Table 2 Multi-level factors impacting stimulant use
Level of influence | Theme | Illustrative quote |
|---|---|---|
Individual | Stimulant use as a cognitive enhancement | “I was still being prescribed Adderall, so I didn’t feel the need to even want to try it [meth] again…Then when they did take me off of the Adderall, I went back [to using meth]—those 9 months, I was like, ‘God, there’s got to be something else I can do in the meantime.” And then I remembered my friend. I was like, ‘Hey, you think you can like [connect me with some meth]?’ And then that’s when I went and tried it again—this time smoking it—and it was a lot less of a shock to the system.” (Latino, 34 years old, no PrEP use, meth use) |
Stimulant use as coping mechanism for minority stress | “It eases my depression. You know, to me, it makes me feel like I'm a better person.” (Black, 49 years old, no PrEP use, coke use) | |
Interpersonal | Stimulant use during sexual encounters Not a primary theme but noted in “Discussion” section | “The guys I end up fucking would usually have it [meth]. So, I'd say, "What’s up? Can I hit that?" And they'd say, "Sure, whatever." I mean, is it—I think using meth just pertains to, like, the sexual activities, sexual activities in general here in South Florida. I feel like everyone that's gay and—I mean, everyone that's gay in South Florida is on [social networking app] and they all do meth.” (Latino, 24 years old, current PrEP and meth use) |
Stimulant use as coping mechanism for minority stress • Perceived stigma by friends and family | “But in the gay community, I feel like [there is a lot of stigma]. Most of the people that I see around, it's [meth] very much related to depression and being lonely. And being sad for not being able to have a family, or thinking about it. Or being, like, judged by society and other people, or maybe their family members, or their friends… But I see lots of people are very depressed, and that's why they do so much drugs.” (White, 27 years old, former PrEP and current meth use) | |
Stimulant use as coping mechanism for minority stress • Anticipated stigma from potential sexual partners | “[There is the] stigma of it, or judgment of people, every time that you think about bringing it up, you don't know if that's gonna be something that, like, hangs up, or blocks you, or whatever, so- I think I kind of consciously and subconsciously screen who I meet based on [whether] I think that they do [meth] or not… because I'll probably want to do it at some point while I'm with them, so… even if they aren't… it's probably better [to know now] if they aren't just gonna get up and walk out, (laughs).” (White, 35 years old, current PrEP and meth use) | |
Cultural Environment | Culture of Stimulant Use in South Florida’s Gay Community • South Florida as LGBTQ + affirming | “[I came here] to be able to be myself. To be able to be gay in peace… There's a little bit of danger for people being gay in Brazil. You know, other people won't like it, and then they will do crimes against you, or hurt you, or anything like that. Here it's more safe and open. I never felt any prejudice [here].” (White, 27 years old, former PrEP, meth use) |
Culture of Stimulant Use in South Florida’s Gay Community • Perceived ubiquity of stimulant use in South Florida SMM community | “It's everywhere [in South Florida]. Every gay house, every gay community. Gay roommates living together, they all, they all have PrEP. And they- they do [meth] for having sex and all that.” (White, 27 years old, former PrEP, meth use) |