title: Alcohol use, drug use and alcohol-related problems among men who have sex with men: the Urban Men's Health Study.
abstract: OBJECTIVE
  To measure the prevalence and independent associations of heavy and problematic use of alcohol and recreational drugs among a household-based sample of urban MSM (men who have sex with men).
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Men who identified as being gay or bisexual or who reported sex with another man in the prior 5 years were included in this analysis (n = 2172).
  
  
  METHODS
  A probability telephone sample of MSM was taken within Zip Codes of four large American cities (Chicago, Los Angeles, New York and San Francisco) estimated to have total concentrations of at least 4% of all households with one resident MSM.
  
  
  METHODS
  Standard measures of alcohol use, problems associated with alcohol use, and recreational drug use were administered by trained telephone interviewers.
  
  
  RESULTS
  Both recreational drug (52%) and alcohol use (85%) were highly prevalent among urban MSM, while current levels of multiple drug use (18%), three or more alcohol-related problems (12%), frequent drug use (19%) and heavy-frequent alcohol use (8%) were not uncommon. The associations of heavy and/or problematic substance use are complex, with independent multivariate associations found at the levels of demographics, adverse early life circumstances, current mental health status, social and sexual practices and connection to gay male culture.
  
  
  CONCLUSIONS
  The complex pattern of associations with heavy and/or problematic substance use among urban MSM suggests that heavy and/or problematic substance use is grounded in multiple levels: the individual, the interpersonal and the socio-cultural.
authors.affiliation: Division of HIV/AIDS Prevention, Behavioural Intervention Research Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: R
authors.initials: R
authors.lastname: Stall
authors.forename: J P
authors.initials: JP
authors.lastname: Paul
authors.forename: G
authors.initials: G
authors.lastname: Greenwood
authors.forename: L M
authors.initials: LM
authors.lastname: Pollack
authors.forename: E
authors.initials: E
authors.lastname: Bein
authors.forename: G M
authors.initials: GM
authors.lastname: Crosby
authors.forename: T C
authors.initials: TC
authors.lastname: Mills
authors.forename: D
authors.initials: D
authors.lastname: Binson
authors.forename: T J
authors.initials: TJ
authors.lastname: Coates
authors.forename: J A
authors.initials: JA
authors.lastname: Catania
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D006679:HIV Seropositivity / Q000453:epidemiology / Q000523:psychology; D006304:Health Status; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012933:Social Identification; D012944:Social Support; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology