Project Description

MDMA Project: MDMA and STD/HIV Risk among hidden Networks of Ecstasy-Using Young Adults

The purpose of this study was to discover whether and in what ways MDMA contributes to sexual behavior and decision making, and when its use is associated with lack of protection. One component of the study examined the current status of ecstasy use and distribution, at a time when use appeared to be rising, and perceptions of risk were low. The study explored beliefs or scripts about MDMA use, where and why it is used and whether it is connected to sexual risk taking. The study also obtained from current users real life stories of MDMA use and sexual behavior and used new analytic techniques to tease out when MDMA makes a difference in sexual decisions and when it does not. The goal was to build an intervention that enhances agency by identifying and promoting continued use of protection in situations where protection is typically used, while avoiding situations when it is not.

Additional Information:

MDMA (3-4 methylenedioxymethamphetamine) is a synthetic, psychoactive drug chemically similar to the stimulant methamphetamine and the hallucinogen mescaline. MDMA is derived from methamphetamine and its reported subjective effect on sexual desire and functioning is similar to methamphetamine. Referred to as ecstasy, it is a drug with multiple functions perceived to increase energy output, social intimacy and sensuality. Media promotion has linked these functions with social status and sexuality. Widespread availability, and expectations about the capacity of ecstasy to improve sexuality coupled with common music and entertainment interests, have brought youth of diverse backgrounds together in the purchase, sharing and consumption of ecstasy and involvement in sexual behavior. Ecstasy is said to increase arousal, while either inhibiting or prolonging erection and is popularly known as a sexual enhancing drug. Further, ecstasy users tend to be polydrug users and ecstasy is often used in the presence of alcohol and marijuana, both of which are widely recognized to increase arousal and disinhibition and increase sexual risk exposure.The new ICR project is a followup to a four-year NIDA study among polydrug users,Pathways to High-Risk Drug Abuse Among Urban Youth, that identified the widespread use of MDMA in the Hartford area in 1999. Ecstasy users are usually polydrug users, combining or sequencing MDMA with alcohol, marijuana, cocaine, and prescription pills. The study helped to draw national attention to the popularity of the drug in association with clubs, bars and party settings, and its diffusion into urban networks. A second study, Urban Lifestyles: Club Drugs, Resource Inequities and Health Risks in Urban Youth, showed links between urban and suburban recreational drug using networks. Despite the traditional view that ecstasy has been used to enhance sensuality but not sexuality, both of our studies suggested a strong association between ecstasy and sexuality, in both expectations and practice. In addition, respondents have mentioned using condoms sometimes but not at other times while using ecstasy. What accounts for the differences is the subject of this study.
The purpose of this 4.5-year intervention study is to develop, conduct and evaluate a new, norms-based approach to drug and sex-risk prevention with 6th and 7th grade students in New Haven, CT. Current research demonstrates that drug and sexual risk behaviors in youth are most strongly influenced not by individual choice but by choice in the context of peer and community norms. The Group Norms Prevention Project studies the efficacy of this approach by comparing its group-based curriculum to the standard social development curriculum used in New Haven middle schools. The project uses the principles of group problem-solving, cooperative learning and social construction in the curriculum design and prevention implementation. Research methodology includes participant observation of the classroom and students, in-depth interviews with students, teachers and school support staff, a pre-post measure and a pre-post test (the Social and Health Assessment survey) administered to all students by the district.
Between 550 and 600 youth (ages 14-20) will be recruited to participate in the Xperience
intervention study. Those enrolled in the intervention and control group will report on their drug use at intake, and 3-4 months at post-test. In the project’s first year, researchers worked with focus groups of youth to develop drug-prevention messages which were then incorporated into the performances of local artists at live entertainment shows, and disseminated via a CD, print materials, a website, and promotional products. Four shows took place in Hartford over the summer of 2006 and a final CD-release show was held in the spring of 2007 with over 180 people in attendance. The Xperience Vol 1 CD was produced and over 500 copies were distributed to youth in the city. Youth who came to the shows were also given free promotional materials with drug prevention messages. Xperience staff promoted the concept of youth-led drug-free entertainment at numerous events and locations throughout the city of Hartford where they will receive Xperience promotional items and the Vol. 1 CD with drug prevention messages. This four and a half month program will be implemented again in March of ’08. Data from the ’07-‘08 intervention cohorts will be compared to a control cohort of youth from Hartford to evaluate the efficacy of the program. A program manual will be completed in 2008 to enable other agencies around the country to host Xperience drug-free events and training programs.
To develop and implement a drug prevention intervention based on youth culture that
integrates entertainment-education with drug prevention messages, to support urban
youth, ages 14 – 20, in their decision not to use drugs.

 To create a brand recognition for Xperience as an approach to “drug-free entertainment” for youth who choose not to use drugs and to hold Xperience shows and events throughout the
city.

 To evaluate the short-term efficacy of the intervention against a matched community
control group.

 To produce a procedural manual and audiovisual product for dissemination of the
intervention model to other sites and promoters in urban areas throughout the country.

 To pilot test the use of Interactive Voice Response technology for survey administration.