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Raymond C Rosen - One of the best experts on this subject based on the ideXlab platform.
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ORIGINAL RESEARCH—OUTCOMES ASSESSMENT Minimal Clinically Important Differences in the Vaginal Insertion and Successful Intercourse Items of the Sexual Encounter Profile
2020Co-Authors: Andre B Araujo, Xiao Ni, Kerstin R Allen, Raymond C RosenAbstract:Introduction. Despite adoption of the successful vaginal insertion (Q2) and intercourse (Q3) items of the Sexual Encounter profile (SEP) as end points in clinical trials, there are no objective data on what constitute minimal clinically important differences (MCIDs) in these items. Aim. The objective was to estimate the MCID for SEP Q2 and Q3. Methods. Using data from 17 randomized, controlled trials of the phosphodiesterase type 5 inhibitor tadalafil, we estimated MCIDs for the SEP using anchor-based approaches. The 17 studies included 3,345 patients treated for 12 weeks. The anchor for the MCID is the minimal improvement measure calculated using change from baseline to 12 weeks on the following question: "Over the past 4 weeks, when you attempted Sexual intercourse how often was it satisfactory for you?" MCIDs were developed using analysis of variance- and receiver operating characteristic (ROC)-based methods in a subset of studies (N = 11) by comparing patients with and without minimal improvement (N = 863). MCIDs were validated in the remaining six studies (N = 377). Main Outcome Measures. The main outcome measures of this study are SEP Q2 and Q3. Results. Using the ROC-based approach, the MCID for SEP Q2 was 21.4%, with estimated sensitivity of 0.55 and specificity of 0.73; the MCID for SEP Q3 was 23.0%, with estimated sensitivity of 0.72 and specificity of 0.78. MCIDs for SEP Q2/Q3 varied significantly (P < 0.001) according to baseline erectile dysfunction (ED) severity. MCIDs distinguished between patients in the validation sample classified as no change or minimally improved in each ED etiology, ED duration, and age group, but less well across geographic regions. Conclusions. The contextualization of treatment-related changes into clinically relevant terms is essential to under- standing treatment efficacy, interpreting results across studies, and for effective patient management. Overall, there was a better balance between sensitivity and specificity of the MCIDs using the ROC-based approach for the SEP intercourse success item than for the vaginal insertion item. Araujo AB, Allen KR, Ni X, and Rosen RC. Minimal clinically important differences in the vaginal insertion and successful intercourse items of the Sexual Encounter Profile. J Sex Med 2012;9:169-179.
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Nonresponders, Partial Responders, and Complete Responders to PDE5 Inhibitors Therapy According to IIEF Criteria: Validation of an Anchor-Based Treatment Responder Classification
The Journal of Sexual Medicine, 2013Co-Authors: May Yang, Angelina Sontag, Heather J Litman, Xiao Ni, Raymond C RosenAbstract:Abstract Introduction Despite widespread use of the International Index of Erectile Function (IIEF) in erectile dysfunction (ED) research, there are no published criteria for classifying ED treatment responders in clinical trials or patient management settings. A new classification for treatment response in men with ED has been developed and validated in a large clinical trial database. Aim The study aims to test discriminant and convergent validity of the responder classification and examine the role of covariates. Method Treatment assignment was used to test discriminant validity. The diary‐based Sexual Encounter Profile (SEP) question (“Did your erection last long enough for you to have successful intercourse?”) and Global Assessment Question (GAQ) (“Has the treatment you have been taking over the past study interval improved your erections?”) were used to evaluate convergent validity. Chi‐square and Cochran–Armitage trend tests were used to examine outcome associations. Logistic regression was used to further assess the relationship of outcomes controlling for covariates. Main Outcome Measure The classification measure was developed and validated in a database from 17 clinical trials in 3,252 men with ED randomized to placebo or tadalafil. The treatment responder is defined as complete (erectile function [EF] ≥ 26); partial (EF Results The new responder definition performed consistently well in all prespecified tests of validity. Eighty‐nine percent of subjects classified as complete responders were in the treatment group, and the responder definition was associated with changes on the SEP and GAQ measures, respectively (SEP odds ratio [OR] = 14, 95% confidence intervals [CI] 11–17; GAQ OR = 50, 95% CI 39–88; complete vs. nonresponders). Conclusions We developed and validated a novel method of defining an ED treatment responder based on multiple IIEF criteria and using other measures (SEP, GAQ) for validation. The results have implications for understanding results of clinical trials in ED, and in monitoring response to treatment in the clinic. Yang M, Ni X, Sontag A, Litman HJ, and Rosen RC. Nonresponders, partial responders, and complete responders to PDE5 inhibitors therapy according to IIEF criteria: Validation of an anchor‐based treatment responder classification. J Sex Med 2013;10:3029–3037.
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minimal clinically important differences in the vaginal insertion and successful intercourse items of the Sexual Encounter profile
The Journal of Sexual Medicine, 2012Co-Authors: Andre B Araujo, Xiao Ni, Kerstin R Allen, Raymond C RosenAbstract:ABSTRACT Introduction Despite adoption of the successful vaginal insertion (Q2) and intercourse (Q3) items of the Sexual Encounter profile (SEP) as end points in clinical trials, there are no objective data on what constitute minimal clinically important differences (MCIDs) in these items. Aim The objective was to estimate the MCID for SEP Q2 and Q3. Methods Using data from 17 randomized, controlled trials of the phosphodiesterase type 5 inhibitor tadalafil, we estimated MCIDs for the SEP using anchor‐based approaches. The 17 studies included 3,345 patients treated for 12 weeks. The anchor for the MCID is the minimal improvement measure calculated using change from baseline to 12 weeks on the following question: “Over the past 4 weeks, when you attempted Sexual intercourse how often was it satisfactory for you?” MCIDs were developed using analysis of variance‐ and receiver operating characteristic (ROC)‐based methods in a subset of studies (N = 11) by comparing patients with and without minimal improvement (N = 863). MCIDs were validated in the remaining six studies (N = 377). Main Outcome Measures The main outcome measures of this study are SEP Q2 and Q3. Results Using the ROC‐based approach, the MCID for SEP Q2 was 21.4%, with estimated sensitivity of 0.55 and specificity of 0.73; the MCID for SEP Q3 was 23.0%, with estimated sensitivity of 0.72 and specificity of 0.78. MCIDs for SEP Q2/Q3 varied significantly (P Conclusions The contextualization of treatment‐related changes into clinically relevant terms is essential to understanding treatment efficacy, interpreting results across studies, and for effective patient management. Overall, there was a better balance between sensitivity and specificity of the MCIDs using the ROC‐based approach for the SEP intercourse success item than for the vaginal insertion item. Araujo AB, Allen KR, Ni X, and Rosen RC. Minimal clinically important differences in the vaginal insertion and successful intercourse items of the Sexual Encounter Profile. J Sex Med 2012;9:169–179.
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original research outcomes assessment minimal clinically important differences in the vaginal insertion and successful intercourse items of the Sexual Encounter profile
2012Co-Authors: Andre B Araujo, Xiao Ni, Kerstin R Allen, Raymond C RosenAbstract:Introduction. Despite adoption of the successful vaginal insertion (Q2) and intercourse (Q3) items of the Sexual Encounter profile (SEP) as end points in clinical trials, there are no objective data on what constitute minimal clinically important differences (MCIDs) in these items. Aim. The objective was to estimate the MCID for SEP Q2 and Q3. Methods. Using data from 17 randomized, controlled trials of the phosphodiesterase type 5 inhibitor tadalafil, we estimated MCIDs for the SEP using anchor-based approaches. The 17 studies included 3,345 patients treated for 12 weeks. The anchor for the MCID is the minimal improvement measure calculated using change from baseline to 12 weeks on the following question: "Over the past 4 weeks, when you attempted Sexual intercourse how often was it satisfactory for you?" MCIDs were developed using analysis of variance- and receiver operating characteristic (ROC)-based methods in a subset of studies (N = 11) by comparing patients with and without minimal improvement (N = 863). MCIDs were validated in the remaining six studies (N = 377). Main Outcome Measures. The main outcome measures of this study are SEP Q2 and Q3. Results. Using the ROC-based approach, the MCID for SEP Q2 was 21.4%, with estimated sensitivity of 0.55 and specificity of 0.73; the MCID for SEP Q3 was 23.0%, with estimated sensitivity of 0.72 and specificity of 0.78. MCIDs for SEP Q2/Q3 varied significantly (P < 0.001) according to baseline erectile dysfunction (ED) severity. MCIDs distinguished between patients in the validation sample classified as no change or minimally improved in each ED etiology, ED duration, and age group, but less well across geographic regions. Conclusions. The contextualization of treatment-related changes into clinically relevant terms is essential to under- standing treatment efficacy, interpreting results across studies, and for effective patient management. Overall, there was a better balance between sensitivity and specificity of the MCIDs using the ROC-based approach for the SEP intercourse success item than for the vaginal insertion item. Araujo AB, Allen KR, Ni X, and Rosen RC. Minimal clinically important differences in the vaginal insertion and successful intercourse items of the Sexual Encounter Profile. J Sex Med 2012;9:169-179.
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validation of stopwatch measurements of erection duration against responses to the Sexual Encounter profile and international index of erectile function in patients treated with a phosphodiesterase type 5 inhibitor
The Journal of Sexual Medicine, 2010Co-Authors: James W Shaw, Raymond C Rosen, Gregory Reardon, David W Sandor, David M FergusonAbstract:ABSTRACT Introduction Although the Sexual Encounter Profile (SEP) and International Index of Erectile Function (IIEF) are frequently used to measure erectile dysfunction (ED) treatment outcomes, stopwatch-assessed duration of erection is a new, objective, and potentially useful endpoint of ED treatment effect. Aims To assess the validity and reliability of stopwatch-assessed erection duration against responses to SEP items 2 (SEP-2) and 3 (SEP-3) and IIEF scale scores. Methods Data were taken from a multi-center trial of vardenafil for the treatment of ED. Patients were randomized to vardenafil 10 mg or placebo for 4 weeks. After a 1-week washout period, patients received the alternate therapy for an additional 4 weeks. An electronic diary was used to record information about Sexual attempts. The duration of erection was measured using a stopwatch and transcribed into the diary. The SEP was completed following each Sexual attempt, and the IIEF was completed at the end of each treatment period. Main Outcome Measures Mean and median values of erection duration, mean SEP-2 and SEP-3 success rates, and scores for each of the 5 IIEF scales were calculated. Results At baseline, correlations of median erection duration with the 5 IIEF scale scores ranged from 0.06 to 0.53, while correlations with mean SEP-2 and SEP-3 success rates were 0.66 and 0.49, respectively. Compared with the other measures, mean and median values of erection duration were less sensitive to differences between placebo- and vardenafil-treated patients and less responsive to clinical change associated with treatment crossover. However, mean erection duration exhibited a good level of reliability (intraclass correlation coefficient = 0.72, P Conclusions This study provides evidence for the validity and reliability of stopwatch-assessed duration of erection. Our findings suggest that erection duration is suitable for use as a unique endpoint in ED treatment-efficacy trials conducted for phosphodiesterase type 5 inhibitors. Shaw JW, Reardon G, Sandor DW, Rosen RC, and Ferguson DM. Validation of stopwatch measurements of erection duration against responses to the Sexual Encounter Profile and International Index of Erectile Function in patients treated with a phosphodiesterase type 5 inhibitor.
Waverly H Vosburgh - One of the best experts on this subject based on the ideXlab platform.
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a review of the literature on event level substance use and Sexual risk behavior among men who have sex with men
Aids and Behavior, 2012Co-Authors: Waverly H Vosburgh, Gordon Mansergh, Patrick S Sullivan, David W PurcellAbstract:In the United States, there continues to be high incidence of HIV infection among men who have sex with men (MSM), who represent 57% of new infections in 2009. While many studies report associations between non-injection substance use and Sexual risk behavior among MSM, overall results are mixed. Summarizing these studies is difficult because researchers have used a variety of assessment periods for substance use and Sexual behavior. We review the scientific literature on event-level measures, which assess substance use and Sexual risk behavior immediately before or during a Sexual Encounter and provide the most precise link between these two behaviors. From January 2009 through March 2010, we searched four databases: Ovid (MEDLINE and PsycINFO), Web of Knowledge, and Sociofile. Across studies, results varied by substance with little within substance consistency or a lack of research except for two notable exceptions: methamphetamine and binge alcohol use. The findings underscore the importance of providing HIV risk-reduction interventions for substance-using MSM.
Clayton W. Schupp - One of the best experts on this subject based on the ideXlab platform.
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Psoriasis and Sexual behavior in men: Examination of the national health and nutrition examination survey (NHANES) in the united states
Journal of Sexual Medicine, 2014Co-Authors: April W Armstrong, Caitlin T. Harskamp, Clayton W. SchuppAbstract:Introduction Epidemiologic data on Sexual behavior in psoriasis patients are lacking. Aim We aim to examine and compare the Sexual behaviors between men with and without psoriasis in the United States. Methods We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006 and 2009 to 2010. Responses from male participants to the dermatology and Sexual behavior questionnaires of the NHANES were collated and analyzed. Main Outcome Measures Outcome measures included Sexual orientation, age of first Sexual Encounter, number of oral and non‐oral Sexual partners, and frequency of unprotected sex. Results Among 6,444 U.S. men that responded to the psoriasis question, 170 (2.6%) reported a physician‐given diagnosis of psoriasis. HeteroSexual men accounted for 95.5% and nonheteroSexual men 4.5% of the overall study population. On multivariate analysis, psoriasis was not associated with differences in Sexual orientation (odds ratio 1.78, 95% confidence interval [CI] 0.75–4.15). HeteroSexual men with psoriasis experienced first Sexual Encounter at an earlier age than those without psoriasis (weighted difference −0.9 years, P = 0.002). HeteroSexual men with psoriasis had significantly fewer female oral Sexual partners compared with heteroSexual men without psoriasis on multivariate analysis (lifetime partner number: rate ratio [RR] 0.65, 95% CI 0.45–0.95; past‐year partner number: RR 0.64, 95% CI 0.42–0.97). No significant differences existed between heteroSexual men with and without psoriasis regarding frequency of unprotected sex (RR 0.96, 95% CI 0.85–1.09). Among nonheteroSexual men with and without psoriasis, no significant differences existed in age first had sex, number of Sexual partners, or frequency of unprotected sex. Conclusion HeteroSexual men with psoriasis have significantly fewer lifetime female oral Sexual partners compared with those without psoriasis. Dermatologists and other healthcare providers need to examine the genital region routinely and initiate appropriate therapy to improve patients' Sexual health. Armstrong AW, Harskamp CT, and Schupp CW. Psoriasis and Sexual behavior in men: Examination of the National Health and Nutrition Examination Survey (NHANES) in the United States. J Sex Med 2014;11:394–400. (PsycINFO Database Record (c) 2016 APA, all rights reserved). (journal abstract)
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Psoriasis and Sexual Behavior in U.S. Women: An Epidemiologic Analysis Using the National Health and Nutrition Examination Survey (NHANES)
The Journal of Sexual Medicine, 2013Co-Authors: April W Armstrong, Caitlin T. Harskamp, Matthew R Follansbee, Clayton W. SchuppAbstract:Introduction. Although Sexual behavior is an integral part of most adults' overall well-being, this aspect of psoriasis patients' quality of life is rarely explored.Aim. The aim of this study is to assess the relationship between psoriasis and Sexual behavior in U.S. women.Methods. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006. Our study focuses on responses to the dermatology and Sexual behavior questionnaires of the NHANES.Main Outcome Measures. This study examines the association between psoriasis and Sexual behavior in U.S. women with regard to Sexual orientation, age of first Sexual Encounter, number of Sexual partners, and frequency of unprotected sex.Results. A total of 3,462 women provided responses to their psoriasis status: 2,753 (80%) women were heteroSexual and 709 (20%) were nonheteroSexual. Among them, 2.7% reported a physician-given diagnosis of psoriasis. On multivariate analyses, psoriasis was not associated with differences in Sexual orientation (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.62–2.01). Among nonheteroSexual women, multivariate analysis revealed a lower number of lifetime female Sexual partners in women with psoriasis (rate ratio [RR] 0.11, 95% CI 0.04–0.33, P = 0.001). Among heteroSexual women, no significant differences existed between those with and without psoriasis in age of first Sexual Encounter (weighted difference −0.54 years, 95% CI −1.27 to 0.19), number of lifetime male Sexual partners (RR 1.19, 95% CI 0.69–2.06), or number of lifetime male oral sex partners (RR 0.72, 95% CI 0.40–1.29). HeteroSexual women with psoriasis had 1.13 times more unprotected sex (RR 1.13, 95% CI 1.02–1.24, P = 0.03) compared with those without psoriasis.Conclusion. Psoriasis is associated with a significantly reduced number of Sexual partners in nonheteroSexual women. Psoriasis may differentially impact Sexual behavior based on Sexual orientation in women. Armstrong AW, Follansbee MR, Harskamp CT, and Schupp CW. Psoriasis and Sexual behavior in U.S. women: An epidemiologic analysis using the National Health and Nutrition Examination Survey (NHANES). J Sex Med **;**:**–**.
Dennis J Fortenberry - One of the best experts on this subject based on the ideXlab platform.
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first i then we exploring the sequence of Sexual acts and safety strategies reported during a Sexual Encounter using a modified timeline followback method
Sexually Transmitted Infections, 2016Co-Authors: Vanessa Schick, Brian Dodge, Aleta Baldwin, Laina Y Baycheng, Dennis J FortenberryAbstract:Objectives Assessments of Sexual safety often rely on questions about the occurrence of condom use within a designated timeline, assuming that penile–vaginal intercourse (PVI) occurred once at the conclusion of the event. An investigation of all Sexual acts and safety strategies that occur during a single event may present a more nuanced picture of Sexual risk. Methods Behaviourally, biSexual women (N=45) were recruited due to the potential diversity of their Sexual behaviour and safety strategies. A modified timeline follow-back method, the SEQUENCE Calendar, was designed to capture information about the participants’ most recent Sexual event with a male partner, including the order of each Sexual act during the Sexual event. Interviews took between 1 and 3 h. These acts were compiled into narratives and the behavioural sequences were reviewed and coded. Results Participants reported an average of 7.9 (SD=4.3) Sexual acts. Over a third (35.9%, N=14) of the participants who reported PVI indicated engaging in genital contact after PVI and over 15% (N=6) of these participants reporting PVI at two different time points, separated by Sexual behaviour. Additional potential for infection outside of condom use and PVI was also identified. Conclusions Sexual interactions are comprised of multiple acts that occur in a variety of permutations. Understanding the complexity of people9s Sexual Encounters has potential to inform the ways we measure condom use and consider Sexual safety.
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lubricant use at last Sexual Encounter with a male partner findings from a nationally representative sample of self identified gay and biSexual men in the united states
Sexual Health, 2015Co-Authors: Brian Dodge, Randolph D Hubach, Vanessa Schick, Debby Herbenick, Michael Reece, Stephanie A Sanders, Dennis J FortenberryAbstract:Background There is a lack of research that examines event-level lubricant use and outcomes among gay and biSexual men, with the majority of current research addressing lubricant use within the context of Sexual risk. Most studies examining Sexual health among gay and biSexual men have relied on convenience sampling strategies for participant recruitment. Methods: Data were collected from the 2012 wave of the National Survey of Sexual Health and Behaviour (NSSHB), which involved the administration of an online questionnaire to a nationally representative probability sample of women and men in the United States aged 18 years and older, including an oversampling of self-identified gay and biSexual men and women. The findings from gay (n = 307) and biSexual (n = 25) participants who reported Sexual behaviours with other male partners during their last Sexual Encounter are included in this paper. Post-stratification data weights were applied to the data to maximise the generalisability of the findings. Results: Men who reported lubricant use during their last Sexual event with a male partner (n = 163) were significantly more likely to be non-White, Hispanic and between 30 and 39 years old. BiSexual men had lower odds of using lubricant than gay-identified men. The majority of men reported using lubricant during anal intercourse, along with lower numbers with a range of other Sexual behaviours. Conclusion: Public health promotion specialists should consider recommending continued lubricant use as a part of comprehensive Sexual health promotion efforts for gay and biSexual men, including that it reduces pain and maximises pleasure.
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dual method use at last Sexual Encounter a nationally representative episode level analysis of us men and women prepared for resubmission to contraception
Contraception, 2014Co-Authors: Jenny A Higgins, Brian Dodge, Vanessa Schick, Debby Herbenick, Michael Reece, Stephanie A Sanders, Nicole K Smith, Dennis J FortenberryAbstract:OBJECTIVES: Male condom use in conjunction with other contraceptives increases protection against pregnancy and Sexually transmitted infections. However few analyses contextualize dual method use within the Sexual episode include reports from men or explore gendered patterns in reporting. STUDY DESIGN: We analyzed dual method use patterns using a nationally representative dataset of 18-44 years old in the US (N=404 men 416 women). Respondents indicated contraceptive methods used at last penile-vaginal intercourse condom practices and relationship and Sexual information about that particular partner. RESULTS: More than one-in-three penile-vaginal intercourse episodes (40%) involved male condom use: 28% condom only and 12% condom plus a highly effective method. Dual method reporting did not differ significantly by gender. Among dual method users only 59% reported condom use during the entire intercourse episode while 35% began intercourse without one and 6% removed the condom during intercourse. A greater proportion of men than women reported incorrect use of condoms (49% versus 35%) though this difference was not statistically significant. Only 50% of dual method users reported condom use in all of their last 10 intercourse episodes. CONCLUSIONS: Many people classified as "dual users" in previous studies may not be using dual methods consistently or correctly. Researchers and practitioners should inquire how and how often condoms are used when assessing and addressing dual method use. Furthermore though men have rarely been surveyed about dual method use they can provide consistent contraceptive estimates and may be more likely to report condom practices such as late application or early removal. IMPLICATIONS STATEMENT: Many US women and men reporting dual method use also reported late application and early removal of condoms as well as multiple condom-less prior Sexual acts with that partner. Clinicians may wish to inquire how and how often clients use condoms; they may also wish to provide condom instruction and/or tips on better integrating condoms into the Sexual experience with ones partner. Copyright (c) 2014 Elsevier Inc. All rights reserved.
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original research article dual method use at last Sexual Encounter a nationally representative episode level analysis of us men and women prepared for resubmission to contraception
2014Co-Authors: Jenny A Higgins, Brian Dodge, Vanessa Schick, Debby Herbenick, Michael Reece, Stephanie A Sanders, Nicole K Smith, Dennis J FortenberryAbstract:Objectives: Male condom use in conjunction with other contraceptives increases protection against pregnancy and Sexually transmitted infections. However, few analyses contextualize dual method use within the Sexual episode, include reports from men or explore gendered patterns in reporting. Study design: We analyzed dual method use patterns using a nationally representative dataset of 18–44 years old in the US (N=404 men, 416 women). Respondents indicated contraceptive methods used at last penile–vaginal intercourse, condom practices and relationship and Sexual information about that particular partner. Results: More than one-in-three penile–vaginal intercourse episodes (40%) involved male condom use: 28% condom only and 12% condom plus a highly effective method. Dual method reporting did not differ significantly by gender. Among dual method users, only 59% reported condom use during the entire intercourse episode, while 35% began intercourse without one and 6% removed the condom during intercourse. A greater proportion of men than women reported incorrect use of condoms (49% versus 35%), though this difference was not statistically significant. Only 50% of dual method users reported condom use in all of their last 10 intercourse episodes. Conclusions: Many people classified as “dual users” in previous studies may not be using dual methods consistently or correctly. Researchers and practitioners should inquire how and how often condoms are used when assessing and addressing dual method use. Furthermore, though men have rarely been surveyed about dual method use, they can provide consistent contraceptive estimates and may be more likely to report condom practices such as late application or early removal. Implications statement: Many US women and men reporting dual method use also reported late application and early removal of condoms, as well as multiple condom-less prior Sexual acts with that partner. Clinicians may wish to inquire how and how often clients use condoms; they may also wish to provide condom instruction and/or tips on better integrating condoms into the Sexual experience with one's partner.
David W Purcell - One of the best experts on this subject based on the ideXlab platform.
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a review of the literature on event level substance use and Sexual risk behavior among men who have sex with men
Aids and Behavior, 2012Co-Authors: Waverly H Vosburgh, Gordon Mansergh, Patrick S Sullivan, David W PurcellAbstract:In the United States, there continues to be high incidence of HIV infection among men who have sex with men (MSM), who represent 57% of new infections in 2009. While many studies report associations between non-injection substance use and Sexual risk behavior among MSM, overall results are mixed. Summarizing these studies is difficult because researchers have used a variety of assessment periods for substance use and Sexual behavior. We review the scientific literature on event-level measures, which assess substance use and Sexual risk behavior immediately before or during a Sexual Encounter and provide the most precise link between these two behaviors. From January 2009 through March 2010, we searched four databases: Ovid (MEDLINE and PsycINFO), Web of Knowledge, and Sociofile. Across studies, results varied by substance with little within substance consistency or a lack of research except for two notable exceptions: methamphetamine and binge alcohol use. The findings underscore the importance of providing HIV risk-reduction interventions for substance-using MSM.
