Substance Use in the MSM Population of New York City during the Era of HIV/AIDS

Abstract

This literature review considers the historical significance, emergence of, and interplay between the HIV and illicit drug use epidemics among gay, bisexual, and other men who have sex with men (MSM) in New York City (NYC). The continual rise in HIV infections in recent years among MSM, particularly among young MSM (YMSM), commands a need for the examination of the effectiveness of current HIV prevention strategies and a more comprehensive understanding of the complex biopsychosocial influences that place YMSM at risk. A chronological perspective of both the HIV and illicit drug use epidemics affecting NYC MSM is presented, followed by a review of the existing research on the synergistic relation between the two. Special consideration is given to the patterns and interconnectivity between HIV, substance use, and housing instability specific to YMSM, as they represent the demographic currently at greatest risk for HIV transmission in NYC. Thereafter, an overview of treatment research is provided. We conclude by offering recommendations for future research and best practices as we move forward in an attempt to reduce the incidence of HIV transmission.

Demographic, Mental Health, Behavioral, and Psychosocial Factors Associated with Cigarette Smoking Status Among Young Men Who Have Sex with Men: The P18 Cohort Study

“…As other studies have shown, the phenomenon of polysubstance use is more common among sexual minority male substance users. 13,34 Therefore, it is unsurprising that men in this sample who used tobacco were also more likely to use marijuana and alcohol. In light of this finding, one might also reexamine how gay community affinity is related to smoking in this population.…”

Crystal Methamphetamine Use and HIV Transmission Among Gay and Bisexual Men

“…Perhaps our ability to address the 'meth-sex' link and to alleviate the population of this burden, our work must be rooted in fully understanding why gay and bisexual men are drawn to methamphetamine, specifically, and substance use more broadly [1]. It is posited that the initiation of methamphetamine may help some gay and bisexual men confront issues of self-esteem, guilt, and shame associated with sexual identity, and may serve as a means of coping with the stigma, internalized homophobia, lack of sense of belonging, and minority stress experienced by some [39•, 40, 41•, 42, 43].…”

“…crystal meth, Tina, crank, ice) has garnered much attention in the behavioral and public health literature, particularly as it relates to use, abuse, and addiction in the population of gay and bisexual men. Despite historical evidence which suggests that the drug has been used and abused in the United States (US) for more than 50 years, the prevalence of use among sexual minority men has been an area of concern because of the close association between use of the drug and the transmission of sexual pathogens, particularly HIV [1,2]. It has been proposed that the hypersexualinducing effects of the substance [3] which may be exacerbated by urban gay culture [4,5] increase the likelihood of HIV transmission, in effect creating a 'dual epidemic' [6].…”

Illicit drug use and its association with sexual risk behaviour among MSM

“…The conceptual nature of syndemic theory means that it is difficult to test as a causal model. Yet crosssectional evidence consistently points to the association between several psychosocial health problems, including substance use, and HIV risk behaviours (41,42). In a community-based sample of young MSM in Chicago, substance use was found to be a key syndemic factor with intimate partner violence, HIV risk behaviours and HIV seropositive status (21).…”