Testing the drug use and condomless anal sex link among sexual minority men: The predictive utility of marijuana and interactions with relationship status

• Type of Material: Article
• Authors: Tyrel J Starks, Hunter College of the City University of New York (CUNY); SS Jones, Hunter College of the City University of New York (CUNY); Kory Kyre, Hunter College of the City University of New York (CUNY); Gabriel Robles, Rutgers University; Demetria Cain, Hunter College of the City University of New York (CUNY); Ruben Jimenez, Hunter College of the City University of New York (CUNY); Robert Stephenson, Emory University; Patrick Sullivan, Emory University
• Language: English
• Date: 2020-11-01
• Publisher: ELSEVIER IRELAND LTD
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 Elsevier B.V. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.drugalcdep.2020.108318
• Title of Journal or Parent Work: DRUG AND ALCOHOL DEPENDENCE
• Volume: 216
• Start Page: 108318
• End Page: 108318
• Keywords: MSM; Sexual minority men; SUBSTANCE USE; TRIAL; BISEXUAL MEN; Life Sciences & Biomedicine; HIV; Substance Abuse; HIV-NEGATIVE GAY; RISK BEHAVIOR; YOUNG GAY; ASSOCIATIONS; Science & Technology; MALE COUPLES; Same-sex male couples; Psychiatry; Drug use

Abstract

Background: The association between drug use and condomless anal sex (CAS) is well documented among sexual minority men (SMM). Less is known about whether this association generalizes to marijuana and across relationship status and sexual agreements groups (single, partnered monogamous, partnered open –outside partners permitted, and partnered monogamish –outside partners permitted when main partners are together). Methods: A nationwide sample of SMM (N = 65,707) were recruited through a geosocial networking app between November 2017 and November 2019. Participants reported on drug use and instances of CAS with casual partners in the previous 30 days. Results: Both marijuana and club drug use were associated with the occurrence of CAS with casual partners among single men. Only club drug use was associated with CAS frequency in this group. The association between marijuana and the occurrence of CAS did not differ significantly among monogamous men, while the associations between club drug use and the occurrence as well as frequency of CAS were significantly weaker. Meanwhile, the associations between club drug use and the occurrence as well as frequency of CAS did not differ significantly between single and non-monogamous (open and monogamish) subgroups; however, the association between marijuana and the occurrence of CAS was significantly weaker. Conclusions: Findings largely replicated the robust association between club drug use and CAS with casual partners. They support the assertion that marijuana use predicts sexual risk for some SMM subgroups. Finally, they illustrate the potential for relationship status – and sexual agreements – to contextualize associations between drug use and CAS.