The recreational use of opioids among men who have sex with men (MSM) is as common as crystal meth use. And while the proportion of MSM reporting use of each type of drug to an ongoing Centers for Disease Control and Prevention (CDC) survey had held steady in recent years, opioid use is increasing among Black MSM and those of low socioeconomic status.

Recreational drug use is more common among MSM than the general population.

CDC researchers analyzed data from the National HIV Behavioral Surveillance (NHBS) survey, which is conducted every three years in 20 U.S. cities. They looked at the 2008, 2011 and 2014 surveys in particular, examining MSM’s reports of non-injection use of meth, cocaine and prescription opioids such as OxyContin, Vicodin and Percocet during the previous 12 months.

The CDC’s Brooke E. Hoots, PhD, MSPH, presented findings from this research at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle.

Meth use rates were higher among MSM who were white, had less education and income, lived in Western cities and were living with HIV. The proportion of respondents who said they used the drug did not change over time to a statistically significant extent, meaning any apparent changes were likely the result of chance and did not reflect changing drug-use patterns in the larger urban MSM population. In 2008, 7.8 percent of the respondents reported meth use, as did 6.6 percent in 2011 and 8.0 percent in 2014.

The reported use of cocaine was more common among MSM who were white or categorized their race as “other” and those who were younger. The rate of cocaine use also did not change significantly over time. In 2008, 2011 and 2014, a respective 18.6 percent, 16.9 percent and 19 percent of the survey participants reported using cocaine.

Opioid use was more common among MSM who were white, younger, had lower education and income and who lived in Western cities. Again, the proportion reporting use of the drug class held steady over time, with a respective 7.5 percent, 7.7 percent and 7.8 percent of the respondents reporting such use in the three years of the survey.

After adjusting the data for various factors, the researchers found that between 2008 and 2014, the rate of opioid use increased 24 percent among Black MSM (although this group still had the lowest usage rate compared with Latinos, whites and those of an “other” race), 21 percent among those with less education and 23 percent among those with incomes below $20,000.

Because the NHBS data is not necessarily nationally representative, the findings of the study may not be generalizable for all MSM living in the United States.

The study is also limited by the fact that it is based on self-reporting, which may be influenced by what is known as social desirability bias, in which respondents give the answers they feel the survey investigators would want rather than totally truthful responses.

To watch a webcast of the conference presentation, click here.