Drug use and sexual risk taking among sexual minority men in the USA early in the COVID-19 pandemic

What is it about?

Sexual minority men (SMM, including gay, bisexual and other men who have sex with men) are more likely to use drugs (both marijuana and illicit drugs) than their heterosexual counterparts. In addition, drug use is a well-established predictor of sexual risk taking in this population. The purpose of the current study was to evaluate the effect of the COVID-19 pandemic on drug use – and the association between drug use and sexual risk taking – among SMM during the initial months of the pandemic. A cohort of 455 adult SMM living in the United States was recruited online through social networking and dating applications between May 6 and May 17, 2022. Participants were compared to a matched sample of respondents selected from a po0ol of 65,707 SMM recruited in the same online spaces between November 2017 and November 2019. The likelihood of reporting marijuana and illicit drug use declined from 45.7% and 22.9% respectively pre-COVID to 34.5% and 11.0% in the sample surveyed during COVID. Respondents in the COVID cohort were also less likely to report CAS with casual partners (26.4% during COVID compared to 71.6% pre-COVID). Despite these declines, the association between illicit drug use and the occurrence – as well as the frequency – of CAS with casual partners were significantly stronger among respondents surveyed during COVID.

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Photo by Dylan Ferreira on Unsplash

Photo by Dylan Ferreira on Unsplash

Why is it important?

Declines in drug use may arise as a result of novel access challenges. The pandemic disrupted the supply of drugs, complicated engagement in drug-related transactions, and also introduced a new source of financial burden for some. While rates of sexual risk taking declined overall among SMM surveyed during these early months of the COVID-19 pandemic, those SMM who use drugs remain the most at risk for engaging in sexual behaviors that might transmit HIV infection. Notably, during these early months of the COVID-19 pandemic when vaccines were not available, these interactions with casual sex partners also carried a degree of risk for COVID-19 transmission as well.