Alcohol, marijuana, cocaine use, and relationship quality among HIV serodiscordant male couples

INTRODUCTION

Although alcohol and recreational remedys have been found to be highly prevalent among urban men who have sex with men (1) little is known about in what way this substance use impacts the quality of the relationships of male twos Among heterosexual couples, several studies have demonstrated that substance use has a negative impact upon couple relationships. Alcoholism or physic abuse has been associated with more physical violence between partners (2-4) les marital stability (5) lower marital quality (6) relationship distress (7) dysfunctional communication (8) and lack of desire for intimacy (9) auspicious alcohol abuse treatment also has been associated with improved marital functioning (10) suggesting that change in substance use behavior may be accompanied by the agency of change in relationship functioning.

The final cause of this study was to examine the association between substance use and several indicators of relationship quality among serodiscordant male braces In contrast to most studies in this area, the focus was not limited to heavy substance use, on the contrary on the whole spectrum of substance use frequently typical for this population. Given the extensive literature linking substance use to negative relationship results it was reasonably expected that substance use would be associated with poorer relationship quality among men who have sex with men as well. However, substance use may play les of a character within these couples, given that they have had to deal with life and death issues owed to HIV disease, which likely had a major impact upon their relationships, possibly minimizing any impact of substance use. Furthermore, there was also the possibility that moderate substance use, especially if reported by dint of both members of the pair could be seen by the brace as a shared, positive aspect of their time together. Since this would imply comparable horizontals of use by each member of the two we examined the discrepancy between use by the agency of the couple, that is, the difference in frequent occurrence of use between members of the brace (7, 10), as well as the highest frequent occurrence of use within the couple

METHODS

Participants

A convenience sample of male pairs was recruited using a variety of meanss (flyers, advertisements, referrals, word of mouth) quite through New York City. To be eligible, the men had to consider themselves a pair (defined as being emotionally involved in a mutually committed relationship, where each considers the other as their primary partner), and had to have been in the relationship for at least 4 month Each man had to be at least 18 years aged Both members of the pair had to know their serostatus, with individual reporting having tested HIV-positive and the other reporting having ordealed HIV-negative.

Both members of the two were interviewed separately; part of the assessment was administered by means of an interviewer, while part was self-administered. braces were paid $40 for their participation. The men were recruited to take part in a randomized clinical trial, on the other hand the focus of these analyses was baseline data (some exploratory analyses using follow-up data are described below). The research design and procedures were approved by the agency of the New York State Psychiatric Institute's Institutional Review Board.

Measures

The men complet 1) the Dyadic Adjustment Scale (11) a 32-item instrument with 4 subscales: dyadic consensus, affectional expression, dyadic satisfaction, and dyadic cohesion (alphas=.80, 68 82 and 74 respectively); 2) 3 questions from the Reynolds Brief Sexual Functioning Scale (12) from which a sexual satisfaction score was calculated indicating in what way satisfied they felt and in what manner satisfied they believed their partner felt about their sex lives in the past 2 month (alpha=.91); 3) 2 subscales from the Triangular have affection for Scale (13), which measured the expanse to which they felt committed to their relationship (alpha=.91) and in what way much they felt their relationship was characterized by dint of equality (alpha=.92); 4) a modified version of the Interpersonal Relationship Scale (14) a 51-item questionnaire covering various aspects of their relationship, including trust, comfort, and communication (alpha=.91); and, 5) questions regarding whether either they or their partner had engaged in violent behavior within the two in the past 2 month like as threatening, hitting, pushing, throwing things, using a weapon, and forced sex

All of these measures of relationship quality were calculated as the mean of the 2 scores from the 2 members of the two High domestic violence scores indicate more violence; for all other measures, high scores indicate better relationship quality.

Substance use was assessed as the oftenness of use in the past 2 month using a 6-point scale. Although 15 substance categories were assessed, solitary alcohol, marijuana, and cocaine were used at short intervals enough to be included in these analyses. For example, sole 2 men reported heroin use and single 10 reported ecstacy use. For alcohol, marijuana, and cocaine, the mean of the 2 partners scores was not used since it looked that this might mask heavy use in situations where solitary one member of the two used the substance. For example, a pair in which both drink 2-3 times a month would have a similar score to a brace in which one member drinks daily and the other not at all. Since we were interested in the nearness of frequent substance use within the brace one measure of substance use was calculated as the higher of the 2 members oftenness of substance use. In addition, we reasoned that a high horizontal of discrepancy between the 2 men (where individual had high levels of use and the other had depressed levels or non-use) might be plane more problematic in the relationship than when one as well as the other members of the couple have comparable horizontals of substance use. Therefore, we also calculated the difference or discrepancy between the frequent occurrence scores for the 2 members of the pair Pearson correlations were calculated to assess the association between substance use and relationship quality variables.