Drug Use Prevalence and Age of First Use in Sexual Minority Men Compared to General Population Men in Spain

The aim of this study was to compare the prevalence of use of ten drugs or groups of drugs and the mean age of onset of drug use among sexual minority men (SMM) and general population men (GPM) in Spain. Participants were men aged 16–64 years living in Spain: 8933 GPM recruited through a population-based survey and 6135 SMM recruited through an online survey disseminated in contact apps/websites and social media. Prevalences of lifetime and past-year drug use and mean age at first use were calculated for both groups. Crude and adjusted prevalence ratios (aPR) were obtained using Poisson regressions, and adjusted mean age differences were calculated using linear regressions. Prevalences of lifetime drug use were higher among SMM compared to GPM for all drugs except cannabis, and the difference increased in past-year drug use. After adjustment, aPR ranged from 1.7 for cannabis to 161.2 for poppers. On average, SMM initiated drug use 4.1 years later than GPM, with the difference ranging from 2.3 to 8.4 years depending on the drug. Drug use is higher among SMM than GPM, particularly when comparing past-year use. Therefore, SMM should be a priority group in drug use-related health promotion programs that use a non-stigmatizing perspective. The mean age of onset of drug use is higher among SMM, which emphasizes the need for tailored programs that consider the specific sociocultural context of this community.