Drug Use Patterns Among Young Men of Color Who Have Sex with Men

Introduction. Many racial/ethnic sexual minority youth experience multiple forms of minority stressors (e.g., racism, homophobia) in multiple settings (e.g., home, school/work). These youth are at high risk for a wide range of adverse health outcomes, including drug addiction. Although sexual minority youth are more likely to use tobacco, alcohol and illicit drugs compared to their sexual majority peers, young men of color who have sex with men (YMCSM) generally report less frequent drug use than their White counterparts. However, YMCSM are at greater risk for drug use when they experience violence, discrimination or harassment. In order to understand the mechanisms underlying these complex processes, we must first identify YMCSM’s patterns of drug use and how these patterns are related to known risk factors. To this end, this study used latent class analysis (LCA) to examine drug use patterns among YMCSM and their associations with demographic and contextual risk factors.

Methods. Analyses included 448 YMCSM (mean age=22.3, SD=2.0; 21.0% Black, 58.9% Latino, 20.1% Multi-Racial/Ethnic) from the Healthy Young Men’s Cohort Study 2.0. Participants self-identified as gay, bisexual or other sexual minority, and as Black, Latino or Multi-Racial/Ethnic. A variety of substances were considered when identifying past 6-month drug use patterns: alcohol, marijuana, tobacco, poppers, cocaine, opioids, club drugs (e.g., ecstasy), and other drugs (e.g., inhalants). LCA was used to identify drug use patterns at study entry and their associations with age, race/ethnicity, food insecurity, meeting basic needs, sex exchange (e.g., for a ride), and residential status (e.g., with family, own place).

Results. Four latent classes of drug use were identified: (1) Non-Users (39% prevalence); (2) Alcohol and Marijuana Users (21%); (3) Alcohol and Marijuana Problem Users with Cigarette, Cocaine and Club Drug Use (32%); and (4) Alcohol and Marijuana Problem Users with Poly-Drug Use (7%). Latent class membership was significantly associated with age, food insecurity, being able to meet basic needs, and sex exchange. In general, men who were younger were more likely to be non-users, and men who were food insecure, unable to meet basic needs, and engaging in sex exchange were more likely to have problems with drug use.

Conclusions: By examining comprehensive drug use patterns and their associations with known risk factors, this study took the first step towards understanding which YMCSM are at greatest risk for certain patterns of drug use. In turn, these results can be used as a starting point for understanding change over time in drug use patterns and the complex processes that underlie drug-related health disparities for YMCSM. Implications for increasing health equity through prevention will be discussed.