Modeling substance use in emerging adult gay, bisexual, and other YMSM across time: The P18 cohort study

Abstract

Objective To examine patterns of substance use over time in a new generation of emerging adult gay, bisexual, and other young men who have sex with men (YMSM). Methods Data were drawn from the first four waves of on ongoing prospective cohort study of YMSM who were ages 18 to19 at baseline and were assessed each 6 months for substance use via calendar based methods. Latent growth curve modeling was utilized to assess changes over time for four drug use categories: alcohol, marijuana, inhalant nitrates, and other drugs (e.g., cocaine, ecstasy) and between groups (race/ethnicity, perceived familial socioeconomic status; SES). Results Use of all substances increased steadily across the follow-up period. White YMSM demonstrated higher levels of alcohol use at the 18-mo follow-up visit compared to other racial/ethnic groups, while rates of change across groups were similar. Marijuana use at 18 months was highest for Hispanics who also indicated the highest rate of change. Finally, YMSM who reported higher perceived SES reported the lowest use and lowest rates of change for other drug use. Controlling for perceived SES, differences in patterns of drug use by race/ethnicity were evident but differences were not as large. Conclusions Increases in substance use in the emerging adulthood of YMSM indicate the need for structural and behavioral interventions tailored to address substance use in these young men before chronic patterns of use develop. Differences in patterns of drug use across racial/ethnic and SES groups suggest that interventions need to consider person-level differences.

Trajectories of alcohol, marijuana, and illicit drug use in a diverse sample of young men who have sex with men

“…Growth from the age of 22 to 24 was only significant for poly-drug use. Previous research has found evidence of increases in alcohol and drug use as YMSM move from adolescence to young adulthood (Dermody et al, 2014; Halkitis et al, 2014; Hatzenbuehler et al, 2008; Marshal et al, 2009; Newcomb et al, 2012), and these analyses expand on prior work and indicate that this growth may occur primarily during the teenage years. We also found that change for all three substance use behaviors was significantly positively correlated at both ages 17–21 and ages 22–24, with the exception of alcohol and poly-drug use which was only correlated at ages 17–21.…”

“…Halkitis and colleagues (2014) followed YMSM at ages 18–19 for eighteen months and found that not only did YMSM increase in alcohol use over time, but that they also increased in marijuana and illicit drug use (defined in this study as cocaine, ecstasy, GHB, ketamine, heroin, rohypnol, and methamphetamine use) as well. These findings are in line with what has typically been found with heterosexual male populations (Chen and Kandel, 1995; Kandel and Logan, 1984).…”

Risk and Protective Factors for Substance Use Among Sexual and Gender Minority Youth: a Scoping Review

“…Several factors were protective against SMY drug use including higher socioeconomic status [65], school connectedness [66], and higher self-esteem [67]. In fact, school enrollment itself predicted less past-3-month drug use in a predominantly Black and Latino SMY sample [68].…”

“…Black and Latino adolescent SMM were also more likely than Whites to report lifetime anabolic steroid use [59], a disparity that was associated with depressive symptomatology [58]. Asian young SMM reported decreasing rates of inhalant use over time, a finding not observed in other racial/ethnic groups [65]. Among Black SMY, race-based discrimination was also associated with adolescent HED and cannabis use [78].…”

Cross-National Investigation of Health Indicators among Sexual Minorities in Norway and the United States

“…The minority stress framework postulates that these patterns of psychosocial distress arise from the experience of discrimination, harassment, and stigma that occur as a result of social and institutional marginalization [15]. Many of the disparities found in sexual minority populations are attributed to minority stress [16].…”