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Published fal eded form as:PMCID: PMC3024451NIHMSID: NIHMS237221AbstractRearch on dg e among gay and bisexual men has primarily foced on examg the lk between dg e – most notably, methamphetame – sexual practic, and risk of HIV transmissn. Drawg on -pth qualative data om 40 terviews wh gay and bisexual Asian Amerin men, we exame perceptns and meangs associated wh e e the San Francis Bay Area gay muny.

Overall, the fdgs suggt that an crease the favorabily of e e might be an untend nsequence of methamphetame preventn mpaigns, targetg the gay muny, wh their emphasis on the harmful effects of dg e, unsafe sex and HIV risk. Keywords: addictn / substance e, bisexuals, ethnicy, gays and lbians, health behavr, HIV/AIDS preventn, men’s health, mori, risk, behavrs, risk, perceptnsRearchers have documented particularly high levels of dg e among men who have sex wh men (MSM) pared to the rt of the populatn (Cochran, Ackerman, Mays, & Ross, 2004; Greenwood et al., 2001).

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Notably, high levels of dg e have been documented among MSM gay urban epicenters such as New York, Los Angel, and San Francis (Clatts, Goldsamt, & Yi, 2005a&b; Grov et al., 2006; Stall & Purcell, 2000). Even though a few studi have noted a crease MSM dg e recent years (Stall & Purcell, 2000), dg e among young MSM, pecially young MSM gay club/party scen, appears to rema high (Greenwood et al., 2001; Hugh & Eliason, 2002; Kipke et al., 2007; Wood, Nil, & Dargan, 2009).

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Rearchers have observed the important role that bars and clubs play gay and bisexual men’s liv and the ways the arenas serve as prcipal social and muny centers for MSM populatns (Lewis & Ross, 1995). Some rearchers have foced on the role that dg nsumptn plays muny buildg among MSM (Hartman, 2000) bee of creased sociabily and posive affect om dg e (Green, 2003), or the uniquely central role of bars and dance clubs gay muni (Lewis & Ross, 1995; Slav, 2004).

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Others have argued that dg e wh the settgs operat as a mechanism for pg wh the stigma of homosexual practic wh the broar society (McKirnan, Vanable, Ostrow, & Hope, 2001) or that feelgs of shame and isolatn and ternalized homophobia draw gay men to dg e (Cabaj, 2000). For non-Whe MSM, this feelg of shame and isolatn might be particularly acute given what some rearchers have scribed as racism wh the gay muny (Phua, 2007), and the view wh popular culture that gayns is synonymo wh whens (Han, 2008; Kumashiro, 1999; Nemoto, Operar, Soma, Bao, Vajrabka, & Crisostomo, 2003; Tnis, 2007). For example, Green (2003) argued that g club dgs might be a strategy for negotiatg tensns that arise om sexualized teractnal patterns (a kd of “sexual socialy”) wh gay muni and club scen.

The physlogil effects of club dgs might facilate the mands many gay club scen for “sexual aroal on mand, sexual endurance, and the abily to have sex wh newly acquated partners” (Green & Halkis, 2006, p.

Moreover, few studi have examed motivatns for g one dg rather than another or the perceptns of each dg’s acceptabily wh particular social groups and the gay muny the past , rearchers studyg dg e among MSM have been particularly ncerned wh issu of dg and alhol e as relat to behavrs that put dividuals at risk for HIV fectn.

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Bonell and lleagu (2008) argued that this foc on methamphetame and s role creasg sexual risk takg not only disunts the role of other dgs, but rc gay men’s health to HIV and preventn. Clearly, gay men are engaged risk behavrs and dg nsumptn practic unrelated to sexual activy; however, the issu are equently viewed as sendary to rearch on risk behavrs that put dividuals at risk for HIV fectn.

After nearly a of work on dg e the San Francis Bay Area club scene, we have noticed a signifint change over time our participants’ perceptns of the acceptabily of e, particularly among our gay and bisexual male participants.

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As we noted above, methamphetame has long been discsed as an example of normative dg e wh the gay club and dance scene (Bermeister, 2007; Reback, 1997), and has more recently been the foc of much of the lerature on dg e wh the gay muny. It has also been the target of aggrsive dg-e preventn mpaigns, both the San Francis Bay Area gay muny and the rt of the untry (Center for AIDS Preventn Studi [CAPS], 2006; Erceg-Hurn, 2008; Grov, Parsons, & Bimbi, 2008). In fact, many of our participants ma direct parisons between methamphetame and e and, many ways, appeared to view e as an “alternative” to methamphetame, which, perhaps due part to mpaigns emphasizg the dangers of methamphetame e, appears to have cled favorabily the gay scene the past several years.

Rather, as we scribe the article that follows, e’s role wh the gay club and bar scene, the physlogil effects of the dg, and the nstctn of the dg’s risks relative to other dgs, has created an environment which e e is safe, fashnable and discsn of e e wh our sample will be divid to four parts, which rrpond to the four rearch qutns outled above.

Then, the third sectn, “Populary, Fashn and Ubiquy, ” we exame our participants’ scriptns of e as the new fashnable dg wh the gay scene and, nsequently, s ubiquy and acceptabily wh the ntext of gay club and dance events and society general.

SNORTG E GAY, SNORTG E, FISTG MORMON

Fally, the fourth sectn, “Perceptns of Risk, ” we explore the risks our participants perceived their e of e relative to those risks associated wh methamphetame, and the perceived impact of the e of each dg on the health of the gay muny general. First, Asian Amerin MSM prise a signifint prence wh the San Francis gay muny, as well as the populatn of the San Francis Bay Area general (Uned Stat Cens Bure, 2000). Fally, the posn of Asian Amerin MSM as mori wh both the Asian Amerin muny and the broar gay muny (Chung & Katayama, 1998; Han, 2006; Kumashiro, 1999; Nemoto et al., 2003), is signifint and might be related to feelgs of social isolatn (Poon & Ho, 2002), and nsequently might be a risk factor for substance e and participatn high-risk sexual behavrs (Choi, Yep, & Kumekawa, 1998; Nemoto et al., 2003; Wilson & Yoshikawa, 2004) llected qualative and quantative data through -pth, face-to-face terviews.

Data for this article me om terviews, nducted between 2005 and 2008, wh a sample of 40 gay and bisexual Asian Amerin men volved the San Francis Bay Area dance scene.

“IT’S ONE OF THE BETTER DGS TO USE”: PERCEPTNS OF COE USE AMONG GAY AND BISEXUAL ASIAN AMERIN MEN

Each potential participant was screened and clud if he satisfied the followg creria: he self-intified as Asian/Asian Amerin and gay/bisexual; had ed at least one of the six Natnal Instute of Dg Abe (NIDA) fed dgs associated wh the club scene (ecstasy [MDMA], LSD, methamphetame, GHB, ketame, Rohypnol), or mhrooms, and was volved the dance mic scene the San Francis Bay Area. 5 More than half (21) of the participants were born the Uned Stat; all of the foreign-born participants were born Asia or the gay and bisexual men the sample were predomantly middle class, and well-ted.

Nearly half (18) of all gay and bisexual male participants had pleted a bachelors’-level (4-year) gree, and an addnal 4 had pleted a masters’- or doctorate-level gree. 5(7)40(16)RultsSocial Procs: Iniatn and Sourc of InformatnWe beg our discsn of our participants’ perceptns of e, s role wh their liv and the gay muny general, wh a discsn of their iatn to e e and their ias about the dg and s ers prr to experiencg for themselv. As we will monstrate, we have found that our participants engaged a plex procs of weighg the risks of e e agast the risks associated wh other dgs, which drew not only on the dgs’ immediate effects, but also the nnotatns of the e of each substance wh the broar gay muny.

Allen, who at the time of the terview ed e 2–3 tim per month and was at one pot a daily e-er, echoed this sentiment about the ubiquy of e at clubs San Francis’s historilly gay neighborhood: “I feel like wh ke, ’s almost sort of a--’s a given.

Whereas e e was wily perceived as beg acceptable wh the dance club scene, the same was not te for methamphetame, which, as a number of our participants asserted, is most equently done private bee is not socially acceptable to be a methamphetame-er wh the gay muny or society general. What was perhaps most tertg about our participants’ discsn of methamphetame and s ers was not their personal experienc wh the dg, but rather their perceptns of the effect of the dg on the health of the gay muny many of our participants’ narrativ, even among those who were or who had been regular ers of methamphetame, g methamphetame was unrstood to be a source of shame, particularly relative to e, which was generally acceptable, and sometim even scribed by our participants as glamoro, trendy, and fashnable.

Moreover, bee of the associatn between methamphetame e and high-risk sexual behavr wh the gay muny, the shame that ers rived om was sometim related to feelgs of guilt for puttg onelf or others at risk for HIV fectn.

However, most of our participants did not discs personal problems wh methamphetame e; rather, they discsed the negative effects of methamphetame e on the health of the gay muny general, particularly as ncerns one’s clatn to participate high-risk sexual activi.

As a rult of this rise populary, many of our participants scribed the dg as ubiquo and expected wh the gay club scene, and went so far as to pare to alhol terms of s prevalence and acceptabily.

It enhanc sexual enunters and creas sexual sire, and was wily perceived as beg both dangero (for physlogil and social reasons), and taboo, particularly wh the gay muny where was equently ced as beg lked to high risks of HIV transmissn. Dpe a relatively small number of parative studi on the perceived effects and meangs of dg e the gay muny, rearchers have monstrated patterns of differentiatn between the “social” effects of e e and the “sexual” effects of methamphetame e (e.

Although crystal e was viewed as beg acceptable wh the gay muny, participants also perceived that many ers, monly referred to as “tweakers, ” tried to hi their e to avoid social rejectn. In our own sample, whereas e was unrstood as enhancg sociabily and was not perceived to be a dg for e durg sexual enunters, many of our participants believed that methamphetame nnot possibly be ed moratn, and found to be pecially problematic the gay muny bee of s nnectn wh HIV transmissn. Dgs, like other modi, are ed by people to perform their inti and reprent their liftyl, and the varyg msag that different dgs rry—as glamoro, as dangero, as social, as sexual—n be important for shapg both patterns of e and beliefs about e (Hunt, Moloney, & Evans, 2010) extreme stigmatizatn of methamphetame is a stark ntrast to scriptns of methamphetame durg the 1990s and early 2000s, durg which time the dg was granted a siar stat to that currently held by e— was a ubiquo, nearly sential part of the gay club scene that ntributed to feelgs of muny and belongg (Green, 2003; Green & Halkis, 2006).

Rearchers have documented a cle the populary of methamphetame as a rult of aggrsive meth-e preventn mpaigns targetg gay men, which emphasize the lk between methamphetame e and unsafe sex, and nsequently, HIV transmissn (Grov et al., 2008).

Given methamphetame has been the target of aggrsive dg-e preventn mpaigns, both the San Francis Bay Area gay muny, and the rt of the untry (CAPS, 2006; Erceg-Hurn, 2008; Grov et al., 2008), n an crease the acceptabily of e e be scribed as an untend nsequence of methamphetame preventn efforts?