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Purpose: This study aimed to explore how the COVID-19 pandemic and physical distancing measures have impacted the well-being and sexual health among adolescent sexual minority males (ASMM) during the initial phase of physical distancing mandates in the U.S., Methods: From March 27, 2020, to May 8, 2020, U.S. ASMM (N = 151; aged 14-17 years) completed the online baseline survey of a sexual health intervention trial. COVID-19-related closed- and open-ended questions were included. A mixed-methods approach assessed COVID-19-related changes in well-being and sexual health by outness with an accepting guardian., Results: The majority (57%) of participants reported being worried about COVID-19. Almost all (91%) were physically distancing. Participants noted that COVID-19 changed school, home, work, and family life. Participants highlighted that COVID-19 reduced their ability to socialize and had a deleterious effect on their mental health. In the past 3 months, participants reported seeing sexual partners in person less often, masturbating and viewing pornography more often, and sexting and messaging on men-seeking-men websites/phone applications about the same amount. Many described being physically distanced from sexual partners, and some noted an increase in their use of virtual ways to connect with partners (e.g., video chatting). There were no differences by outness with an accepting guardian in quantitative or qualitative responses., Conclusions: These findings provide a snapshot of the initial effects of the COVID-19 pandemic among a convenience sample of U.S. ASMM and underscore the need to provide access to resources sensitive to their social, developmental, and sexual health needs during this crisis., (Copyright © 2020 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: Criminal justice involvement is a significant problem in the United States, and poses substantial negative immediate and long-term effects, particularly among adolescents and young adults. Research has been mixed on the association between a history of arrest or incarceration and an increased risk of human immunodeficiency virus, but there are clear trends in the association between criminal justice involvement and sexual risk behaviors., Methods: Drawing from a racially or ethnically diverse sample of young men who have sex with men, we conducted an investigation into whether there was a temporal relationship between history of criminal justice involvement and engagement in high-risk sexual behaviors. We also examined whether sexual behaviors among black men who have sex with men (MSM) were more substantially impacted by arrest or incarceration than those of non-black MSM. Data were collected within a longitudinal study of young MSM in Chicago., Results: More than one-third of participants (37.8%) reported having ever been in trouble with the police in their lifetime, and 10% had been incarcerated. In multivariable analysis, black race, history of incarceration, and the interaction were all significantly positively associated with an increase in reported number of male anal sex partners., Conclusions: We found that the intersection between race and criminal justice involvement plays a major role in sexual behaviors. More research is needed to understand why a history of arrest or incarceration has a much more profound effect on black MSM than on non-black MSM., (Copyright © 2018 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Substance use and condomless sexual behaviours are both well studied in sexual minority men, but few researchers have used event-level data collection to examine sexualised drug use in sexual and gender minority young adults. The aim of this study is to describe the co-occurrence of sex under the influence of substances and condomless sexual behaviours, using nuanced event-level data, in a racially/ethnically and socioeconomically diverse sample in New York City., Methods: Data from one wave of a cohort of sexual and gender minority young adults who were assigned male at birth (n = 500) were used to characterise co-occurrence of sex under the influence of drugs and condomless sexual behaviours (oral receptive, anal insertive, and anal receptive sex), in the last 30 days. Logistic regression models were constructed to assess associations between sex while high and condomless sexual behaviours, controlling for sociodemographic factors., Results: Preliminary analyses indicated significant associations between engaging in sex while high and condomless sexual behaviours. In unadjusted regression models, sexualised and non-sexualised drug use were both significantly associated with increased odds of condomless sexual behaviours. In adjusted models, sexualised drug use remained significantly associated with condomless anal insertive sex (AOR = 3.57) and condomless anal receptive sex (AOR = 4.98). Having multiple sexual partners was also significantly associated with greater odds of condomless sexual activity in all three adjusted models., Conclusion: Multivariable analyses indicated that engaging in sex while high on any drug was associated with increased condomless sexual behaviour, but that sexualised drug use was associated with particularly elevated condomless anal sex. These findings provide insight for understanding the co-occurrence of substance use and condomless sex, and suggest a need for HIV/STI risk reduction strategies that address the role of sexualised drug use., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Introduction: Cross-sectional research has found that young men who have sex with men (YMSM) are more likely to engage in heavy drinking and to have higher rates of marijuana and other illicit drug use compared to their heterosexual peers, but considerably less is known about their patterns of substance use over time., Methods: In this study, we combined two longitudinal samples of racially diverse YMSM (N=552) and modeled their substance use trajectories from late-adolescence to young adulthood, including their frequency of alcohol use, frequency of marijuana use, and poly-drug use, using piecewise latent curve growth modeling to model change from ages 17-21 and change from ages 22-24., Results: We found that all three substance use behaviors increased linearly over the adolescent-to-adult transition. The trajectories for all three substance use behaviors were significantly correlated from ages 17-21. Black YMSM had significantly lower growth from ages 17-21 in alcohol, marijuana, and poly-drug use compared to White YMSM. Hispanic/Latino YMSM had significantly higher growth from ages 22-24 in alcohol use but significantly lower growth in poly-drug use compared to White YMSM. YMSM with higher alcohol frequency slopes and YMSM with higher marijuana use slopes were more likely to have alcohol-related and marijuana-related problems, respectively, at the last wave of the study., Conclusions: The results of the present study suggest that the transition from adolescence to adulthood for YMSM is a time of increasing and co-varying substance use and may be a critical period for substance use behaviors to grow into substance use problems., (Copyright © 2017 Elsevier B.V. All rights reserved.)

The differences between direct ties (i.e., ties between a respondent and their nominees) and ties between nominees (indirect) are key to understanding network structure, yet remain understudied. Within a sample of 175 young men who have sex with men, we explored the corroboration of sex and drug ties, and factors associated with corroboration. The majority of instances in which there was no corroboration for either sex or drug ties was due to one individual not appearing in another respondent's network. When an individual did appear in another respondent's network, direct sex and drug ties were corroborated in most cases. We also found that more indirect sex ties were corroborated than direct sex ties (95.7% vs. 88.9%), but the reverse was true for indirect versus direct drug ties (73.1% vs. 84.1%). Strength of relationship and frequency of communication were both associated with confirmed direct ties, but not with indirect ties. Based on these findings, we recommend that direct and indirect ties be treated differently in network analyses.

Background: Young men who have sex with men (YMSM) use alcohol and other drugs at rates higher than their heterosexual peers. While social networks of YMSM have been acknowledged as an important contextual influence on their health behavior, studies have largely focused on social and sexual networks rather than substance use networks, despite the potential importance of substance use alters in shaping substance use behavior., Method: Using data collected from a diverse sample of YMSM (n=156), two multilevel models examined the associations between network (e.g., degree and transitivity), dyadic (e.g., strength of relationship), and individual characteristics and two alter level dependent variables: recent drug use (versus no recent drug use) and frequency of substance use., Results: Results indicated that transitivity was associated with both recent drug use (OR=1.21, p=0.012) and more frequent substance use (b=0.08, p=0.002). Degree was not significantly associated with either variable. Furthermore, participants were also less likely to have recently used drugs (OR=0.93, p<0.001) and tended to use substances less frequently (b=-0.01, p=0.028) with older alters., Conclusions: Despite substantial interest in network influences on health, much remains unknown about the impact of network structures on substance use. The current findings suggest that structural characteristics of substance use networks may provide important information regarding the drug and alcohol use behavior of YMSM even when controlling for dyadic and individual characteristics., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Purpose: Adolescent gay and bisexual men (AGBM) are disproportionately affected by human immunodeficiency virus (HIV), but little is known about testing rates among men aged 18 years and under or about the barriers that they face when contemplating an HIV test. Therefore, we investigate here the testing behaviors and barriers among a diverse national sample of AGBM., Methods: A total of 302 AGBM aged 14-18 years were recruited via Facebook ads to participate in an mHealth (text messaging-based) HIV prevention program. Recruitment was stratified to ensure approximately 50% were sexually inexperienced., Results: Only 30% of sexually active participants had ever been tested for HIV, and nearly half of them did not know where they could go to get tested for HIV (42.9%). Based on exploratory factor analysis, nine questions assessing potential barriers to HIV testing factored into three subscales: external factors, fear, and feelings of invincibility. Among sexually active participants, those who had never tested for HIV had significantly greater scores on the external factors (odds ratio, 1.63; 95% confidence interval, 1.01-2.66) and fear (odds ratio, 1.88; 95% confidence interval, 1.11-3.19) subscale. Older (16-18 years old) youth were especially likely to be affected by external factor barriers, and fear was associated with never testing among gay-identified individuals., Conclusions: HIV testing rates were low among AGBM. Several modifiable barriers emerged, especially a lack of knowledge about the closest testing site. Interventions and programs that target high school-age adolescents could address external barriers by introducing HIV testing services into high schools., (Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Objectives: Substance use is prevalent among young men who have sex with men (YMSM) and may be associated with intimate partner violence (IPV). Experiences of IPV are associated with several adverse health conditions among adult MSM, but there is a gap in knowledge about this relationship among YMSM, which warrants further investigation., Methods: This study employs baseline data from a prospective cohort study to examine lifetime experiences of IPV in relation to substance use in the previous 30 days among n=528 YMSM in New York City from 2009 to 2011. To examine the extent to which IPV (any experiences, victimization, and perpetration) are related to substance use (alcohol, marijuana, stimulant, and other drugs) in the last 30 days, distinct 2-step multinomial logistic regression models, controlling for sociodemographic differences, were constructed., Results: 44.3% reported lifetime IPV experience, with 39.2% of reporting victimization and 30.5% reporting perpetration. IPV is associated with a 1.6 increased odds of 2 or more instances of alcohol use, a 1.6-1.8 increased odds of 2 or more instances of marijuana use, a 1.8-2.5 increased odds of 2 or more instances of stimulant use, and a 4.1-6.1 increased odds of 2 or more instances of other substance use., Conclusion: Findings highlight the strong association between IPV and increased frequency of substance use among YMSM and provide support that violence may exist as part of a syndemic facing YMSM. Prevention and intervention strategies may be improved by addressing substance use in the context of IPV and other related health challenges., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Background: Prescription drug misuse (i.e. opioids, tranquilizers and stimulants) has become the fastest growing area of substance abuse among young adults. Limited studies focus on prescription drug misuse among young men who have sex with men (YMSM, aged 18-29 years). Furthermore, little is known about YMSM's motivations for misuse. The purpose of this study was to explore personal motivations for prescription drug misuse among YMSM, including the possible connection between misuse and sexual behaviors., Methods: As part of a larger mixed methods study of 191 YMSM recruited in Philadelphia during 2012-2013, we conducted semi-structured qualitative interviews with 25 of these participants to gather additional contextual information about their prescription drug misuse. We conducted thematic analysis of qualitative data., Results: While our results corroborated previous literature on motives for misuse of prescription drugs, our data yielded some distinct motivations specific among YMSM. These motives included social/recreational motives, facilitating sex with other men (including motives such as use of opioids for less painful anal receptive sex), and psychological motives such as depression, stress management, coping with everyday hardships (opioids and tranquilizers) or feeling more energized (stimulants). Prescription drugs were commonly misused within the broader contexts of participants' polysubstance use, adding to the significance of this problem., Conclusions: Our findings offer insights into YMSM's motivations for prescription drug misuse, and point to the importance of recognizing and addressing them. While substance use is likely related to various psychosocial issues impacting YMSM, it also may lead to significant health consequences. Results support the need to include prescription drugs and polysubstance use in harm reduction messages and treatment approaches aimed at substance using YMSM., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: Limited research has focused on prescription drug misuse among young men who have sex with men (YMSM), or investigated risk factors contributing to misuse. This study aims to investigate the relationship between multiple psychosocial risk factors (i.e., childhood abuse, discrimination, mental health distress) and prescription drug misuse among YMSM who are current substance users., Methods: YMSM (N=191) who reported prescription drug misuse in the past 6 months were recruited in Philadelphia between 2012 and 2013 to complete an anonymous survey assessing demographic information, substance use, and psychosocial factors., Results: High levels of childhood physical abuse and perceived stress were associated with higher opioid misuse, while high levels of depression were associated with lower misuse of opioids. Those with higher levels of perceived stress were more likely to report higher tranquilizer misuse, while those with more experiences of social homophobia/racism and higher levels of depression and somatization reported higher stimulant misuse. Regarding demographic correlates, older participants were more likely than younger participants to report higher opioid misuse, while racial minorities were less likely than White participants to report higher misuse of tranquilizers, stimulants, and illicit drug use. Bisexual/heterosexual/other identified participants were more likely than gay identified participants to report higher misuse of all three classes of prescription drugs., Conclusions: Associations of risk factors with substance use among YMSM are complex and offer opportunities for additional research. Our findings show that prevention efforts must address substance use among YMSM in sync with psychosocial stressors., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Objective: To examine patterns of substance use over time in a new generation of emerging adult gay, bisexual, and other young men who have sex with men (YMSM)., Methods: Data were drawn from the first four waves of on ongoing prospective cohort study of YMSM who were ages 18 to 19 at baseline and were assessed each 6 months for substance use via calendar based methods. Latent growth curve modeling was utilized to assess changes over time for four drug use categories: alcohol, marijuana, inhalant nitrates, and other drugs (e.g., cocaine, ecstasy) and between groups (race/ethnicity, perceived familial socioeconomic status; SES)., Results: Use of all substances increased steadily across the follow-up period. White YMSM demonstrated higher levels of alcohol use at the 18-mo follow-up visit compared to other racial/ethnic groups, while rates of change across groups were similar. Marijuana use at 18 months was highest for Hispanics who also indicated the highest rate of change. Finally, YMSM who reported higher perceived SES reported the lowest use and lowest rates of change for other drug use. Controlling for perceived SES, differences in patterns of drug use by race/ethnicity were evident but differences were not as large., Conclusions: Increases in substance use in the emerging adulthood of YMSM indicate the need for structural and behavioral interventions tailored to address substance use in these young men before chronic patterns of use develop. Differences in patterns of drug use across racial/ethnic and SES groups suggest that interventions need to consider person-level differences., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)