Abstract

Substance use has become a major health problem globally for sexual minorities. However, few studies have explored multi-dimensional factors associated with smoking, drinking, and prescription drug use. We aimed to investigate the factors affecting painkiller, sedative/hypnotic, nicotine and unhealthy alcohol use among gay and bisexual men in Taiwan. We recruited 500 gay or bisexual men and assessed their experiences of using painkillers, sedatives/hypnotics, nicotine, alcohol and multi-dimensional factors with self-reported questionnaires. Multivariate logistic regression with a forward stepwise model was used to verify the factors associated with substance use. Overall, 9.4%, 5.4%, and 13.8% of the participants reported using painkillers, sedatives/hypnotics, and nicotine, respectively, and 5.6% reported unhealthy alcohol use. Victims of traditional homophobic bullying in childhood and adolescence were more likely to report nicotine use, sedative/hypnotic use, and unhealthy alcohol use in early adulthood than non-victims. Missing classes or truancy at senior high school was associated with painkiller and sedative/hypnotic use in early adulthood. Traditional homophobic bullying and missing classes or truancy in childhood and adolescence predicted substance use in early adulthood among the gay and bisexual men in this study. Timely preventions and interventions for substance use are crucial for gay and bisexual men, especially for those who experience homophobic bullying and missing classes or truancy.

Highlights

  • We found that missing classes or truancy at senior high school was significantly associated with multiple substance use in early adulthood, including painkillers, sedatives/hypnotics, and nicotine

  • We found that multi-dimensional factors were associated with substance use, including painkillers, nicotine, sedatives/hypnotics, and unhealthy alcohol use

  • We provided new information that homophobic bullying and school-related factors in childhood and adolescence affected substance use in early adulthood

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Summary

Introduction

Substance use has become a major health concern globally for sexual minorities. Problematic substance use increases the mental health burden of sexual minorities. A previous study reported that a third of young men who have sex with men (MSM; 90% of them identified themselves as gay or bisexual men) who used club drugs (e.g., MDMA or ketamine) had attempted suicide, and that more than half of MSM who regularly use club drugs had a high level of depressive symptoms [1]. Another study reported that polydrug use among gay and bisexual men is predominantly associated with HIV infection and high-risk sexual practices [2]. Many studies have focused on substance use in

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