Broadening the study of risk and protective factors for alcohol, drug use and HIV risk among young men who have sex with men

Young men who have sex with men (YMSM) are a vulnerable population that is at increased risk for a range of poor health outcomes, such as alcohol and drug dependence, HIV infection, and depression. Few studies, however, have attempted to examine the range of individual, familial, social, and community-level risk and protective factors that are associated with these outcomes among YMSM. The Healthy Young Men's Study was initiated in 2005 to longitudinally track a large (N=526) and ethnically diverse (195 Caucasian, 126 African American, 205 Latino of Mexican descent) cohort of urban YMSM, ages 18-24. Analyses were performed to characterize predictors of alcohol misuse, drug use, and HIV sexual risk behaviors, including indices of mental health, stressful life events, sexual identity disclosure, internalized homophobia, social support, and community connectedness. Results indicated that YMSM experience numerous stressful life events that put them at particularly high risk for alcohol misuse, drug use, and sexual risk. In addition, depression was found to be significantly associated with increased sexual risk, while sexual identity disclosure to family and friends was significantly associated with alcohol misuse and drug use. In contrast, social support was found to be significantly associated with lower sexual risk, and YMSM with high levels of life satisfaction and connectedness to community were less likely to use drug. Profiles of risk were found to differ according to age and race/ethnicity. The implications of these findings with respect to prevention and risk reduction will be discussed.