We're only as sick as our secrets: An assessment of the substance use prevention needs of African American/Black MSM who use methamphetamine

HIV prevalence in San Francisco is highest among African American/Black men who have sex with men (MSM), at 11%. Several studies have found an association between methamphetamine (meth) use and HIV and STD infection in the general MSM population. However, there is a paucity of research specific to African American MSM who use meth, and none exploring effective substance use harm reduction strategies. A team of Masters in Public Health students from San Francisco State University partnered with tweaker.org and the Stonewall Project of the San Francisco AIDS Foundation to conduct an assessment of the substance use prevention needs of this population. Fifteen in-depth interviews were conducted with African American/Black MSM who use meth and 15 interviews with service providers who have worked with the population. Key questions: the types of support African American MSM need to reduce meth use, barriers to prevention, and culturally competent strategies surrounding both ethnicity and sexual identity. Findings: a) meth is used to cope with mental health issues and a lack of economic and social opportunities, b) dialogue surrounding meth is taboo in the African American community due to disbelief that it is a problem, c) stigma around sexual orientation, race, and meth use impacts the population's ability to seek support for meth harm reduction. Further investigation of how environmental and social structures influence meth use needs to be conducted, and to create culturally responsive harm reduction strategies. Agencies serving the population should lead a community effort to create dialogue and address social stigma.