Background:
High-risk, substance-using MSM comprise a population with great potential for STD and HIV transmission.

Objective:
To describe the prevalence of reported STDs in the past 12 months by HIV-status, race/ethnicity, and substance use during sex.

Method:
1540 men completed a baseline behavioral assessment using Audio Computer-Assisted Self-Interview (ACASI) in Chicago, Los Angeles, New York City, and San Francisco during 2005-06. Men were recruited through outreach and ads, and were eligible if they reported substance use during anal sex and unprotected anal sex with a man during the prior 6 months. Self-reported HIV status and STDs in the past 12 months were assessed, and analyses below compared STD prevalence by subgroup.

Result:
The baseline sample was 32% Black, 19% Latino, and 47% HIV-positive. Overall, 33% of the men reported having an STD in the prior 12 months, with HIV-positive men more likely to report an STD compared to HIV-negative/-unknown men (37% vs. 30% respectively, p<.01). There were no differences (p>.05) for STDs overall by race/ethnicity, however there were racial differences for specific STDs. Men who reported using a drug (besides alcohol) prior to their most recent anal sex encounter were more likely to report having an STD in the prior 12 months compared to men who did not use a drug (35% vs. 30%, p<.05). Specifically, methamphetamine use (yes, 41% [had an STD] vs. no, 31%; p<.05) and Viagra use (yes, 42% vs. no, 32%; p<.05) were associated with an STD in the prior 12 months.

Conclusion:
In this sample of MSM at high risk for sexually-transmitted infections, a large percentage reported having an STD in the past year, especially HIV-positive men and men who used drugs before sex.

Implications:
STD and HIV risk reduction should be further addressed among high-risk MSM, including targeted efforts based on HIV-status and substance use before or during sex.