
|
45-54 |
22 |
5 |
15 |
62% |
6 |
27% |
8 |
37% |
|
55+ |
26 |
4 |
16 |
63% |
6 |
26% |
6 |
23% |
|
Total |
121 |
6 |
77 |
64% |
43 |
37% |
41 |
37% |
* Percentages are weighted
Cell sizes less than 10 may produce unstable estimates
Table 24: Sexual activity and substance use in heterosexuals living with HIV in Texas, MMP 2017-2018
|
Sexually Active Men and Women Who Engaged in Heterosexual Contact |
Average number |
Had condomless vaginal or anal sex with a partner of the opposite sex in the past 12 months |
Had condomless vaginal or anal sex with a partner whose HIV status was discordant or unknown in past 12 months |
Used injection or non-injection drugs in the past 12 months |
||||
|---|---|---|---|---|---|---|---|---|
|
Number |
Number |
Number |
%* |
Number |
%* |
Number |
%* |
|
| Race/Ethnicity | ||||||||
| White |
7 |
1 |
6 |
84% |
** |
** |
4 |
50% |
|
Black |
54 |
1 |
19 |
40% |
14 |
31% |
8 |
13% |
|
Hispanic |
16 |
2 |
7 |
50% |
5 |
41% |
3 |
16% |
|
Total |
77 |
1 |
32 |
48% |
19 |
29% |
15 |
18% |
|
Age group (years) |
||||||||
|
18-34 |
15 |
2 |
7 |
58% |
5 |
44% |
4 |
19% |
|
35-44 |
31 |
1 |
12 |
35% |
7 |
16% |
7 |
24% |
|
45-54 |
16 |
1 |
8 |
70% |
5 |
51% |
** |
** |
|
55+ |
15 |
1 |
5 |
41% |
** |
** |
3 |
25% |
|
Total |
77 |
1 |
32 |
48% |
17 |
26% |
14 |
18% |
* Percentages are weighted
** Cell suppressed for numbers less than 3
Cell sizes less than 10 may produce unstable estimates
Texas HIV Epidemiologic Profile