Exploring influences on methamphetamine use among Black gay,bisexual and other men who have sex with men in Atlanta: A focus group study |
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| Affiliation: | 1. Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, Georgia, USA;2. Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, Georgia, USA;3. Department of Behavioral, Social and Health Education Sciences, Emory University Rollins School of Public Health, 1518 Clifton Road, NE, Atlanta, Georgia, USA;4. Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road, NE, Atlanta, Georgia, USA;5. Division of Medical and Preventive Services, Fulton County Board of Health, 10 Park Place South, SE, Atlanta, Georgia, USA;1. Friends Research Institute, Inc., 1419 N. La Brea Ave, Los Angeles, CA 90028, USA;2. Integrated Substance Abuse Programs, David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 11075 Santa Monica Blvd., Suite 200, Los Angeles, CA 90095, USA;3. Center for HIV Identification, Prevention and Treatment Services, University of California, Los Angeles, 10880 Wilshire Blvd, Suite 1800, Los Angeles, CA 90024, USA;4. Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, USA |
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| Abstract: | BackgroundMethamphetamine use is a contributor to HIV risk and poor health outcomes among gay, bisexual and other men who have sex with men (GBMSM). There is a paucity of research examining methamphetamine use and its social context specifically among Black GBMSM. We therefore sought to: (1) describe trends in methamphetamine use among Black GBMSM in Atlanta, Georgia, and (2) examine the risk environment (micro-, meso‑ and macro-level factors operating in the political, social, physical, economic, and healthcare environments) that might elevate risk for methamphetamine use in this population.MethodsWe conducted a qualitative study consisting of eight focus groups with 54 key informants between December 2019 and March 2020. Participants represented community-based and healthcare organizations that work closely with Black GBMSM. Our thematic analysis included an iterative, team coding approach combining deductive and inductive elements.ResultsParticipants unanimously agreed that methamphetamine use was increasingly prevalent among Black GBMSM in Atlanta, with many describing a historical arc in which methamphetamine use – previously associated with predominantly white, affluent GBMSM – was now common among younger, lower socioeconomic status Black GBMSM. At the micro-level, participants described contributors to increasing methamphetamine use including use as a sex drug, and the interrelated burdens of stress and mental illness, housing instability, geographic mobility and poverty. At the meso‑level, participants described virtual and physical sex scenes including use of geosocial networking apps that facilitated the spread of methamphetamine use in the Black GBMSM community. At the macro-level, participants described how policies prioritizing other concerns (e.g., HIV, opioids) seemed to limit resources available for methamphetamine prevention and treatment programming.ConclusionMulti-level environmental influences are working together to elevate risk for methamphetamine use among Black GBMSM in Atlanta, with potential to adversely impact health and well-being and undermine HIV prevention and treatment efforts. |
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