Although the use of illicit substances, particularly those commonly categorized as “club drugs”, among men who have sex with men (MSM), is well established in the literature, little is known about the decision making process that is used in deciding whether or not to use a particular substance. In this study, we examine the positive and negative attitudes and perceptions among young men who have sex with men (YMSM) in regards to three specific drugs: crystal methamphetamine, cocaine, and ecstasy. The findings reported here emerged from the baseline quantitative interviews and an accompanying qualitative phase of the Healthy Young Men's study (HYM), a longitudinal study examining risk and protective factors for substance use and sexual risk among an ethnically diverse sample of YMSM. Findings are discussed in relation to framing how service providers and others can design new and innovative interventions to prevent young men from initiating substance use.
Get full access to this article
View all access options for this article.
References
1.
AgarM. A.ReisingerH. S.2001Using trend theory to explain heroin use trends. Journal of Psychoactive Drugs, 33, 203–209.
2.
AgarM. A.ReisingerH. S.2004Ecstasy: Commodity or disease. Journal of Psychoactive Drugs, 36, 253–264.
3.
AjzenI.1985From intentions to actions: A theory of planned behavior. In KuhlK.BeckmanJ. (Eds.), Action-control: From cognition to behavior (pp. 11–39). Heidelberg, Germany: Springer.
4.
AjzenI.FishbeinM.2005The influence of attitudes on behavior. In AlbarracinD.JohnsonB.ZannaM. (Eds.), The handbook of attitudes (pp. 173–221). Mahwah, NJ: Lawrence Erlbaum Associates.
5.
ArnettJ. J.2000Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55 (5), 469–480.
6.
BeckJ.RosenbaumM.1994Pursuit of ecstasy: The MDMA experience. Albany: State University of New York Press.
7.
BoeriM.SterkC.ElifsonK.2004Rolling beyond raves: Ecstasy use outside the rave setting. Journal of Drug Issues, 34 (4), 831–860.
8.
BoysA.MarsdenJ.FountainJ.GriffithsP.StillwellG.StraingJ.1999What influences young people's use of drugs: A qualitative study of decision-making. Drugs: Education, Prevention and Policy, 6, 373–387.
9.
BuxD. A.1996The epidemiology of problem drinking in gay men and lesbians: A critical review. Clinical Psychology Review, 16 (4), 227–298.
10.
ChesneyM. A.BarrettD. C.StallR.1998Histories of substance use and risk behavior: Precursors to HIV seroconversion in homosexual men. American Journal of Public Health, 88, 113–118.
11.
ClattsM. C.GoldsamtL. A.YiA. H.2005Club drug use among young men who have sex with men in NYC: A preliminary epidemiological profile. Substance Use and Misuse, 40, 1317–1330.
12.
CochranS. D.AckermanD.MaysV. M.RossM. W.2004Prevalence of non-medical drug use and dependence among homosexually active men and women in the US population. Addiction, 99, 989–998.
13.
DíazR. M.HeckertA. L.SánchezJ.2005Reasons for stimulant use among Latino gay men in San Francisco: A comparison between methamphetamine and cocaine users. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 82 (Supplement 1), i71–i77.
14.
DolezalC.RemienR.WagnerG.Carballo-DieguezA.HungY.2005Alcohol, marijuana, cocaine use, and relationship quality among HIV serodiscordant male couples. The American Journal of Drug and Alcohol Abuse, 31, 593–600.
15.
ElliotD. S.HuizingaD.AgetonS. S.1985Explaining delinquency and drug use. Beverly Hills: Sage.
16.
FernándezM. I.BowenG. S.VargaL. M.CollazoJ. B.HernandezN.PerrinoT.2005High rates of club drug use and risky sexual practices among Hispanic men who have sex with men in Miami, Florida. Substance Use & Misuse, 40 (9–10), 1347–1362.
17.
FishbeinM.MiddlestadtS.1989Using the theory of reasoned action as a framework for understanding and changing AIDS-related behaviors. In MaysV.AlbeeGSchneiderS (Ed.), Primary Prevention of AIDS: Psychological Approaches. Newbury Park, CA: Sage.
18.
FountainJ.BartlettH.GriffithsP.GossopM.BoysA.StrangJ.1999Why say no: Reasons given by young people for not using drugs. Addiction Research, 7, 339–353.
19.
GlaserB. G.1992Basics of grounded theory analysis: Emergence vs. forcing. Mill Valley, CA: Sociology Press.
20.
GlaserB. G.StraussA.1967The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine Publishing Company.
21.
GussJ. R.2000Sex like you can't even imagine: “Crystal,” crack and gay men. Journal of Gay and Lesbian Psychotherapy, 3, 105–122.
22.
HalkitisP. N.GreenK. A.MourguesP.2005Longitudinal investigation of methamphetamine use among gay and bisexual men in New York City: Findings from Project BUMPS. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 82 (Supplement 1), i18–i25.
23.
HalkitisP. N.FischgrundB. N.ParsonsJ. T.2005Explanations for methamphetamine use among gay and bisexual men in New York City. Substance Use and Misuse, 40, 1331–1345.
24.
HalkitisP. N.ParsonsJ. T.2002Recreational drug use and HIV-risk sexual behavior among men frequenting gay social venues. Journal of Gay and Lesbian Social Services, 14 (4), 19–38.
25.
HalkitisP. N.ParsonsJ. T.StirrattM.2001A double epidemic: Crystal methamphetamine drug use in relation to HIV transmission among gay men. Journal of Homosexuality, 41 (2), 17–35.
26.
HalkitisP. N.ParsonsJ. T.WiltonL.2003An exploratory study of contextual and situational factors related to methamphetamine use among gay and bisexual men in New York City. Journal of Drug Issues, 33 (2), 413–432.
27.
HartT.HeimbergR. G.2005Social anxiety as a risk factor for unprotected intercourse among gay and bisexual male youth. AIDS and Behavior, 9 (4), 505–512.
28.
HirshfieldS.RemienR.HumberstoneM.WalavalkarI.ChiassonM.2004Substance use and high-risk sex among men who have sex with men: A national online study in the USA. AIDS Care, 16 (8), 1036–1047.
29.
HuntG.EvansK.WuE.ReyesA.2005Asian American youth, the dance scene and club drugs. Journal of Drug Issues, 35 (4), 695–731.
30.
KellyB.2005Conceptions of risk in the lives of club drug-using youth. Substance Use and Misuse, 40, 1443–1459.
31.
KipkeM. D.WeissG.DoreyF.RamirezM.Ritt-OlsonA.IversonE.2007Club drug use in Los Angeles among young men who have sex with men. Substance Use and Misuse, 42, in press.
32.
KissingerP.RiceJ.FarleyT.TrimS.JewittK.MargavioV.1999Application of computer-assisted interviews to sexual behavior research. American Journal of Epidemiology, 149 (10), 950–954.
33.
KlitzmanR.GreenbergJ.PollackL.DolezalC.2002MDMA (ecstasy) use and it association with high risk behaviors, mental health, and other factors among gay/bisexual men in New York City. Drug and Alcohol Dependence, 66 (2), 115–125.
34.
KlitzmanR.PopeH.HudsonJ.2000MDMA (ecstasy) abuse and high-risk sexual behaviors among 169 gay and bisexual men. American Journal of Psychiatry, 157 (7), 1162–1164.
35.
KrebsC.SteffeyD.2005Club drug use among delinquent youth. Substance Use and Misuse, 40, 1363–1379.
36.
LevyK.O'GradyK.WishE.ArriaA.2005An in-depth qualitative examination of the ecstasy experience: Results of a focus group with ecstasy-using college students. Substance Use and Misuse, 40, 1427–1441.
37.
MacKellarD.ValleroyL.KaronJ.LempG.JanssenR.1996The young men's survey: Methods for estimating HIV seroprevalence and risk factors among young men who have sex with men. Public Health Reports, 111 (Supplement 1), 138–144.
38.
McDowellD.2000Gay men, lesbians and substances of abuse and the “club and circuit party scene”: What clinicians should know. Journal of Gay and Lesbian Psychotherapy, 3 (3/4), 37–57.
39.
McElrathK.2005MDMA and sexual behavior: Ecstasy user's perceptions about sexuality and sexual risk. Substance Use & Misuse, 40, 1461–1477.
40.
McKirnanD.OstrowD.HopeB.1996Sex, drugs, and escape: A psychological model of HIV-risk sexual behaviours. AIDS Care, 8, 655–659.
41.
McKirnanD.PetersonP.1989Alcohol and drug use among homosexual men and women: Epidemiology and population characteristics. Addictive Behaviors, 14, 545–553.
42.
McNallM.RemafediG.1999Relationship of amphetamine and other substance use to unprotected intercourse among young men who have sex with men. Archives of Pediatrics and Adolescent Medicine, 153, 1130–1135.
43.
MillerB.Furr-HoldenD.VoasR.BrightK.2005Emerging adult's substance use and risky behaviors in club settings. Journal of Drug Issues, 35 (2), 357–378.
44.
MuhibF.LinL.SteuveA.MillerR.FordW.JohnsonW.2001The community intervention trial for youth (CITY) study team: A venue-based method for sampling hard to reach populations. Public Health Reports, 116 (S2), 216–222.
45.
MurrayJ.1998Psychophysiological aspects of amphetamine-methamphetamine abuse. Journal of Psychology, 132, 227–237.
46.
NovoaR.OmpadD.WuY.VlahovD.GaleaS.2005Ecstasy use and its association with sexual behaviors among drug users in New York City. Journal of Community Health, 30 (5), 331–343.
47.
OstrowD.2000The role of drugs in the sexual lives of men who have sex with men: Continuing barriers to researching this question. AIDS and Behavior, 4 (2), 205–219.
48.
PanagopoulosI.RicciardelliL.2005Harm reduction and decision making among recreational ecstasy users. International Journal of Drug Policy, 16, 54–64.
49.
RebackC.1997The social construction of a gay drug: Methamphetamine use among gay and bisexual males in Los Angeles. Los Angeles: City of Los Angeles, AIDS Coordinator.
50.
RosarioM.SchrimshawE.HunterJ.2004Predictors of substance use over time among gay, lesbian, and bisexual youths: An examination of three hypotheses. Addictive Behaviors, 29, 1623–1631.
51.
RossM.TikkanenR.MansoonS.2000Differences between Internet and samples and conventional samples of men who have sex with men. Social Science and Medicine, 4, 749–758.
52.
SafrenS.PantaloneD.2006Social anxiety and barriers to resilience among lesbian, gay, and bisexual adolescents. In OmotoA.KurtzmanH. (Eds.), Sexual orientation and mental health: Examining identity and development in lesbian, gay, and bisexual people (pp. 55–71). Washington, DC: American Psychological Association.
53.
SempleS.PattersonT.GrantI.2002Motivations associated with methamphetamine use among HIV+ men who have sex with men. Journal of Substance Abuse Treatment, 22 (3), 149–156.
54.
StallR.PurcellD.2000Intertwining epidemics: A review of research on substance use among men who have sex with men and its connection to the AIDS epidemic. AIDS and Behavior4, 181–192.
55.
SterkC.TheallK.ElifsonK.2006Young adult ecstasy use patterns: Quantities and combinations. Journal of Drug Issues, 36 (1), 201.
56.
TheallK.ElifsonK.SterkC.2006Sex, touch, and HIV risk among ecstasy users. AIDS and Behavior, 10 (2), 169–178.
57.
TurnerC.KuL.RogersS.LindbergL.PleckJ.SonensteinF.1998Adolescent sexual behavior, drug use, and violence: Increased reporting with computer survey technology. Science, 280, 867–873.
58.
WaldoC.McFarlandW.KatzM.MacKellarD.ValleroyL.2000Very young gay and bisexual men are at risk for HIV infection: The San Francisco Bay Area young men's survey II. Journal of Acquired Immune Deficiency Syndromes, 24, 168–174.
59.
WilliamsonS.GossopM.PowisB.GriffithsP.FountainJ.StrangJ.1997Adverse effects of stimulant drugs in a community sample of drug users. Drug and Alcohol Dependence, 44, 87–94.
60.
WolitskiR.ValdiserriR.DenningP.LevineW.2001Are we headed for a resurgence of the HIV epidemic among men who have sex with men?American Journal of Public Health, 91 (6), 883–888.
61.
YoshidaT.1997Use and misuse of amphetamine: An international overview. In KleeH. (Ed.), Amphetamine misuse (Vol. 1–16). Amsterdam: Harwood Academic Publishers.
62.
ZinbergN. E.1984Drug, set and setting: The basis for controlled intoxicant use. New Haven: Yale University Press.
