Short communicationPrevalence of recent illicit substance use and reporting bias among MSM and other urban males
Introduction
While it is clear that many men who have sex with men (MSM) do not use illicit drugs, research shows that illicit substance use is prevalent in this population (Stall et al., 2001, Thiede et al., 2003), and prevalence rates for a variety of illicit substances have consistently been higher for MSM than for non-MSM in studies where direct comparisons are available (McCabe et al., 2005, Woody et al., 2001). Several recent studies indicate that “club drugs” (e.g., MDMA, amphetamines, and LSD) in particular may be used to a greater extent among MSM (Fendrich et al., 2003, McCabe et al., 2003, Stall et al., 2001). The tracking of emerging substance use trends within any particular population subgroup facilitates the targeting of community based prevention efforts and can also serve as a means of evaluating ongoing program activities. Within the context of MSM, research on substance use behavior has particular import because of purported associations with risky sexual behavior and practices which potentially increase the spread of HIV (Stall & Purcell, 2000).
An issue which has not been addressed is the extent to which differences in self-reported substance use may be an artifact of differential willingness to report the use of illicit substances. Some studies of MSM, including our own, systematically screen for gay identity or MSM behavior as a criteria for study inclusion. Subjects who are willing to disclose MSM behavior at screening may generally be more willing to share “private” information in research surveys. In addition, to the extent that substance use is relatively more prevalent among MSM, substance use may be more normative and this behavior may be relatively less “sensitive”. If the reports of elevated rates of substance use among MSM compared to men in general are artifactual, this has implications for studies relating substance use to risky sexual behavior. Greater willingness among MSM to disclose sensitive behaviors such as drug use and risky sex may lead to overestimation of the association between the two behaviors, as well as inflated differences between MSM and heterosexual men in both drug use and sexual behavior. The present study addresses this issue by examining self-reported rates of use of several substances, and corrected rates using the results of biological tests (urine and oral fluid) between MSM and community samples of adult respondents.
Section snippets
Sample and procedure
This study employed two multi-stage area household probability samples of men in Chicago. The first was a sample of more than 600 Chicago residents, ages 18–40, conducted from June 2001 to January 2002, and described in detail elsewhere (Fendrich, Johnson, Wislar, Hubbell, & Spiehler, 2004). Interviews were completed with 242 men; 92% of these men self-identified as being only heterosexual. The second sample was obtained as a supplement to the general population survey, and was concentrated in
Self-reported substance use prevalence
Prevalence estimates based on self-reported substance use are shown in Table 2, Table 3. Significance levels are adjusted for 10 comparisons. No estimates are shown for Rohypnol as there was no reported use of this substance in either sample within the past year.
Young MSM were significantly more likely than young general population males to report past year use of Ecstasy (F = 15.57, p < .01), inhalants (F = 12.92, p < .01), Ketamine, (F = 6.90, p < .05) methamphetamine (F = 9.67, p < .05), and
Discussion
Higher rates of self-reported use in the past year, and in the past month were found among MSM compared to men in the general population sample for several substances. Differences in past month use were evident only among men over 30 years old, for cocaine, Ecstasy, inhalants, and Ketamine. When corrected for underreporting, Ecstasy and Ketamine use, but not cocaine use, appeared as more prevalent among older MSM. In multivariate analyses, adjusting for age, White race/ethnicity, and education
Acknowledgment
This study was funded by a grant from the National Institute on Drug Abuse, U.S.A. (R01DA018625).
References (12)
- et al.
Controlling the false discovery rate: A practical and powerful approach to multiple testing
Journal of the Royal Statistical Society. Series B, Statistical Methodology
(1995) - et al.
Club drug use among young men who have sex with men in NYC: A preliminary epidemiological profile
Substance Use and Misuse
(2005) - et al.
The utility of drug testing in epidemiological research: Results from a general population survey
Addiction
(2004) - et al.
A contextual profile of club drug use among adults in Chicago
Addiction
(2003) - et al.
Sexual identity and substance use among undergraduate students
Substance Abuse
(2003) - et al.
Assessment of difference in dimensions of sexual orientation: Implications for substance use research in a college-age population
Journal of Studies on Alcohol
(2005)
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