Abstract: Early Sexual Debut As a Risk Indicator for Substance Use Among Men Who Have Sex with Men (MSM) in Kazakhstan (Society for Social Work and Research 27th Annual Conference - Social Work Science and Complex Problems: Battling Inequities + Building Solutions)
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558P Early Sexual Debut As a Risk Indicator for Substance Use Among Men Who Have Sex with Men (MSM) in Kazakhstan

Schedule:
Saturday, January 14, 2023
Phoenix C, 3rd Level (Sheraton Phoenix Downtown)
* noted as presenting author
Caitlin Laughney, MSW, Doctoral Research Assistant, Columbia University, New York, NY
Yong Gun Lee, MSW, Graduate Research Assistant, Columbia University School of Social Work, New York City, NY
Guakhar Mergenova, MD, Project Director, Global Health Research Center of Central Asia, Kazakhstan
Vitaliy Vinogradov, Project Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan
Gulnara Zhakupova, MSW, Project Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan
Emily Allen Paine, PhD, Postdoctoral Research Fellow, Columbia University, New York, NY
Sholpan Primbetova, MS, MPharm, Deputy Regional Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan
Assel Terlikbayeva, MD, Regional Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan
Nabila El-Bassel, PhD, University Professor, Columbia University School of Social Work, New York, NY
Elwin Wu, PhD, Professor / Co-Director, Columbia University, New York, NY
Background and Purpose: Limited research have examined predictors of illicit use of drugs and binge-drinking among gay, bisexual, and other men who have sex with men (MSM) in Kazakhstan and Central Asia. Early sexual debut has been found to be a predictor of risky substance use behavior among MSM, but these associations have yet to be examined among MSM in Kazakhstan. The purpose of this study is to examine early sexual debut as a risk factor for lifetime and recent substance use behaviors among MSM in Kazakhstan.

Methods: We conducted a secondary analysis of self-reported data from a NIDA-funded HIV prevention trial including 899 adult cisgender MSM in Kazakhstan who completed structured screening interviews. Measures used in these analyses include sociodemographic information, age of sexual debut, and lifetime and recent reports of substance use behaviors. Logistic regression models were used to estimate associations between early sexual debut (ages 16 and older as the reference group) and lifetime and recent substance use, with covariance adjustment for sociodemographic characteristics.

Results: The majority of Kazakhstani MSM in our sample reported lifetime binge drinking behavior (72%) and illicit use of drugs (64%). Participants with an early sexual debut before 13 years old had significantly higher odds of lifetime binge drinking and any illicit use of drugs (aOR= 2.3, 95%CI: 1.2-4.5; aOR=3.1, 95%CI: 1.6-5.9). MSM who reported an early sexual debut between 13-15 years old had significantly higher odds of lifetime binge-drinking and illicit use of any drugs (aOR=1.5, 95%CI: 1.1-2.3; aOR=1.6, 95%CI: 1.1-2.3); as well as recent binge-drinking behavior (aOR=1.6, 95%CI: 1.2-2.2). Additional significant associations were found between early sexual debut and specific types of drugs (e.g. marijuana, heroin, stimulants).

Conclusions and Implications: Findings suggest that early sexual debut is a significant risk factor for lifetime and recent substance use behaviors among MSM in Kazakhstan. Future research should examine pathways between consensual and non-consensual early sexual experiences and risky substance use behaviors among sexually diverse populations. Early sexual experiences during childhood and adolescence may be relevant contextual information for interventions aimed at substance use risk prevention, treatment, and recovery among MSM populations.

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