Reasons for stimulant use among Latino gay men in San francisco:: A comparison between methamphetamine and cocaine users

The literature on drug-using gay men has documented a strong relationship between methamphetamine (MA) use and high-risk sexual practices. Of particular concern is that MA use is associated with powerful sexual effects that may facilitate the transmission of HIV. As a group, Latino gay men show high risk for HIV infection, and such risk has been related to episodes of sex under the influence of drugs. However, little information exists about stimulant use among Latino gay men, and it is not known whether MA use in this population is similarly motivated by sexual effects. This study reports reasons for stimulant use in a sample of 300 Latino gay men randomly selected from social and sexual venues; only men who reported stimulant use in the last 6 months were included in the study. Of stimulant users, 51% (n=153) reported MA, 44% (n=133) reported cocaine, and 5% (n=14) reported crack as their "most frequently used stimulant" (MFS); reasons for use were assessed for the participant's specific MFS. Reasons for stimulant use clustered by five main factors, including energy, sexual enhancement, social connection, coping with stressors, and focused work productivity. MA users gave reasons more frequently related to sexual enhancement (to have better sex, more sex, and more anal sex) whereas cocaine users gave reasons more often related to social connections (to be more sociable and to fit in with other gay men). These findings suggest that Latino gay men use stimulants for reasons that are important in their social, emotional, work, and sexual lives. Like non-Latino Whites, Latino gay men were found to rely on MA for reasons related to sexual enhancement, possibly to meet cultural expectations and norms of sexual prowess and sexual success in the gay community.