Changes in substance use among HIV-negative MSM: A longitudinal analysis, 1995-2019

Area of Science:

• Public Health
• Epidemiology
• Substance Use Research

Background:

• Recreational drug consumption patterns among men who have sex with men (MSM) have evolved over recent decades.
• Understanding these shifts is crucial for public health initiatives and targeted interventions.
• Previous research indicates changing trends in substance use within this population.

Purpose of the Study:

• To evaluate population-level mean trajectories of substance use among HIV-negative MSM.
• To examine trends in the use of alcohol, cannabis, ecstasy, cocaine, and poppers between 1995 and 2019.
• To assess changes in substance use specifically during sexual encounters.

Main Methods:

• Utilized open cohort study data from the Netherlands, following 1495 MSM since 1995.
• Applied generalized estimating equations to analyze population-averaged estimates of substance use.
• Examined trends for five specific substances and their concurrent use during sexual activity over a 25-year period.

Main Results:

• Alcohol use decreased significantly from 1995 to 2019 (predicted probabilities from .96 to .87).
• Cocaine and poppers use showed significant increases during this period, with use during sex also rising substantially.
• Ecstasy use increased overall, but not specifically during sexual encounters, while cannabis use remained stable.

Conclusions:

• Despite mixed trends in overall substance use, a notable increase in cocaine and poppers consumption during sexual encounters was observed among HIV-negative MSM.
• These findings underscore the ongoing importance of public health efforts and interventions addressing substance use in conjunction with sexual activity.
• Continued monitoring and targeted strategies are essential for promoting the health and well-being of this population.