Substance use and technology: testing an innovative method for recruitment of young men who have sex with men

Young men who have sex with men (YMSM; aged 18 to 24) report significantly higher rates of substance use compared to their heterosexual peers. Studies examining the psychosocial determinants of substance use among YMSM have historically relied on samples of men recruited from venues that arguably condone substance use (e.g., gay bars). This may artificially inflate substance use prevalence estimates in this communiy and limit the generalizability of these studies to the full population of YMSM. Further, recent research has indicated that YMSM are increasingly using smartphone technology (i.e., geosocial networking applications, or GSNAs) to find sexual partners and forgoing the use of venues. To date, no study has investigated whether a sample of YMSM drawn from a GSNA differs from a sample recruited through venues. Therefore, the overarching goal of this dissertation was to recruit two samples of YMSM through venue-based probability sampling and GSNA-based probability sampling to (a) compare substance use and the psychosocial covariates of substance use of the two samples, and (b) investigate the feasibility of implementing each recruitment method (i.e., cost and recruitment efficiency). A cross-sectional online survey design was utilized with a sample of 111 YMSM recruited in Los Angeles, CA. Sixty-eight participants were recruited through venue-based probability sampling procedures and 43 were recruited using GSNA-based probability sampling. The GSNA method systematically identified locations for recruitment using spatial analysis of app-user densities in the geographic sampling frame. Sample substance use (e.g., alcohol, binge drinking, cocaine, poppers), substance use covariates (e.g., discrimination, depression, gay community connection), sexual risk (e.g., recent unprotected sex, HIV testing) and demographics were compared using chi-square tests and two-sample t-tests. The relationships between covariates and substance use were also tested for moderation by recruitment type using linear and logistic regressions. All costs and hours of work were recorded throughout the recruitment preparation and implementation process. The samples significantly differed in demographics characteristics (i.e., race and ethnicity, revealing sexual orientation to all parents, employment, education). No significant differences in psychosocial covariates of substance use or sexual risk emerged. Regressions indicated significant differences (higher in the venue sample) in lifetime and recent substance use between the two samples of men. The relationship between gay community connection and recent alcohol consumption was moderated by recruitment type. Venue-based recruitment was more than 2 times more expensive and required more than 3 times more work hours to complete. Results indicate that recruitment method affects substance use prevalence levels for YMSM. Although differences in prevalence emerged, findings that psychosocial covariates of substance use did not differ between samples offer support for population generalizability. This dissertation also found evidence regarding the feasibility of using technology to recruit probability samples of YMSM. Venue-based procedures cost more than 2 times as much as GSNA procedures, a notable difference. GSNA-based methods may be especially applicable to areas in which venues are not readily accessible (e.g., rural areas and international contexts in which being a sexual minority is stigmatized). Future research should consider the application of these methods outside of an urban area to investigate feasibility.