Substance-related problems and treatment among men who have sex with men in comparison to other men in Chicago.

This study compares a sample of urban men who have sex with men (MSM) with a general population sample of men in the same city on self-reported problems with substance use indicative of dependence and history of substance use treatment. Both samples were randomly selected using multistage probability methods. All participants completed audio computer-assisted self-interviews, including questions on substance use, problems related to substance use experienced in the past 12 months, and substance treatment. Problem use of alcohol, marijuana, and cocaine did not differ between samples. Compared to men in the general population sample, MSM were significantly more likely to experience problems related to the use of sedatives, tranquilizers, or prescription pain relievers. Among MSM, history of substance treatment was associated with a positive HIV test, and treatment usually preceded HIV diagnosis. Research is needed on effective methods for integrating HIV prevention for MSM into substance treatment settings, including physician-administered buprenorphine treatment for opiate addiction.