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Order in the court! The involvement of gay and bisexual men in the criminal justice system deserves a stronger research focus because of the unique challenges facing such men and also because arrests are yet another marker for a host of health risks among them.

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S CDC Since the beginning of the epidemic, substance abuse has been shown to be one of the strongest predictors of sexual risk behaviors and seroconversion among this population Mansergh et. The term MSM is used to describe the findings of other studies in those cases where sexual behavior was the defining parameter for the sample. Research findings about individual substances are divergent in part because the popularity of specific drugs in gay communities—and specifically the popularity for use during sex—tends to change rapidly NDIC ; Kurtz Sexual sensation seeking the need for novel sexual experiences and the willingness to take risks to have them; Kalichman et al.

Men who develop same-sex attraction and who disclose their sexual orientation at younger ages are especially vulnerable to sexual abuse and to emotional and physical victimization Friedman et al. In part, this increased risk may be related to internalized homophobia, as gay men attempt the performance of hegemonic masculine roles and sexuality and react with hostility toward effeminacy Taywaditep ; Halkitis Also, since the advent of the gay civil rights movement, gay male subcultures in large cities have maintained an intimate connection between recreational drug use, all-night parties, and sexual freedom Kurtz ; Kramer The circuit party generally, a large week-long dance event that attracts a national or international gathering of gay men was the primary symbol of this theme throughout the s Signorile More recently, the Internet is a primary contact point for sex parties and individual hookups that include the combining of drugs with casual sex encounters Kim et al.

In addition to high rates of sexual risk behaviors and substance abuse that may come to be seen as normative by many men attached to gay subcultures, the loss of social capital is a third health and social risk factor. Social capital built up within the home community is often lost upon migration, and urban gay subcultures are frequently limited in their capacity to provide access and connections to economic opportunities or to the larger society with its broad range of options for social support and engagement Kurtz In press.

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The involvement of gay and bisexual men with the criminal justice system is largely absent from the literature Fisher et al. Sexual orientation classification was based on past 30 day sexual behaviors. Data on the nature of the charges leading to the arrests reported in the study were not collected. Census Bureau Hispanics By , the Miami Metropolitan Statistical Area reported CDC The seroprevalence rate among substance-using MSM is undoubtedly much higher. South Florida zip codes with high concentrations of gay residential areas, entertainment venues, health and social service agencies, and sex solicitation and cruising sites were mapped.

In addition to geographic mapping, the Internet sites commonly used by local men for making sexual connections were also documented, with an emphasis on those websites where sexual interactions combined with drug use are often solicited. Using all of these sources, potential participants were contacted through direct outreach, print and electronic media advertisements, flyers placed in health and social service agencies, banner ads on sex-oriented websites, and chat room contacts through websites that permitted the posting of service-oriented profiles.

Recruitment efforts aimed to maximize diversity in terms of age, ethnicity and serostatus.

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All notices directed interested men to the project website, which described the study in more detail. The project was housed in a field office conveniently located to the county highway system and to residential concentrations of gay and bisexual men. At the first formal contact, callers were screened to determine eligibility over the telephone. Eligible men who expressed interest in participating were asked to visit the field office, where trained interviewers explained the confidential nature of the study and the purpose of the project.

They completed a standardized baseline demographic, behavioral, health history and social risk assessment.


The baseline interview lasted approximately 90 minutes and was conducted using laptop-based computer-assisted personal interviewing procedures. In addition to the collection of demographic, life history, and social risk data, the GAIN includes DSM IV-R diagnostics for substance abuse and dependence as well as clinical measures of depression, anxiety and other mental health problems.

The primary dependent variable for this report was lifetime arrest history. To the extent possible, hypothesized predictors of arrest were also assessed using lifetime historical measures, e.

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Serostatus was based upon self-report rather than contemporaneous testing. Data from the interview questionnaires were analyzed using a standard statistical package, SPSS Bivariate and multivariate logistic models were developed to predict both lifetime arrest and crime category property, violent, drug and status crimes by demographics and by measures of health disparities suggested by syndemic theory, including substance use, mental health distress, sex sensation seeking, and victimization.

Demographics, social stability, mental health and victimization characteristics of the sample are shown in Table 1. These demographics reflect the targeted sampling strategies, which aimed for maximum diversity across these variables. Education levels averaged two years of college, but income levels were quite low. Social risk indices were high across all measures, with almost half Depression, anxiety and traumatic stress levels were clinically significant for sizeable proportions of respondents.

More than half Lifetime rates of emotional, physical, and sexual victimization were very high as well, and almost half More than a third Table 2 shows current past 90 day substance use and sexual risk behaviors. Participants were current users of a wide range of substances, including: The sample reported being high or drunk all day on an average of 24 out of the past 90 days data not shown. Participants averaged over 12 different anal sex partners and over 18 unprotected anal intercourse events with non primary partners in the past 90 days.

Arrest histories by type of crime are shown in Table 3. The distribution of crimes was widespread across all categories, including property and violent crimes in addition to the drug violations that would be expected given the study eligibility criteria. Property crimes were primarily related to aspects of theft rather than destruction. Status crimes included a number of subcategories that are or are possibly e. Of the 81 participants with arrest histories, just 25 Among those with multiple arrests, few Almost all of the hypothesized mental health and social risk indices are significant in the bivariate models, with substance abuse treatment history, cocaine use and a lower level of education demonstrating the most powerful effects.

Prior victimization, including a history of physical abuse and childhood abuse, increase the likelihood of having been arrested, as did higher levels of mental health distress, including sexual sensation seeking. In multivariate models, substance abuse treatment, use of cocaine, high sex sensation seeking and lower education level emerged as strong independent predictors of prior arrest.

In additional bivariate analyses not show in the table, these same variables generally predicted each of the four types of arrests property, violent, drug, and status crimes separately. The only areas in which the four specialized models meaningfully diverged from the overall arrest history model were: These results may be due to the loss of power available for the analyses of predictors by type of crime. There are two primary limitations to the study. Also, the data presented here rely on self-report, and some respondents may have refrained from reporting the full extent of socially undesirable behaviors.

Given the extensive substance abuse and sexual risk behaviors reported by the participants in the study, underreporting of these and other stigmatized behaviors would seem less likely. Furthermore, the most likely experience of the respondents was to have been arrested for multiple types of crime. Although social capital was not directly measured by the assessments, the relatively poor economic circumstances and high levels of social instability reported by the study participants point to the lack of social capital as a potentially important aspect of syndemic theory.

A few of the important research questions would appear to be: Unless and until there are widespread institutional efforts to collect sexual identification and behavioral data within criminal justice systems, behavioral researchers with access to gay and bisexual men might strongly consider including these questions in data collection instruments and qualitative research programs. National Center for Biotechnology Information , U.

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J Psychoactive Drugs. Author manuscript; available in PMC Dec 1. Steven P. Kurtz , Ph. Find articles by Steven P. Author information Copyright and License information Disclaimer. Please address correspondence and reprint requests to Steven P.

Kurtz, Ph. Copyright notice. See other articles in PMC that cite the published article. Open in a separate window. Substance Use and Sexual Risk Behaviors Table 2 shows current past 90 day substance use and sexual risk behaviors. Arrest Histories Arrest histories by type of crime are shown in Table 3. High School Education or Less Homelessness History 5. Ecstasy 2. Physical Abuse History 3.

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