Abstract
Objectives:
Although ample research associates drug use and sexual risk-taking of men who have sex with men (MSM), very little research attempts to understand MSM’s subjective meanings and overall intended functions of drug use during sexual behaviors. This qualitative study explored (1) the relationship between substance use and sexual behaviors and (2) the perceived role of drug use in unsafe sexual behaviors among MSM.
Method:
This exploratory study utilized a maximum variation sampling strategy with respect to age, sexual identity, sexual behaviors, occupation, and drug use to recruit a diverse group of MSM. In response to 17 open-ended semistructured interview items, participants described their drug use behaviors, affiliation with drug “scenes,” and drug use during sexual play. Analysis of audiotaped and transcribed interviews of participants’ accounts revealed common themes consistent across the participants’ experiences.
Results:
The research participants consisted of 27 MSM who were sexually active and used recreational substances within the last 3 months of their interview. Regardless of their sexual identity, participants believed in a widely held assumption that drug use is pervasive within the urban gay male community and highly characteristic of most gay men. Such an assumption stressed the intimate connection between drug use and the “gay lifestyle” that not only described, but also prescribed gay male sexual behaviors. Participants used drugs not only to initiate anonymous or casual MSM sexual encounters, but also to incorporate recreational substance use as part of the sexual act as a means to accomplish specific desired effects. Despite the importance of recreational substance use during their MSM sexual behaviors, many participants were skeptical of the persistent expectation that drug use necessarily “causes” unsafe sex. Instead, participants attributed unsafe sexual behaviors to an individual’s personal choice, maturity, or experience with MSM.
Conclusion:
Careful consideration should be given to the social role and subjective meanings of drug use as it relates to sexual behaviors to further understand the link between recreational substance use and the transmission of human immunodeficiency virus (HIV) among innercity MSM.