“Becoming Bold”: Alcohol Use and Sexual Exploration among Black and Latino Young Men Who Have Sex with Men (YMSM)

Abstract

Alcohol use is correlated with unprotected sex, which may place young men who have sex with men (YMSM) who use alcohol with sex at increased risk for contracting HIV. However, little is known about how this link develops. This study used qualitative interviews to explore how alcohol became associated with sex and sexual risk among YMSM. We purposively sampled 20 Black and 20 Latino YMSM (N = 40), ages 21 to 24, who used substances (alcohol, marijuana, and crystal methamphetamine) with sex. Interviews focused on participants’ personal histories to trace how these associations developed for each individual. Drawing on sexual script, emotion regulation, and alcohol expectancy theories, analyses followed a modified grounded theory approach. Participants stated that alcohol enabled them to engage in sexual behaviors with men that they wanted to try, allowing them to be more “bold,” overcome stigma about homosexuality, and feel increased comfort with their sexual desires and identities. The use of alcohol during sex was helpful to some of the participants but could also lead to sexual risk behaviors. Intervention programs seeking to reduce alcohol misuse and sexual risk should take into account how YMSM conceptualize associations between alcohol and sex. These programs may be more effective if they provide support for sexual identity exploration.

Acknowledgments

The authors wish to gratefully acknowledge the collaborators, staff, and volunteers who contributed to this work, including Dr. Ricky Bluthenthal, Kristi Jackson, MEd, Tara McKay, MA, Dialika Sal, Marissa Holden, Kim Bui, Caroline Hu, Baldomero Gonzalez, Kristecia Estem, Sandra Huerta, and Kinjal Patel. We also thank the participants who generously shared their stories and perspectives with us. This research was supported by the National Institute on Drug Abuse at the National Institutes of Health (R03DA026731-02). The development of this manuscript was supported by the National Institute of Mental Health (R15MH095689). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse, the National Institute of Mental Health, or the National Institutes of Health.

Notes

^a In the past 30 days, how much money did you get altogether? Please include money you got from all sources. Please do not include money that your parents make, except for money they give you. Sources may include from work, gifts, tips, financial aid.

*Total percentage sums to more than 100 because participants could select multiple sexual identities.

**Total number does not equal 40 due to missing data from 3 participants.

***Total number does not equal 21 due to missing data from 2 participants.