Insights for the substance use disorder care continuum: findings from a qualitative study with sexual and gender minority individuals who use methamphetamine.
7 affiliations
- 1CUNY Institute for Implementation Science in Population Health, New York, NY, USA.
- 2Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy CUNY, City University of New York (CUNY), 55 W 125 Street, 7th Floor, New York, NY, 10027, USA.
- 3Department of Epidemiology, University of Florida, Gainesville, FL, USA.
- 4Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.
- 5Department of Health Promotion and Disease Prevention, Florida International University, Miami, FL, USA.
- 6Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy CUNY, City University of New York (CUNY), 55 W 125 Street, 7th Floor, New York, NY, 10027, USA. [email protected].
- 7CUNY Institute for Implementation Science in Population Health, New York, NY, USA. [email protected].
Abstract
Background
Methamphetamine use continues to disproportionately affect sexual and gender minority (SGM) communities and is associated with physical, mental, and sexual health harms, including heightened HIV vulnerability. While prior epidemic waves have been well documented, the current resurgence (particularly among SGM individuals), remains underexplored and occurs within an evolving HIV prevention landscape. Persistent challenges within the substance use disorder care continuum (SUDCC), including stigma and limited treatment responsiveness, underscore the need for patient-centered clinical guidance. This study examines treatment navigation experiences of SGM individuals who use methamphetamine and their recommendations for improving their substance use care.Methods
Participants were recruited from a U.S. national HIV prevention cohort that oversampled for individuals reporting recent methamphetamine use. Twenty-nine participants completed semi-structured, in-depth interviews between December 2024 and January 2025. Interviews focused on healthcare experiences, treatment navigation, and participants' recommendations for SUDCC stakeholders. Interviews were recorded and transcribed verbatim into written transcripts, which were analyzed using a codebook approach to thematic analysis.Results
Our findings were organized into four major themes: (1) Variation in Motivation to Use Meth, (2) Need for Destigmatized Care, (3) Desire for SGM-Affirming Care, and (4) A Spectrum of Care Needs. Participants reported a variety of motivations for using meth, including to enhance their sex lives, cognition, and emotion regulation-motivations that providers may benefit from understanding as they aim to address the overlapping physical and psychosocial health needs of patients who use methamphetamine. The importance of reducing stigma in clinical encounters was underscored frequently by participants, and represented a salient theme throughout interviews and across thematic categories. Participants described both experienced and anticipated stigma when underscoring the need for de-stigmatized substance use care, and illustrated how stigma hindered substance use care engagement and use of emergency services. Moreover, many reported a desire for community among other SGM individuals, particularly within group recovery contexts, but also elucidated the risks that accompanied drug network expansion within these treatment environments.Conclusion
This study advances the substance use and treatment literature by amplifying the voices of SGM individuals who use methamphetamine and providing guidance for providers who work directly with these populations.
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BibTeX
@article{combs2026insights,
title = {{Insights for the substance use disorder care continuum: findings from a qualitative study with sexual and gender minority individuals who use methamphetamine.}},
author = {Conley Combs and Alexa B D'Angelo and Kira Argenio and Drew A Westmoreland and Raymond L Moody and Adam W Carrico and Christian Grov},
journal = {Addiction science \& clinical practice},
year = {2026},
month = aug,
doi = {10.1186/s13722-026-00710-1},
url = {https://europepmc.org/article/MED/42972486},
note = {CC BY},
}
RIS
TY - JOUR
TI - Insights for the substance use disorder care continuum: findings from a qualitative study with sexual and gender minority individuals who use methamphetamine.
AU - Conley Combs
AU - Alexa B D'Angelo
AU - Kira Argenio
AU - Drew A Westmoreland
AU - Raymond L Moody
AU - Adam W Carrico
AU - Christian Grov
PY - 2026
DA - 2026/08/01
JO - Addiction science & clinical practice
DO - 10.1186/s13722-026-00710-1
UR - https://europepmc.org/article/MED/42972486
AB - Background Methamphetamine use continues to disproportionately affect sexual and gender minority (SGM) communities and is associated with physical, mental, and sexual health harms, including heightened HIV vulnerability. While prior epidemic waves have been well documented, the current resurgence (particularly among SGM individuals), remains underexplored and occurs within an evolving HIV prevention landscape. Persistent challenges within the substance use disorder care continuum (SUDCC), including stigma and limited treatment responsiveness, underscore the need for patient-centered clinical guidance. This study examines treatment navigation experiences of SGM individuals who use methamphetamine and their recommendations for improving their substance use care.Methods Participants were recruited from a U.S. national HIV prevention cohort that oversampled for individuals reporting recent methamphetamine use. Twenty-nine participants completed semi-structured, in-depth interviews between December 2024 and January 2025. Interviews focused on healthcare experiences, treatment navigation, and participants' recommendations for SUDCC stakeholders. Interviews were recorded and transcribed verbatim into written transcripts, which were analyzed using a codebook approach to thematic analysis.Results Our findings were organized into four major themes: (1) Variation in Motivation to Use Meth, (2) Need for Destigmatized Care, (3) Desire for SGM-Affirming Care, and (4) A Spectrum of Care Needs. Participants reported a variety of motivations for using meth, including to enhance their sex lives, cognition, and emotion regulation-motivations that providers may benefit from understanding as they aim to address the overlapping physical and psychosocial health needs of patients who use methamphetamine. The importance of reducing stigma in clinical encounters was underscored frequently by participants, and represented a salient theme throughout interviews and across thematic categories. Participants described both experienced and anticipated stigma when underscoring the need for de-stigmatized substance use care, and illustrated how stigma hindered substance use care engagement and use of emergency services. Moreover, many reported a desire for community among other SGM individuals, particularly within group recovery contexts, but also elucidated the risks that accompanied drug network expansion within these treatment environments.Conclusion This study advances the substance use and treatment literature by amplifying the voices of SGM individuals who use methamphetamine and providing guidance for providers who work directly with these populations.
SN - 1940-0632
SN - 1940-0640
ER -