Venue-Based Network Analysis to Understand Substance Use Among Young Gay, Bisexual and Other Men Who Have Sex With Men

Background and Purpose: Young gay, bisexual and other men who have sex with men (hereafter YMSM) are at disproportionate risk for substance use and abuse as compared to their heterosexual counterparts. YMSM substance use often takes place in bars, clubs and other venues where YMSM congregate. Despite the fact that most venues stand alone as physical brick-and-mortar entities, they are part of an interconnected social space constituted by the men who frequent those venues. The present paper uses a novel analytic method, venue-based social network analysis, to understand the association between network position and substance use. This approach may be useful in the formulation of substance use prevention for this vulnerable population.

Methods: Cross-sectional data from the Healthy Young Men study were used for the present analysis.  Participants were asked to report their recent substance use and to nominate up to three favorite venues in which to socialize with other YMSM. Informed by the Theory of Duality of Persons and Groups, two-mode network analysis was used to create a person-by-venue matrix with unique identifiers for study participants on the row (N=484) and nominated venues on the column (N=110). Matrix algebra in UCINet was used to generate a person-by-person matrix (484x484), which was graphed using the social network visualization program Netdraw. Network measures, including centrality, were calculated and used to document the association between position in the network and substance use variables.

Results: Nearly all participants (99%) were connected by at least one venue and over 80% were connected by two or more venues. The majority of YMSM indicated recent alcohol use (94%) and large percentages had smoked cigarettes (82%) and used marijuana (62%) in the past 3 months. Users of these commonly available substances were more central to the person network and were positioned next to other users more frequently than non-users were positioned next to non-users. Illicit substance users (29%) and club drug users (23%) were evenly dispersed throughout the person network and were more likely to be connected to non-users than other users.

Conclusions and Implications: YMSM are highly interconnected by their shared venue attendance. Associations between central position in the network and alcohol, cigarette, and marijuana use indicate a higher degree of venue-sharing among users of these commonly available substances. One possible explanation for higher centrality scores among those who drink, smoke and use marijuana may relate to availability and social acceptability of these substances in the venues where YMSM congregate. Structural interventions and/or venue-based interventions that seek to change social norms regarding alcohol, cigarette, and marijuana may be effective with YMSM. Reducing illicit substance use and club drug use among YMSM may require individually tailored interventions.