Heavy drinking is a major public health concern among men who have sex with men (MSM), as it is in many other populations. However, the consequences of heavy drinking among MSM may be particularly severe, especially for sexual risk behavior, due to the relatively high prevalence of HIV. Minority stress models suggest that, among members of marginalized groups, discrimination may be associated with heavier alcohol use as these individuals increasingly drink to cope with such experiences. Past studies have provided some support for this association. However, they have not explored the role other drinking motives play, how these relationships might differ across MSM who are HIV-positive versus HIV-negative, or how this relationship extends to alcohol-related problems.
[Photo: Dr. Tyler Wray]
This study, by Dr. Tyler Wray, assistant professor of behavioral and social sciences in the Brown University School of Public Health, and colleagues, used path modeling to explore associations between perceived discrimination experiences, drinking motives, alcohol use, and alcohol-related problems in samples of heavy drinking MSM with and without HIV.
In both HIV-negative and positive MSM, perceived discrimination was significantly positively associated with alcohol problems. Drinking to cope appears to play an important role in this relationship in both samples. Reporting more discrimination experiences was associated with drinking more frequently for sexual reasons among both groups. While the total effect of drinking to facilitate sex was positively associated with alcohol-related problems, sex motives did not mediate associations between discrimination and either drinking outcome.
These results suggest that alcohol interventions tailored for MSM may be improved by incorporating content on healthier ways of coping with discrimination. Results also suggest interventions challenging drinking motivations that lead to heavy alcohol use and problems in other populations may likely be effective with heavy drinking MSM. Moreover, specifically challenging the tendency to drink to facilitate or enhance sex may also be an effective addition to alcohol interventions designed for HIV-positive MSM.
This study was published in Drug and Alcohol Dependence, Volume 166, September 2016.