Abstract
The American Men’s Internet Survey (AMIS) is conducted annually with 10,000 men aged 15+ who have sex with men (MSM). Modeling was used with 6,388 AMIS surveys from rural MSM across 7 cycles between December 2013 to January 2020 to identify substance use prevalences and temporal trends in reported substance use (within the 12 months preceding the survey), both overall and stratified by participants’ region of residence and age group. Overall, prevalences of use of each substance analyzed remained low, even when stratified by region and age group. The use of poppers (amyl nitrate) significantly increased among all rural MSM as a whole. Rural MSM in the Northeast showed significant increases in hallucinogen use. Rural MSM in the Midwest demonstrated significant increasing trends in the use marijuana, poppers, and non-injection powdered cocaine. Rural MSM in the South exhibited significant variation in substance use for painkillers and methamphetamines. Use of marijuana and hallucinogens significantly increased among participants aged 15-24 years. Reported lifetime injection drug use and methamphetamine use significantly increased among participants aged 30-39 years. Use of poppers and hallucinogens significantly increased among participants aged 40+ years. Although the overall low prevalences of substance use are encouraging, the increasing trends noted across sub-groups of MSM suggest reason for concern and more targeted intervention approaches if we are to mitigate the transmission and progression of the HIV epidemic in the rural United States.
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