Factors Associated with Cessation or Reduction of Methamphetamine Use among Gay, Bisexual, and Other Men Who Have Sex with Men (gbMSM) in Vancouver Canada

Abstract

Background: Methamphetamine (MA) use among gay, bisexual, and other men who have sex with men (gbMSM) is a pervasive issue, associated with detrimental health outcomes. We identified factors associated with discontinuation or reduction in MA among a subset of gbMSM reporting frequent (at least weekly) use, with a specific focus on symptoms of anxiety and depression. Methods: We recruited sexually-active gbMSM aged ≥16 years in Vancouver, Canada into a prospective-cohort study using respondent-driven sampling. Participants completed study visits once every six months. We used generalized linear mixed models to identify factors associated with reductions in MA use following a visit where participants previously reported using MA at least weekly. Results: Of 584 cohort participants with at least one follow-up visit, 67 (11.5%) reported frequent MA use at baseline or in follow-up visits. Of these, 46 (68.7%) had at least one subsequent study visit where they transitioned to less frequent (monthly or less) or no MA use. In multivariable models, reduced MA use was less likely for those who spent >50% of social time with other gbMSM (aRR = 0.49, 95%CI:0.28–0.85), gave or received drugs in exchange for sex (aRR = 0.34, 95%CI:0.13–0.87), injected drugs (aRR = 0.35, 95%CI:0.18–0.68), or used gamma-hydroxybutyrate (GHB) (aRR = 0.41, 95%CI:0.21–0.78). Symptoms of anxiety or depression were not associated with reductions in MA use. Conclusions: Social connection and drug-related factors surrounding MA use were associated with reductions, but anxiety and depressive symptomatology were not. Incorporating socialization and polysubstance-related components with MA reduction may help in developing efficacious interventions toward reducing MA use for gbMSM.

Keywords:

• Methamphetamines
• gay
• bisexual and other men who have sex with men (gbMSM)
• substance use reduction
• anxiety
• depression

Acknowledgements

We would like to thank the Momentum Health Study participants, office staff and community advisory board as well as our community partners: Health Initiative for Men, YouthCO HIV & Hep C Society, and Positive Living Society of BC.

Disclosure statement

The authors of this study have no conflicts of interest to disclose.

Additional information

Funding

This work was supported by the National Institute on Drug Abuse (R01DA031055-01A1) and the Canadian Institutes of Health Research (MOP-107544, FDN-143342, PJT-153139). BC was supported by a Summer Student Research Award from the UBC Faculty of Medicine in partnership with the Providence Health Care Research Institute. NJL was supported by a CANFAR/CTN Postdoctoral Fellowship Award. HLA was supported by a Postdoctoral Fellowship award from the Canadian Institutes of Health Research (Grant #MFE-152443). DMM and NJL are supported by Michael Smith Foundation for Health Research Scholar Awards (#5209, #16863). KGC is supported by a Canadian Institutes of Health Research Health Systems Impact Fellowship award, a Michael Smith Foundation for Health Research Trainee award, and a Canadian HIV Trials Network/Canadian Foundation for AIDS Research Postdoctoral Fellowship award.