Miller School of Medicine, University of Miami, Miami, FL, USA.
Department of Mental Health Law and Policy, University of South Florida, Tampa, FL, USA.
Harm Reduct J. 2023 Apr 26;20(1):58. doi: 10.1186/s12954-023-00787-w.
In the US, stimulant use is associated with a 3-6 times greater rate of HIV seroconversion in sexual minority men (SMM) than in those who do not use stimulants. Annually, 1 in 3 SMM who HIV seroconvert will be persistent methamphetamine (meth) users. The primary objective of this qualitative study was to explore experiences of stimulant use in SMM living in South Florida, a high priority region for the Ending the HIV Epidemic initiative.
The sample included 25 SMM who use stimulants, recruited via targeted ads on social networking apps. Participants completed one-on-one semi-structured qualitative interviews, conducted from July 2019 through February 2020. A general inductive approach was used to identify themes relating to experiences, motivations, and overall relationship with stimulant use.
Mean age of participants was 38.8, ranging from 20 to 61 years old. Participants were 44% White, 36% Latino, 16% Black and 4% Asian. Most participants were born in the US, self-identified as gay, and preferred meth as their stimulant of choice. Themes included: (1) stimulants as cognitive enhancements for focus or task completion, including transitioning to meth after first using prescription psychostimulants; (2) unique South Florida environment where participants could be open regarding their sexual minority status while also being influential on their stimulant use; (3) stimulant use as both stigmatizing and a coping mechanism for stigma. Participants anticipated stigma by family and potential sexual partners due to their stimulant use. They also reported using stimulants to cope with feelings of stigma due to their minoritized identities.
This study is among the first to characterize motivations for stimulant use in SMM living in South Florida. Results highlight both the risk and protective factors of the South Florida environment, psychostimulant misuse as a risk for meth initiation, and the role of anticipated stigma on stimulant use in SMM. Understanding stimulant use motivations can help to shape intervention development. This includes developing interventions that address individual, interpersonal, and cultural factors that drive stimulant use and increase risk of HIV acquisition. Trial registration NCT04205487.
在美国，性少数群体男性（SMM）使用兴奋剂与 HIV 血清转换率相比不使用兴奋剂的男性高出 3-6 倍。每年，HIV 血清转换的 SMM 中有 1/3 是持续使用甲基苯丙胺（冰毒）的人。这项定性研究的主要目的是探讨居住在南佛罗里达州的 SMM 使用兴奋剂的经历，南佛罗里达州是终结艾滋病流行倡议的重点地区。
该样本包括通过社交网络应用程序的定向广告招募的 25 名使用兴奋剂的 SMM。参与者完成了一对一的半结构化定性访谈，访谈于 2019 年 7 月至 2020 年 2 月进行。采用一般归纳方法确定与使用兴奋剂的经历、动机和总体关系有关的主题。
参与者的平均年龄为 38.8 岁，年龄范围为 20 至 61 岁。参与者中 44%是白人，36%是拉丁裔，16%是黑人，4%是亚洲人。大多数参与者出生在美国，自认为是同性恋者，首选冰毒作为他们的兴奋剂。主题包括：（1）兴奋剂作为专注或完成任务的认知增强剂，包括在首次使用处方兴奋剂后转向冰毒；（2）南佛罗里达州独特的环境，参与者可以在这里公开他们的性少数群体身份，同时也对他们的兴奋剂使用产生影响；（3）兴奋剂使用既是污名化的原因，也是应对污名化的一种机制。参与者因使用兴奋剂而预期会受到家庭和潜在性伴侣的污名化。他们还报告说，使用兴奋剂来应对因少数族裔身份而产生的污名化感。
这项研究是首批描述居住在南佛罗里达州的 SMM 使用兴奋剂动机的研究之一。结果突出了南佛罗里达州环境的风险和保护因素、作为冰毒使用起点的精神兴奋剂滥用，以及预期的污名化对 SMM 使用兴奋剂的作用。了解兴奋剂使用的动机可以帮助制定干预措施。这包括制定干预措施，以解决驱动兴奋剂使用和增加 HIV 获得风险的个人、人际和文化因素。试验注册 NCT04205487。
