Methamphetamine Use Among Black Sexual Minority Men in Chicago: The Other Public Health Crisis

Background and Purpose

Methamphetamine use is a growing phenomenon among Black gay, bisexual, and other men who have sex with men (BGBMSM). Behavioral research suggests that BGBMSM who use methamphetamine are more likely to engage in condomless anal intercourse and to have multiple sex partners, increasing their likelihood of HIV transmission and acquisition. Moreover, the risk behaviors associated with methamphetamine use amplify social network factors that have historically contributed to disparate HIV infection rates among this population.

Methods

Employing a Community-Based Participatory Research framework, the primary aim of Crystal CLEAR Chicago (CCC) was to understand and describe the reported rise in methamphetamine use/abuse among BGBMSM in Chicago. CCC also focused on identifying available treatment resources and informing the development of novel strategies for addressing this emerging phenomenon. A series of focus groups (n=6) were conducted with various subcommunities of BGBMSM, followed by in-depth interviews with current and past methamphetamine users (n=20) and supplementary interviews with medical and social service providers in Chicago (n=7). In alignment with the primary aims of the project, transcripts were coded and analyzed using thematic analysis.

Results

Findings suggest that methamphetamine use/abuse is indeed a growing and concerning phenomenon among BGBMSM in Chicago. While participants estimate that upwards of 20-35% of BGBMSM in the city are potentially using methamphetamine, leaders within the House Ballroom and Family scenes believe that this number may be even higher within their respective communities. Motivations for use include escapism from the trauma of adverse childhood experiences (including familial rejection based on sexual orientation) and general life stressors (including housing instability and living with HIV), as well as curiosity about the impact of methamphetamine on sexual drive and experience.

Participants had very limited knowledge of available treatment resources. Current and past users who indicated that they had sought treatment offer that existing substance abuse services throughout the city do not focus specifically on methamphetamine use and lack cultural competency for attending to the specific needs of BGBMSM. At most, treatment facilities served as a place of refuge from the cold and rough streets of Chicago for a limited period of time. Past users who are currently in recovery credit their faith in God and the support of a small number of Black- and Latinx-led and staffed community-based organizations throughout the city with helping them to achieve and maintain sobriety. Self-help groups such as Crystal Meth Anonymous were also reported as helpful although lacking in diversity (i.e., the majority of participants in these groups are not African American or Latinx).

Conclusions and Implications

Grounded in harm reductionist philosophies, three primary recommendations have emerged from CCC. First, a social marketing campaign is needed to inform BGBMSM about the dangers associated with methamphetamine use/abuse as well as available treatment resources. Second, the number of culturally-responsive, sex-positive treatment resources focused specifically on methamphetamine use and BGBMGM must be increased. Finally, faith leaders (particularly from within the Black church) who are both welcoming and affirming of Black GBMSM must be identified, engaged, and promoted.