A comparative analysis of methamphetamine use: Black gay and bisexual men in relation to men of other races
Introduction
Epidemiological and drug surveillance data indicate that methamphetamine abuse is a growing health concern in Black communities (Maxwell, 2004, United States General Accounting Office, 1998). This potential public health problem is supported by clinical observations at community-based substance abuse treatment settings and by empirical research with Black gay and bisexual men (Halkitis et al., 2003, Reback and Grella, 1999, Semple et al., 2002, Semple et al., 2005). For this segment of the population, which like other Black communities across the United States is disproportionately affected by the HIV epidemic (Centers for Disease Control and Prevention, CDC, 2006), the potential for widespread methamphetamine use creates the possibility of exacerbating a “dual epidemic” (Halkitis, Parsons, & Stirratt, 2001). This potential is supported by the synchronous increase in methamphetamine use and HIV seroconversion in Black communities (Beatty et al., 2004, Wheeler, 2005). Because of its availability, relatively low cost, recent increase in purity (Colliver & Gfroerer, 2006), devastating physical and psychological effects, and the sexual risk taking facilitated with use, methamphetamine holds the potential to cause enormous damage in the often resource-limited Black communities of New York City (Davis, Johnson, Randolph, & Liberty, 2006).
Over the last decade, gay communities of New York City have witnessed a significant increase in the use of methamphetamine (Halkitis et al., 2005, Molitor et al., 1998, Rawson et al., 2002, Rawson et al., 2004, Shoptaw et al., 1998). A formative study of HIV-positive gay and bisexual identified men conducted in 1997–1998 identified a prevalence rate of 7% in a New York City sample (Purcell, Parsons, Halkitis, Mizuno, & Woods, 2001), and recent investigations of club drug users have found that use transcended racial/ethnic lines. In 2005, a study of 311 “health-seeking” men-who-have-sex-with-men (MSM) attending New York City gyms, more Black MSM (BMSM) reported methamphetamine use than White men (28.1% vs. 15.2%) (Halkitis et al., in press). Taken together, these findings demonstrate the growth and enormity of methamphetamine addiction in the MSM communities of New York City, and support the idea that this addiction transcends age, race/ethnicity, and HIV serostatus.
Even though there exists modest epidemiological and behavioral data on methamphetamine use in Black gay and bisexual identified men, no studies appear to have been published to date on the patterns and correlates of use in this segment of the population. Rather, the nuances of use in this specific segment of the gay and bisexual community are often masked by the study samples, as much of the current empirical research on methamphetamine use has been undertaken with mostly gay identified, White samples, thus necessitating more focused examinations of the population. As such, the purpose of our analyses was to (1) consider the frequencies and patterns of methamphetamine use among Black gay and bisexual men in comparison to men from other racial/ethnic groups and (2) to compare Black gay and bisexual methamphetamine users to their non-using counterparts. In particular, we examined the extent to which methamphetamine is used by Black gay and bisexual men, as compared to men of other races, in relation to both the use of other drugs such as cocaine, which had historically been used more in a more widespread manner in New York City and with regard to the geographic representation of our methamphetamine using sample to consider whether the drug is manifested outside traditionally gay neighborhoods of New York City. By doing so, we gain a greater understanding of the use of methamphetamine by Black gay and bisexual men who may or may not be immersed in traditional gay cultural circles. Such understandings have immediate implications for prevention efforts targeting Black gay and bisexual methamphetamine users as well as non-gay Black users of the drug, and provide a potential indicator of the movement of the drug to areas of the population outside that of gay and bisexual men. Additionally, studies on the use of methamphetamine in gay and bisexual men have immediate public health implications for the Black population of our city where Black gay and bisexual men and Black individuals in general are overrepresented among those with chronic and preventable diseases (Bowen-Reid and Harrell, 2002, Fullilove, 2006, Millett et al., 2006).
Section snippets
Study overview
Participants for this analysis were drawn from Project BUMPS, a large-scale (N = 450), longitudinal, mixed-methods investigation of club drug use among gay and bisexual men in New York City conducted from 2000 to 2005 and funded by the National Institute on Drug Abuse. In this study, we sought to determine patterns of club drug use and their relation to sexual risk taking. In addition, we sought to disentangle psychosocial factors that may predispose men to use club drugs. We focused on five
Race and other participant characteristics in relation to methamphetamine use
The overall sample consisted of 450 men and is more fully described elsewhere (Halkitis, Palamar, & Pandey Mukherjee, 2007). Of these men assessed at baseline, 293 (65.1%) reported use of methamphetamine in the 4 months prior to this time point. In terms of self-identified race/ethnicity, 32 of the 293 methamphetamine users (10.9%) identified as Black or African American. The other users identified as follows: White (56.3%, n = 165), Latino regardless of race (19.1%, n = 56), and mixed race/other
Discussion
As concerns regarding methamphetamine abuse continue to grow in the United States (Rawson et al., 2002), one area requiring attention is that of the infiltration of the drug into the Black population. Since little is known or has been documented about this matter, an analysis of the usage patterns of methamphetamine from our longitudinal investigation of club drug using gay and bisexual men was undertaken. We believe that these data, which were collected between 2000 and 2005, indicate that the
Limitations
As is the case with any study that utilizes self-report to capture behavioral data, the issue of social desirability may affect our findings. However, given our use of ACASI technology and our reputation as trustworthy researchers working with the gay community, we have confidence in the relative accuracy of the data that we collected. With regard to the poly-drug use patterns, we did capture data on simultaneous use of the drugs with methamphetamine; however we did not capture the relative
Conclusions
The patterns of methamphetamine use described here, when coupled with the recently reported rates of HIV infection among BMSM, suggest a potentially dangerous condition. Given the disproportionate impact of HIV on the Black population, even low levels of methamphetamine use in this segment of the population can cause high levels of damage. While the work presented here documents the patterns of methamphetamine use in a Black sub-sample of users, further, more-enumerated investigations are
Acknowledgements
This research was funded by a grant from the National Institute on Drug Abuse (Contract # R01DA13798). We thank Marty McDonough for his assistance with the geographical mapping.
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