JMIR Publications

ABSTRACT

Background:

Gay, bisexual and other men who have sex with men (GBMSM) are disproportionately affected by methamphetamine (meth) use, with recent studies suggesting an increase in use specifically among Black GBMSM. Black GBMSM face unique structural barriers to achieving optimal health. Given its harmful effects, and in light of existing health disparities, an increase in meth use among Black GBMSM poses a significant public health concern.

Objective:

The HISTORY study (Health Impacts and Struggles to Overcome the Racial Discrimination of Yesterday) is investigating the potential impacts of exposure to census tract level structural racism and discrimination (SRD) on meth use among Black GBMSM in Atlanta, and will identify intervention targets to improve prevention and treatment of meth use in this population.

Methods:

This study utilizes a mixed-methods and multilevel design over a five-year period, and incorporates participatory approaches. Individual-level quantitative data will be collected from a community-based cohort of Black GBMSM (n = 300) via periodic assessment surveys, ecological momentary assessments, and medical record abstractions. Census tract level measures of SRD will be constructed using publicly available administrative data. Qualitative data collection will include longitudinal, repeated in-depth interviews with a subset (n = 40) of study participants. Finally, using a participatory group model-building process, we will build on our qualitative and quantitative data to generate causal maps of SRD and meth use among Black GBMSM, which in turn will be translated into actionable recommendations for structural intervention.

Results:

Enrollment in the HISTORY study commenced in March 2023 and is anticipated to be completed by November 2024.

Conclusions:

The HISTORY study will serve as a crucial background upon which future structural interventions can be built, to mitigate the effects of meth use and SRD among Black GBMSM.