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Berlin GW, Dermody SS, Noor SW, Skakoon-Sparling S, Ghauri Y, Zahran A, Card KG, Lachowsky NJ, Cox J, Moore DM, Lambert G, Jollimore J, Grace D, Zhang H, Apelian H, Sang JM, Dvorakova M, Lal A, Hart TA. Minority Stress, Psychological Distress, Sexual Compulsivity, and Avoidance-Based Motivations Associated with Methamphetamine Use Among Sexual Minority Men Living with HIV: Examining Direct and Indirect Associations Using Cross-Sectional Structural Equation Modeling. Subst Use Misuse 2024:1-11. [PMID: 38950280 DOI: 10.1080/10826084.2024.2369159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
OBJECTIVE Sexual minority men (SMM) living with HIV report significantly greater methamphetamine use compared with heterosexual and HIV-negative peers. Greater use may be related to stressors (e.g., HIV-related stigma) faced by SMM living with HIV and subsequent psychological and behavioral sequelae. We tested an integrated theoretical model comprised of pathways between stigma, discrimination, childhood sexual abuse, psychological distress, sexual compulsivity, and cognitive escape in predicting methamphetamine use among SMM living with HIV. METHODS Among 423 SMM living with HIV, we tested a structural equation model examining factors hypothesized to be directly and indirectly associated with methamphetamine use. Analyses were adjusted for demographic covariates and sampling bias. RESULTS The model showed good fit (CFI = 0.96, RMSEA = 0.01). Heterosexist discrimination was associated with psychological distress (β = 0.39, p < 0.001) and psychological distress was associated with sexual compulsivity (β = 0.33, p < 0.001). Sexual compulsivity was associated with cognitive escape (β = 0.31, p < 0.001), which was associated with methamphetamine use (β = 0.51, p < 0.001). Psychological distress was associated with methamphetamine use via serial indirect effects of sexual compulsivity and cognitive escape (β = 0.05, p < 0.05). CONCLUSIONS Heterosexist discrimination contributed to psychological distress among SMM living with HIV. Psychological distress is linked to methamphetamine use via sexual compulsivity and cognitive avoidance. Interventions seeking to reduce the likelihood that SMM living with HIV use methamphetamine should include coping strategies specific to heterosexism and related psychological distress.
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Affiliation(s)
| | | | - Syed W Noor
- Toronto Metropolitan University, Toronto, Canada
- Louisiana State University Shreveport, Shreveport, Louisiana, USA
| | | | - Yusuf Ghauri
- Toronto Metropolitan University, Toronto, Canada
| | - Adhm Zahran
- Toronto Metropolitan University, Toronto, Canada
| | - Kiffer G Card
- University of Victoria, Victoria, Canada
- Simon Fraser University, Vancouver, Canada
| | | | - Joseph Cox
- McGill University, Montreal, Canada
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - David M Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Gilles Lambert
- Research Institute of the McGill University Health Centre, Montreal, Canada
- Institute National de Santé Publique du Québec, Montreal, Canada
| | - Jody Jollimore
- Canadian AIDS Treatment Information Exchange (CATIE), Toronto, Canada
| | | | | | - Herak Apelian
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Jordan M Sang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Milada Dvorakova
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Allan Lal
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Trevor A Hart
- Toronto Metropolitan University, Toronto, Canada
- University of Toronto, Toronto, Canada
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Mammadli T, Hong C. Substance Use and Misuse among Sexual and Gender Minority Communities Living in Former Soviet Union Countries: A Scoping Review. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2024; 36:59-76. [PMID: 38600900 PMCID: PMC10903640 DOI: 10.1080/19317611.2024.2303517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/04/2024] [Indexed: 04/12/2024]
Abstract
Objectives We reviewed literature examining substance use among sexual and gender minorities (SGM) living in the former Soviet Union (USSR) nations. Methods Searches were conducted across five databases (PubMed, SocINDEX, CINAHL, PscyInfo, LGBTQ + Source) to identify peer-reviewed literature. Results Across 19 studies, high hazardous substance use prevalence was documented. Substance use was correlated with (a) sexual health and behaviors and (b) mental wellbeing and the use of other substances. Conclusion We discuss minority stress implications and challenges presented by the paucity of evidence in the literature examining substance use among SGM women and SGM living in countries unrepresented in reviewed studies.
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Affiliation(s)
- Tural Mammadli
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - Chenglin Hong
- Department of Social Welfare, University of California Los Angeles, Los Angeles, CA, USA
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Card KG, Shen T, Barath J, Sang J, Lal A, Moore DM, Lachowsky NJ. Patterns of Event-Level Concurrent Substance Use During Sex Among Gay, Bisexual, and Other Men Who Have Sex with Men in Metro Vancouver. AIDS Behav 2023:10.1007/s10461-023-04036-w. [PMID: 36943600 DOI: 10.1007/s10461-023-04036-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2023] [Indexed: 03/23/2023]
Abstract
This study identified patterns of sexualized substance use among gay, bisexual, and other men who have sex with men (gbMSM) and examined associated risk factors for sexually transmitted and blood borne infections (STBBI). Data were from a longitudinal cohort recruited using respondent-driven sampling between Feb-2017 and Feb-2019. Participants reported on events with up to five of their most recent sexual partners. Latent class analysis examined patterns of concurrent substance use 2 h prior to or during sex. Multinomial regression identified demographic, partner-level, and event-level factors associated across 11,877 sexual events reported by 757 participants. Most combinations of substance use were rare, but most drugs were frequently combined with other drugs when they were used prior to or during a sexual event. Six latent classes of concurrent event-level substance use were identified. The referent class (58.8% of events) was characterized by limited use of any drugs. The Common Drug Use class (12.1%) was characterized by use of alcohol, cannabis, and poppers and the Licit Drug Use class (21.6%) was characterized by use of alcohol alone. The Party 'N' Play (PnP) class (2.3%) was characterized by use of crystal methamphetamine GHB, Poppers, and Erectile Drugs; The Multi-use (3.5%) class was characterized by the PnP substances plus alcohol and ecstasy; and the Cannabis + class was characterized by use of Cannabis, Erectile Drugs, and Ecstasy. Relative to the referent class, all other classes were associated with events with more behavioural and network risk factors for STBBIs-highlighting the need for harm reduction interventions for gbMSM who use these drugs.
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Affiliation(s)
- Kiffer G Card
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
| | - Tian Shen
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Justin Barath
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Jordan Sang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- British Columbia Centre on Substance Use, Vancouver, Canada
| | - Allan Lal
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - David M Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Nathan J Lachowsky
- School of Public Health and Social Policy, University of Victoria, Victoria, Canada
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4
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Íncera-Fernández D, Gámez-Guadix M, Moreno-Guillén S. Mental Health Symptoms Associated with Sexualized Drug Use (Chemsex) among Men Who Have Sex with Men: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413299. [PMID: 34948907 PMCID: PMC8701799 DOI: 10.3390/ijerph182413299] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 01/21/2023]
Abstract
Background: Sexualized drug use (SDU), also known as chemsex, refers to the use of psychoactive substances for sexual purposes among men who have sex with men (MSM), which has been associated with mental health symptoms. The objective of this review is to systematically review the available evidence on mental health outcomes in MSM who use sexualized drugs. Methods: To prepare this systematic review, search strategies were developed and applied to the Web of Science, Science Direct, PubMed, and Scopus databases. A total of 117 articles were found, of which 12 were selected for the final review. Results: Those MSM who practiced SDU were more likely to experience from depression, anxiety, or a substance dependence, although these results were not found in all the studies analyzed. Among those who practiced the administration of intravenous drugs (referred to as slamsex), the mental health symptoms were more severe. Conclusions: This systematic review contributes to a fuller understanding of the mental health symptoms present in MSM who consume drugs for sexual purposes. Greater uniformity in data collection instruments is required, as well as the need to conduct a more in-depth assessment of the psychosocial adjustment of people who practice chemsex.
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Affiliation(s)
- Daniel Íncera-Fernández
- Department of Personality, Assessment and Psychological Treatment, Autonomous University of Madrid, 28049 Madrid, Spain;
- Correspondence: ; Tel.: +34-686-454-251
| | - Manuel Gámez-Guadix
- Department of Personality, Assessment and Psychological Treatment, Autonomous University of Madrid, 28049 Madrid, Spain;
| | - Santiago Moreno-Guillén
- Department of Medicine and Medical Specialties, Alcalá University, 28871 Alcala de Henares, Spain;
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