New Research On Accessibility of Substance Abuse Treatment Services
In a new global study, we found that most men who have sex with men (75%) use alcohol and/or other substances. However, among those who report substance use, very few (11%) report availability of substance abuse treatment programs. There is a strong need to develop novel substance use programs outside traditional treatment settings.
Background: Substance use is common among men who have sex with men (MSM) worldwide, and epidemiologic data suggest that alcohol/substance-using MSM are at greater risk for HIV. However, there are scarce data on substance abuse treatment programs (SATPs) for substance-using MSM. Objectives: We examined proportions of substance use as well as SATP availability and use. We used multivariable regression models, controlling for potential confounders, to examine behavioral and demographic correlates of SATP availability and use.
Methods: This is a cross-sectional study of a multiregion, online sample of substance-using MSM.
Results: In this sample, 75% were substance-using MSM of whom 36% reported at-least-weekly use. Substance use was most prevalent among respondents from Eastern Europe/Central Asia (86%) and Latin America (79%). Among substance-using MSM, 96% and 33% reported alcohol intoxication and other substance use, respectively; 11% reported having high SATP availability; and 5% reported using SATPs. Controlling for global region of origin and age, high SATP availability was associated with high access to HIV risk-reduction education (aOR = 3.19; CI = 1.48–6.89), mental health services (aOR = 2.53; CI = 1.32–4.83), and medical care (aOR = 2.32; CI = 1.12–4.80); less than college-level education (aOR = 0.32; CI = 0.18–0.54); and higher comfort levels with providers (aOR = 1.75; CI = 1.30–2.37). Controlling for substance use frequency and personal income additionally, using SATPs was associated with higher levels of connection to the gay community (aOR = 2.76; CI = 1.22–6.22).
Conclusion: In this global sample of MSM, we found high alcohol intoxication and other substance use proportions. Few substance-using MSM report SATP availability, highlighting the need to develop novel substance use programs outside traditional treatment settings.
Juan M. Flores, Glenn-Milo Santos, Keletso Makofane, Sonya Arreola, and George Ayala
Columbia University Mailman School of Public Health, New York, USA; Center for Public Health Research, San Francisco Department of Public Health, San Francisco, California, USA; Department of Community Health Systems, University of California San Francisco, San Francisco, California, USA; The Global Forum on MSM & HIV, Oakland, California, USA