Higher and Higher? Drug and Alcohol Use and Misuse among HIV-Vulnerable Men, Trans Men, and Trans Women Who Have Sex with Men in the United States

Drew A. Westmoreland, Adam W. Carrico, Renee D. Goodwin, David W. Pantalone, Denis Nash, Christian Grov

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Substance use (SU) and misuse are disproportionately more common among sexual and gender minority (SGM) individuals compared to their heterosexual peers. Yet, little is known about regional and demographic differences in use and misuse among SGM. In this study, we investigated regional and demographic differences in SU and misuse in a U.S. national, internet-based cohort (n = 6,280) of men and trans persons who have sex with men. Methods: Data collected included the WHO ASSIST (substance) and AUDIT (alcohol) SU scales to estimate recent (≤ 3 months) non-problematic use (≤ 3 ASSIST, ≤ 10 AUDIT) and misuse (≥4 ASSIST, ≥11 AUDIT). We used bivariate and multivariable logistic models to examine demographic and regional factors associated with SU and misuse. Results: Participants reported using alcohol (85.6%), cannabis (53.9%), and inhalants (39.1%) in the past three months. More than one-third self-reported misuse of cannabis, Gamma-Hydroxybutyrate (GHB), inhalants, methamphetamines, and prescription sedatives. We observed regional differences in substance use for cannabis (Southeast aOR = 0.76, 95% CI: 0.63–0.93; West aOR = 1.27, 95% CI: 1.02–1.59, ref. Northeast) and prescription Stimulants (Midwest aOR = 1.39, 95% CI: 1.00–1.93), as well as for cannabis misuse (Southeast aOR = 0.83, 95% CI: 0.69–0.99). We also observed significant associations between socioeconomic factors with use and misuse. Conclusions: Findings suggest geographic differences in misuse of certain substances among men and trans persons who have sex with men in the US, and that socio-economic factors, also play a key role in indicating risk.

Original languageEnglish (US)
Pages (from-to)111-122
Number of pages12
JournalSubstance Use and Misuse
Volume56
Issue number1
DOIs
StatePublished - 2021

Keywords

  • ASSIST
  • AUDIT
  • MSM
  • Substance use
  • geographic contexts
  • substance misuse

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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