Drug Dependence Severity and Associated Factors Among Cisgender Gay, Bisexual and Other Men Who Have Sex With Men in Japan.

This study aimed to assess the severity of drug dependence and identify factors associated with high dependence among gay, bisexual, and other men who have sex with men (gbMSM) in Japan. Data were collected from a nationwide community-based online survey conducted from November 2022 to January 2023. gbMSM with a history of drug use completed the Japanese version of the Drug Abuse Screening Test-20 (DAST-20). Multivariable logistic regression explored factors linked to high DAST-20 scores. Of 4,472 cisgender gbMSM, 19.1% (853/4472) reported lifetime drug use, and 3.3% (146/4472) reported use in the past 12 months. Among 142 participants with a recent history of drug use, the most reported drugs were alkyl nitrites (38.7%, 55/142), methamphetamine (25.4%, 36/142), and cannabis (17.6%, 25/142). A total of 26.8% (38/142) had DAST-20 scores of 6 or higher, indicating intermediate to severe dependence. High DAST-20 scores (≥6) were associated with recent methamphetamine use (aOR: 6.85; 95% CI: 2.01-23.29), using drugs to escape reality (aOR: 3.17; 95% CI: 1.06-9.50), and fostering intimacy with the person recommending the drug (aOR: 3.97; 95% CI: 1.36-11.62). Expanding screening opportunities and ensuring access to psychosocial care are essential in providing tailored support services to gbMSM with diverse health needs.