Time Since First Acting on Same-Sex Attraction and Recreational Drug Use among Men Who Have Sex With Men (MSM): Is There an Effect of “Gay Age”?

ABSTRACT

Background: Men who have sex with men (MSM) have higher rates of substance use compared to men who have sex with women. Among MSM, drug use is linked to higher-risk sexual behavior and acquisition of HIV and other sexually transmitted infections. Objectives: We hypothesize that time since first acting on one's same sex attraction, or one's “gay age”, could be predictive of drug using behavior. Methods: We examined this question among 176 MSM, aged 18–35, presenting at a public sexual health clinic. Behavioral data were captured using interviewer- and self-administered surveys and clinical data were extracted from medical records. We used modified Poisson regression to examine associations between gay age and recent recreational drug use, and separately, between gay age and recent marijuana use. Results: In total, 43% of participants reported recent marijuana use and 26% of participants reported recent use of other drugs. The associations between gay age and marijuana use and other drug use varied by HIV status. After adjustment for biological age, race, and education, a one-year increase in gay age was associated with significantly increased drug use among HIV-negative men (adjusted prevalence ratio (aPR): 1.08; 95% confidence interval (CI): 1.03–1.14), but we observed no association between gay age and drug use among HIV-positive men (aPR: 0.96, 95% CI: 0.86–1.07). Gay age was not associated with marijuana use in HIV-negative (aPR: 1.00, 95% CI: 0.95–1.04) or HIV-positive (aPR: 1.06, 95% CI: 0.98–1.14) men. Conclusions: In summary, HIV-negative MSM who had experienced more time since first same-sex experience had significantly increased prevalence of recent drug use.

KEYWORDS:

• Men who have sex with men (MSM)
• marijuana
• recreational drug use
• HIV

Declaration of interest

The authors report no conflicts of interest.

Funding sources

This project was supported by the Ohio State University Center for Clinical and Translational Science (OSU CCTS). The OSU CCTS is supported by the National Center for Research Resources, Grant UL1RR025755, and is now at the National Center for Advancing Translational Sciences, Grant 8UL1TR000090-05. This research was further supported by award P50 DA039838 from NIDA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Advancing Translational Sciences, the National Institute on Drug Abuse, or the National Institutes of Health. The funding sources had no role in data collection, data analysis, data interpretation, writing of this report, or the decision to publish this manuscript.

Acknowledgments

The authors thank Mysheika Williams Roberts, Jose Bazan, Maurizio Macaluso, and the Division of Infectious Diseases at The Wexner Medical Center at the Ohio State University for their support of this project. The authors thank the clinicians from Columbus Public Health Sexual Health Clinic and study volunteers (Alexandra Medoro, Aliza Spaeth-Cook, Angela Palmer-Wackerly, Chelsea Muyskens, Julie Anderson, Laura Drew, Samantha Lahey, and Tiffany Wang) for their assistance with data collection.