Harm Reduction Journal volume 20 , Article number: Cite this article. Metrics details. Alcohol consumption is common among young men and occurs in many contexts. The sexualized substance use literature has generated some insight into the role of alcohol alongside other substances in the context of sex, though there remain opportunities for targeted and context-sensitive studies to examine the sexual practices and outcomes associated with alcohol, specifically.
This interpretive description study explores how experiences and contexts of alcohol use feature in the sexual lives of young men who use substances with sex. Data were analyzed in an iterative manner through a social constructivist lens and an interpretive description framework, leveraging constant comparison techniques. This analysis yielded three interconnected themes: 1 using alcohol for sexual ity freedoms; 2 backgrounding alcohol within a sexualized polysubstance milieu; and 3 navigating the risks and consequences of using alcohol with sex.
Alcohol use was found to reduce inhibitions and support experimentation, including by facilitating the transgression of conservative or restrictive social and sexual norms. Alcohol was seldom explicitly classified as a sexualized substance, though it was evidently a widespread and normative social practice. This practice was associated with important risk and consequences, including with respect to consent, pregnancy and sexually transmitted and bloodborne infection risk, and sexual dysfunction.
Findings from this study position alcohol as a backgrounded yet significantly influential substance that young men use with sex. Specifically, sexual health and primary care providers working with young men should invite and open up meaningful conversation about how they may be using substances including alcohol with sex, while offering de-stigmatizing, sex-positive, and affirming education and supports to promote safer sex and substance use. Research at the intersections of substance use and sexual health represents a growing field of inquiry, with scholars working to understand strategies to reduce harms that can arise among men who use substances with sex [ 1 ].
For example, epidemiological studies have examined the interconnections between substance use practices, sexual behaviors, and sexually transmitted and bloodborne infection STBBI risk among sexual minority menβthat is, cisgender and transgender gay, bisexual, queer, and other men who have sex with men [ 1 , 2 , 3 , 4 , 5 ]. Research has also generated understandings of the benefits and risks associated with sexualized substance use among sexual minority men, as well as strategies for risk-mitigation [ 4 ].
