Validation of the Stimulant Use Motives Scale and Assessment of Its Associations with Psychosocial Functioning and Sexual Health in U.S. Men Who Have Sex with Men

Background Among men who have sex with men (MSM), stimulant use (e.g., cocaine, crystal methamphetamine) is both more frequent than in the general population, occurs within sexual settings, and is associated with elevated risk of HIV acquisition and with suboptimal adherence to pre-exposure prophylaxis (PrEP). Understanding stimulant use motives and their relations to patterns and consequences of use among MSM may be important to developing effective interventions unique to this population.Methods In the present study, we sought to validate the Stimulant Use Motives Scale (SUMS), an adaptation of the DMQ-R, among a U.S. sample of 237 HIV negative, adult MSM with past month stimulant use. Using Structural Equation Modeling, a four-factor model was estimated. The four factors were: 1) social motives (enjoying social events more), 2) enhancement motives (liking the feeling/being high), 3) coping motives (with emotions, problems, mood), and 4) sexual motives (enjoyment, less inhibited or nervous).Results The 12-item four factor model demonstrated acceptable fit. Social motives were negatively associated with stimulant use consequences (p < 0.05). Enhancement motives were positively associated with frequency of stimulant use in the context of sex (p < 0.001) and general stimulant use frequency (p < 0.05). Coping motives were positively associated with consequences (p < 0.05). Sexual motives were negatively associated with poly-stimulant use (p < 0.05). Depressive symptoms were also associated with stimulant use frequency and consequences (p < 0.05).Conclusion The present study highlights the importance of addressing specific motives in targeted interventions, providing an understanding of stimulant use patterns and associated sexual risk for HIV among MSM.