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.
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References
Apolone, G., & Vecchia, C. L. (2002). Post-traumatic stress disorder. New England Journal of Medicine, 346, 1495.
Bancroft, J., Janssen, E., Strong, D., Carnes, L., Vukadinovic, Z., & Long, J. S. (2003a). The relation between mood and sexuality in heterosexual men. Archives of Sexual Behavior, 32, 217–230.
Bancroft, J., Janssen, E., Strong, D., & Vukadinovic, Z. (2003b). The relation between mood and sexuality in gay men. Archives of Sexual Behavior, 32, 231–242.
Benotsch, E. G., Kalichman, S., & Cage, M. (2001). Men who have met sex partners via the Internet: Prevalence, predictors, and implications for HIV prevention. Archives of Sexual Behavior, 31, 177–183.
Binik, Y. M., Mah, K., & Kiesler, S. (1999). Ethical issues in conducting sex research on the Internet. Journal of Sex Research, 36, 82–90.
Carver, C. S., & Scheier, M. F. (1994). Situational coping and coping dispositions in a stressful transaction. Journal of Personality and Social Psychology, 66, 184–195.
Catania, J. A., Osmond, D., Stall, R. D., Pollack, L., Paul, J. P., Blower, S., et al. (2001). The continuing HIV epidemic among men who have sex with men. American Journal of Public Health, 91, 907–914.
Cosgrove, D. J., Gordon, Z., Bernie, J. E., Hami, S., Montoya, D., Stein, M. B., et al. (2002). Sexual dysfunction in combat veterans with post-traumatic stress disorder. Urology, 60, 881–884.
Dolezal, C., Meyer-Bahlburg, H. F. L., Remien, R. H., & Petkova, E. (1996). Substance use during sex and sensation seeking as predictors of sexual risk behavior among HIV+ and HIV− gay men. AIDS and Behavior, 1, 19–28.
Elford, J., Bolding, G., Davis, M., Sher, L., & Hart, G. (2004). Web-based behavioral surveillance among men who have sex with men: A comparison of online and offline samples in London, U.K. Journal of Acquired Immune Deficiency Syndromes, 35, 421–426.
Elford, J., Bolding, G., & Sherr, L. (2001). Seeking sex on the Internet and sexual risk behaviour among gay men using London gyms. AIDS, 15, 1409–1415.
Galea, S., Ahern, J., Resnick, H., Kilpatrick, D., Bucuvalas, M., Gold, J., et al. (2002). Psychological sequelae of the September 11 terrorist attacks in New York City. New England Journal of Medicine, 346, 982–987.
Gribble, J. N., Miller, H. G., Cooley, P. C., Catania, J. A., Pollack, L. & Turner, C. F. (2000). The impact of T-ACASI interviewing on reported drug use among men who have sex with men. Substance Use & Misuse, 35, 869–890.
Janssen, E., Lykins, A., & Graham, C. (2003, July). The relationship between negative mood and sexuality in heterosexual women. Paper presented at the meeting of the International Academy of Sex Research, Bloomington, IN.
Kaplan, P. M. (1989). Post-traumatic stress syndrome and sexual dysfunction. Journal of Sex and Marital Therapy, 15, 74–77.
Kazdin, C. (2001, September 21). Sex in a time of terror. Salon.com. Last retrieved August 9, 2004, from http://dir.salon.com/sex/feature/2001/09/21/terror/index.html
Kelleher, K. (2001, October 1). Perhaps the most primal post-disaster reaction: Sex. The impulse to sleep with someone, even a stranger, comes from an instinctive place and may have nothing to do with attraction. Los Angeles Times. Last retrieved August 9, 2004, from http://www.latimes.com/features/lifestyle/la-10010birds,1,6297500,print.story
Koblin, B. A., Chesney, M. A., Husnik, M. J., Bozeman, S., Celum, C. L., Buchbinder, S., et al. (2003). High-risk behaviors among men who have sex with men in 6 US cities: Baseline data from the EXPLORE study. American Journal of Public Health, 93, 926–932.
Koblin, B. A., Taylor, P. E., Avrett, S., & Stevens, C. E. (1996). The feasibility of HIV-1 vaccine trials among gay/bisexual men in New York City: Project ACHIEVE. AIDS community health initiative enroute to the vaccine effort. AIDS, 10, 1555–1561.
Kotler, M., Cohen, H., Aizenberg, D., Matar, M., Loewenthal, U., Kaplan, Z., et al. (2000). Sexual dysfunction in male posttraumatic stress disorder patients. Psychotherapy and Psychosomatics, 69, 309–315.
Lehner, T., & Chiasson, M. A. (1998). Seroprevalence of human immunodeficiency virus type 1 and sexual behaviors in bisexual African-American and Hispanic men visiting a sexually transmitted disease clinic in New York City. American Journal of Epidemiology, 47, 269–272.
Letourneau, E. J., Schewe, P. A., & Frueh, B. C. (1997). Preliminary evaluation of sexual problems in combat veterans with PTSD. Journal of Traumatic Stress, 10, 125–132.
McKirnan, D. J., Vanable, P. A., Ostrow, D. G., & Hope, B. (2001). Expectancies of sexual “escape” and sexual risk among drug and alcohol-involved gay and bisexual men. Journal of Substance Abuse, 13, 137–154.
Newman, J. C., Jarlais, D. C. D., Turner, C. F., Gribble, J., Cooley, P., & Paone, D. (2002). The differential effects of face-to-face and computer interview modes. American Journal of Public Health, 92, 294–297.
North, C. S., Nixon, S. J., Shariat, S., Mallonee, S., McMillen, J. C., Spitznagel, E. L., et al. (1999). Psychiatric disorders among survivors of the Oklahoma City bombing. Journal of the American Medical Association, 282, 755–762.
North, C. S., Tivis, L., McMillen, J. C., Pfefferbaum, B., Cox, J., Spitznagel, E. L., et al. (2002). Coping, functioning, and adjustment of rescue workers after the Oklahoma City bombing. Journal of Traumatic Stress, 15, 171–175.
Rasinski, K. A., Berktold, J., Smith, T. W., & Albertson, B. L. (2002). America recovers: A follow-up to a national study of public response to the September 11th terrorist attacks. Chicago, IL: University of Chicago, NORC.
Ross, M. W., Tikkanen, R., & Mansson, S. (2000). Differences between Internet samples and conventional samples of men who have sex with men: Implications for research and HIV interventions. Social Science and Medicine, 51, 749–758.
Schuster, M., Stein, B. D., Jaycox, L. H., Collins, R. L., Marshall, G. N., Elliott, M. N., et al. (2001). A national survey of stress reactions after the September 11, 2001, terrorist attacks. New England Journal of Medicine, 345, 1507–1512.
Silver, R. C., Holman, E. A., McIntosh, D. N., Poulin, M., & Gil-Rivas, V. (2002). Nationwide longitudinal study of psychological responses to September 11. Journal of the American Medical Association, 288, 1235–1244.
Stall, R., Paul, J. P., Greenwood, G. Pollack, L. M., Bein, E., Crosby, G. M., et al. (2001). Alcohol use, drug use, and alcohol-related problems among men who have sex with men: The Urban Men's Health Study. Addiction, 96, 1589–1601.
Stewart, S. H. (1996). Alcohol abuse in individuals exposed to trauma: A critical review. Psychological Bulletin, 120, 83–112.
Stueve, A., O'Donnell, L., Duran, R., Doval, A. S., Geier, J., & Community Intervention Trial for Youth Study Team. (2002). Being high and taking sexual risks: Findings from a multisite survey of urban young men who have sex with men. AIDS Education and Prevention, 14, 482–495.
Toomey, K. E., & Rothenberg, R. B. (2000). Sex and cyberspace-virtual networks leading to high-risk sex. Journal of the American Medical Association, 284, 485–487.
Ursano, R. J. (2002). Post-traumatic stress disorder. New England Journal of Medicine, 346, 130–132.
Vlahov, D., Galea, S., Resnick, H., Ahern, J., Boscarino, J., Bucuvalas, M., et al. (2002). Increased use of cigarettes, alcohol, and marijuana among Manhattan, New York, residents after the September 11th terrorist attacks. American Journal of Epidemiology, 155, 988–996.
Witte, J. C., Amoroso, L. M., & Howard, P. E. N. (2000). Method and representation in Internet-based survey tools: mobility, community, and cultural identity in survey 2000. Social Science Computer Review, 18, 179–195.
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Chiasson, M.A., Hirshfield, S., Humberstone, M. et al. Increased High Risk Sexual Behavior After September 11 in Men Who Have Sex with Men: An Internet Survey. Arch Sex Behav 34, 527–535 (2005). https://doi.org/10.1007/s10508-005-6278-5
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DOI: https://doi.org/10.1007/s10508-005-6278-5