Community norms and peer expectations: Substance use among young African American, Latino, and Multiracial men who have sex with men (MSM) in Los Angeles and New York

Background: Young African American and Latino MSM are at a disproportionately high risk of acquiring HIV. However, there is a dearth of information on the social contexts of substance use among YMSM. Methods: Using a modified time-space sampling methodology, 18- 24 year old YMSM were recruited throughout 2006 and 2007 at 18 Black and Latino Gay Pride events in Los Angeles and in New York. Semi-structured interviews were conducted with 30 participants who reported using at least one substance during sex in the previous 3 months in order to explore the meanings and contexts of their substance use. Data were entered into NVivo, coded, and analyzed using a grounded theory approach. To ensure the validity of analyst interpretations, we used data source triangulation (across participants and methods) and researcher triangulation (across investigators in the collection and analysis processes). Results: Analyses of the qualitative data revealed a spectrum of beliefs that associated particular substances such as alcohol, crystal and poppers with both gay/bisexual communities as well as with different racial/ethnic groups. Marijuana was seen as common in African American communities, crystal was seen as a gay ‘white' drug; alcohol use was seen as linked to both gay and racial/ethnic communities, especially for Latino YMSM. Substance use depends on peer norms and expectations for sex, which may lead to increased social support or episodes of unprotected sex. Conclusion: Identifying how connections to peers/community expectations affect substance use during sex may be important when culturally tailoring prevention programs with and for YMSM.