Poppers Use and Sexual Health Correlates Among Sexual Minority Men in the United States

Alkyl nitrites, commonly referred to by the slang term "poppers," are widely used in sexual contexts among sexual minority men. Despite longstanding regulatory ambiguity in the United States, few contemporary studies have examined poppers use alongside sexual health behaviors and HIV prevention engagement. This study analyzed survey data from the Men's Body Project, an online survey of sexual minority men in the United States. Analyses were restricted to participants who completed poppers-related items (n = 441). Logistic regression models examined associations between past-year poppers use during sexual intercourse and sexual health behaviors, including number of sexual partners, condom use at last sexual intercourse, and current use of pre-exposure prophylaxis. Approximately 31.5% of participants reported using poppers during sexual intercourse. In adjusted analyses, participants reporting three to five sexual partners (adjusted odds ratio [aOR] = 1.22, 95% confidence interval [CI]: 1.10-1.39) and six or more partners (aOR = 1.54, 95% CI: 1.39-1.70) had higher odds of poppers use compared with those reporting one to two partners. Poppers use was also associated with current PrEP use (aOR = 1.32, 95% CI: 1.16-1.50). Poppers use remains common among sexual minority men and appears closely linked to sexual context and engagement with HIV prevention strategies. These findings highlight the importance of integrating discussions of sexualized drug use into harm reduction, sexual health care, and public health policy responses.