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RESEARCH ARTICLE
Contents Vol 6(2)

The consequences of substance use among gay and bisexual men: A Consensual Qualitative Research analysis

Amy B. Mullens A B E , Ross McD. Young B , Elisabeth Hamernik C and Michael Dunne D
+ Author Affiliations
- Author Affiliations

A Sexual Health and HIV Service, 270 Roma Street, Brisbane, Qld 4000, Australia.

B Institute of Health and Biomedical Innovation, Queensland University of Technology, GPO Box 2434, Qld 4001, Australia.

C Department of Renal Medicine, Royal Brisbane & Women’s Hospital, Herston Road, Herston, Qld 4029, Australia.

D School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, GPO Box 2434, Qld 4001, Australia.

E Corresponding author. Email: ab.mullens@student.qut.edu.au

Sexual Health 6(2) 139-152 https://doi.org/10.1071/SH08061
Submitted: 7 August 2008  Accepted: 1 February 2009   Published: 18 May 2009

Abstract

Background: Substance use is common among gay/bisexual men and is associated with significant health risks (e.g. HIV transmission). The consequences of substance use, across the range of substances commonly used, have received little attention. The purpose of this study is to map participant’s beliefs about the effects of substance use to inform prevention, health promotion and clinical interventions. Methods: Participants were interviewed about experiences regarding their substance use and recruited through medical and sexual health clinics. Data were collected though a consumer panel and individual interviews. Responses regarding perceived consequences of substance use were coded using Consensual Qualitative Research (CQR) methodology. Results: Most participants reported lifetime use of alcohol, cannabis, stimulants and amyl nitrite, and recent alcohol and cannabis use. A wide range of themes were identified regarding participant’s thoughts, emotions and behaviours (including sexual behaviours) secondary to substance use, including: cognitive functioning, mood, social interaction, physical effects, sexual activity, sexual risk-taking, perception of sexual experience, arousal, sensation, relaxation, disinhibition, energy/activity level and numbing. Analyses indicated several consequences were consistent across substance types (e.g. cognitive impairment, enhanced mood), whereas others were highly specific to a given substance (e.g. heightened arousal post amyl nitrite use). Conclusions: Prevention and interventions need to consider the variety of effects of substance use in tailoring effective education programs to reduce harms. A diversity of consequences appear to have direct and indirect impacts on decision-making, sexual activity and risk-taking. Findings lend support for the role of specific beliefs (e.g. expectancies) related to substance use on risk-related cognitions, emotions and behaviours.

Additional keywords: alcohol, drugs, HIV transmission, MSM, risk-taking, sexual behaviour.


Acknowledgements

Portions of this paper were presented at the Seventeenth International Harm Reduction Conference, Vancouver, Canada, April 2006. The authors thank the participants, Darren Gill for co-facilitating the CP, Patricia Obst for data assistance, and the staff of the Sexual Health & AIDS Service, Gladstone Road Medical Centre, Central Brunswick Street Medical Centre, Queensland Association for Healthy Communities, Queensland Positive People and Spiritus Positive Directions for contributions to recruitment and project development.


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