Interpersonal needs of gay, bisexual, and other msm who practice sexualized substance use: a critical component in treating substance use disorders among sexual minorities

While clinical literature provides some information about special considerations for working with men who have sex with men (MSM), this information is limited largely to risk of HIV acquisition, internalized homophobia, and prevalence of substance use disorders in this population. Clinicians are encouraged to become culturally competent and the importance of specialty substance use disorder care for MSM is well documented. Yet current treatment protocols seem to lack a clear understanding of the unique challenges facing sexual and gender minorities with substance use disorders and the ways in which these challenges may contribute to their chances of recovery.

This qualitative study seeks to identify the psychosocial needs of sexual and gender minorities that use methamphetamine and other related psychoactive substances in order to develop addiction services adapted to the sociocultural reality of this diverse population. Based on the Rapid Assessment Process, this study provides in-depth semi-structured interviews with 27 men from three Canadian cities that self-identify as sexual and gender minorities and consume methamphetamine and other related psychoactive substances.

Study participants report interpersonal needs such as a sense of belonging and connection, acceptance and validation by their peers, experiencing intimacy and sexuality devoid of the inhabitations associated with their status as a marginalized group while using methamphetamine, and struggling to meet these needs when they stop using methamphetamine. A more nuanced understanding of the perceived benefits of substance use in this population seems necessary to provide more effective treatment to this often-marginalized group.

Data from our study highlight the complex interplay between substance use and the interpersonal needs of sexual and gender minorities. Treatment protocols should consider the interpersonal needs of this minority group to improve clinical outcomes.