243754 Toward theoretically informed substance use prevention among young men who have sex with men

Monday, October 31, 2011: 5:30 PM

Dorian E. Traube, PhD , School of Social Work, University of Southern California, Los Angeles, CA
Sheree M. Schrager, MS, PhD , Division of Adolescent Medicine, Children's Hospital Los Angeles, Los Angeles, CA
Ian W. Holloway, MSW, MPH , School of Social Work, University of Southern California, Los Angeles, CA
Michele D. Kipke, PhD , Community, Health Outcomes, and Intervention Research Program, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA
Young men who have sex with men (YMSM) remain at higher risk for substance use and abuse than their heterosexual counterparts, yet recent reviews indicate a paucity of effective, theoretically based drug risk reduction interventions for this population. Informed by Social Action Theory (SAT, Ewart, 1991), which includes individual, social, and contextual determinants of health behavior, the present study sought to understand how changes in a range of psychological, social, and cognitive factors contribute to illicit substance use among YMSM. Data come from the NIDA-funded "Healthy Young Men" study, which longitudinally tracked an ethnically diverse cohort of YMSM ages 18-26. We used latent growth curve modeling to understand the relationships between contextual influences (e.g., history of violence and discrimination experiences), changing individual and social process variables (e.g., health values, self-efficacy, social support), and health protective behavior, psychological distress, and illicit drug use outcomes among 487 YMSM recruited through probability sampling in Los Angeles, California. Experiences of discrimination, violence and homophobia predicted illicit drug use indirectly through their influence on social support, psychological distress, and health values; individual and social process measures also significantly predicted health protective behavior. Our analyses also demonstrate significant intercorrelations between the process variables over time, which indicates that the shared relationship between them ultimately impacts illicit drug use. Results highlight the oscillating relationships between environmental experiences, psychological, social, and cognitive factors, and illicit drug use, underscoring the need for interventions tailored for YMSM to address the complex constellation of factors that contribute to illicit drug use in this population. The inclusion of multiple dimensions (social context, linkages between self-change and interpersonal environments, and macro-social and environmental influences) points to the importance of multidimensional targeting of behavior when constructing substance use prevention interventions for YMSM.

Learning Areas:
Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
(1) Explain the importance of theoretically driven substance use prevention programs for YMSM; (2) List three key variables that contribute to substance use among YMSM; (3) Discuss the psychosocial processes that place YMSM at risk for substance use and abuse.

Keywords: Substance Abuse, Gay Men

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a member of the Community, Health Outcomes, and Intervention Research Program team who conducted the study. I developed the statistical models included in the paper and supervised all related data analysis, and I contributed the methods and results sections of the paper.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.