Sarah Abboud
S. Abboud1, D. W. Seal2, K. Khoshnood3, D. Khouri4, F. M. Fouad4, R. Heimer3. 1University of Illinois Chicago, United States; 2Tulane University, United States; 3Yale University, United States; 4American University of Beirut, Lebanon
Background: Global evidence shows that drugs and alcohol use are highly prevalent among men who have sex with men (MSM). Their use is influenced by high rates of stigma, discrimination, and violence directed at MSM that produce psychological stress and trauma. As part of a larger study, we examined the use of drugs and alcohol among Lebanese and displaced Syrian MSM living in Lebanon.
Methods: We conducted semi-structured, in-depth interviews with 13 displaced Syrian MSM and 12 Lebanese MSM. The topic guides were designed to gain information about minority stress-syndemic pathways and explore how these factors impacted risk behaviors.
Results: Participants experienced multiple stressors related to financial hardship, discrimination, and social isolation that exposed them to psychological and sexual health risks. These stressors were more heightened for displaced Syrian MSM based on their intersectional minority identities. One of the most common coping strategies was extensive use of drugs and alcohol, especially among Lebanese participants. Participants reported using “sex-drugs” including methamphetamine, erectile dysfunction drugs, volatile nitrates, and “club-drugs” such as ketamine, MDMA, and GHB. Participants described using drugs for two reasons: 1) to facilitate sexual pleasure and performance, and 2) to relieve stigma- and discrimination-related stress and depression. Drug and alcohol use during sex impacted risk behaviors where most participants described no condom use.
Conclusion: Our findings suggest that increased mental health interventions, informed by the unique experiences of Lebanese and displaced Syrian MSM are needed to improve the coping strategies and decrease drugs and alcohol use among MSM in Lebanon.