Social Capital and Chemsex Initiation in Young Gay, Bisexual, and Other Men Who Have Sex With Men: the Pink Carpet Y Cohort Study

Abstract

Background: Young gay, bisexual, and other men who have sex with men (YMSM) are especially vulnerable to the risks associated with sexualized substance use, or ‘chemsex’. Engaging in chemsex established as a major risk factor for Human Immunodeficiency Virus (HIV) acquisition, and is thus a public health issue of increasing urgency. This paper attempts to explore the association between measures of social capital and patterns of sexualized substance use among a sample of YMSM in Singapore.Methods: Results of this study were derived from baseline data of the Pink Carpet Y Cohort Study in Singapore, comprising a sample of 570 HIV-negative YMSM aged 18 to 25 years old. Latent class analysis was employed to identify classes with similar patterns of sexualized substance use, and multinomial logistic regression was employed to examine associations between class membership and measures of social capital. Logistic regression was employed to examine associations between measures of social capital and past sexualized substance use.Results: Latent class analysis revealed three classes of YMSM based on their histories of sexualized substance use, which we labelled as ‘substance-naïve’, ‘substance-novice’, and ‘chemsex’. Participants with a later age of sexual debut were increasingly less likely to be in the substance novice and chemsex classes, compared to the substance-naïve class; they were also less likely to report sexualized alcohol, poppers and methamphetamine use. Connectedness to the lesbian, gay, bisexual and transgender (LGBT) community was negatively associated with sexualized methamphetamine use, while outness to family was positively associated with sexualized methamphetamine and erectile dysfunction drug use.Conclusions: Varying measures of social capital such as an earlier age of exposure to sexual networks or family-related stress may predispose YMSM to greater opportunities for sexualized substance use, while on the other hand, community connectedness may be protective. Future interventions should target YMSM who become sexually active at an earlier age to reduce the risks associated with sexualized substance use.