Change over time in drug and alcohol use patterns among Black and White young men who have sex with men

BACKGROUND: Young men who have sex with men (MSM) report high rates of risk behaviors including alcohol and drug use. We examined factors related to changes in substance use over a three year period among young Black and White MSM.

METHODS: We recruited 461 MSM ages 15 to 29 in Philadelphia and Baltimore who reported recent use of alcohol and/or drugs. Follow-up interviews were completed with 317 (69%) at 12 months post-baseline and 294 (64%) at 24 months post-baseline.

RESULTS: Comparing number of drugs used at three time points, we found that 20% of MSM consistently used no drugs or only one drug (usually marijuana), 11% consistently used 2 or more drugs, 21% decreased their number of drugs over time, 6% consistently increased drug use and 37% reported fluctuating drug use. MSM who reported less binge drinking were significantly more likely to have increased or stable high rates of drug use. White MSM were more likely than Black MSM to report high rates of drug use at all time points, with racial differences in the specific drugs used. There were no differences in change patterns by age, income or city.

CONCLUSIONS: For many young MSM, substance use patterns change over time. For some, drugs may replace the use of alcohol, indicating the need to examine how these substance use patterns are inter-related.