# Structural Influences on Methamphetamine Use among Black Gay and Bisexual Men in Atlanta

> **NIH NIH R01** · EMORY UNIVERSITY · 2023 · $694,129

## Abstract

PROJECT SUMMARY
Emerging data demonstrates a rise in methamphetamine (meth) use among Black gay, bisexual and other
men who have sex with men (GBMSM). Meth is associated with myriad physical and social harms, and has the
potential to exacerbate existing health inequities impacting Black GBMSM. Existing meth prevention and
treatment interventions do not address the unique social position of Black GBMSM or the related health
impacts of structural racism and discrimination (SRD). Based on our preliminary studies, we hypothesize that
four forms of SRD are likely to influence meth use among Black GBMSM: housing discrimination, gentrification,
racial and income segregation, and discriminatory LGBT community climate. Additionally, we posit that these
forms of SRD operate through housing instability and inadequate service access to increase risk for meth use
among Black GBMSM. The goal of this project is to generate knowledge that will inform the design of multi-
level, culturally congruent structural approaches to prevent meth use and associate harms among Black
GBMSM. Our study will be based in Atlanta, Georgia – an ideal setting to examine these questions given the
cultural significance for Black Americans, large population of Black GBMSM, and recent SRD-related
demographic shifts. Drawing on the risk environment framework as its theoretical foundation, this study will
pursue three specific aims: (1) to examine the impacts of census-tract level measures of SRD on housing
instability, service access and meth use among Black GBMSM in Atlanta; (2) to elicit narratives of meth use,
housing instability, service access and SRD among Black GBMSM; and (3) to examine systems of structural
influence and develop qualitative causal maps linking various forms of SRD, service access, housing and meth
use among Black GBMSM. For the first aim, we will recruit N=300 Black GBMSM into a longitudinal cohort
study, and conduct serial surveys every 6 months over a two-year follow-up period. Additional location and
meth use data will be obtained monthly using ecological momentary assessment technology. Individual survey
responses will be linked to geolocated census-tract level measures of SRD and service access. For the second
aim, we will conduct a longitudinal qualitative study including in-depth interviews and walking ethnographies
with N=40 cohort participants, to gather insights on their experiences with SRD, housing, service access and
meth use. For the third aim, we will use a community-based system dynamics approach to convene a group
model building workshop with key stakeholders (N=25), which will lead directly to the development of causal
maps that will inform structural interventions. The proposed research is highly significant because of its
potential to inform effective structural strategies for preventing meth use and ameliorating meth-related harms
among Black GBMSM.

## Key facts

- **NIH application ID:** 10631104
- **Project number:** 5R01DA056235-02
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Sophia A. Hussen
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $694,129
- **Award type:** 5
- **Project period:** 2022-06-01 → 2027-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10631104

## Citation

> US National Institutes of Health, RePORTER application 10631104, Structural Influences on Methamphetamine Use among Black Gay and Bisexual Men in Atlanta (5R01DA056235-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10631104. Licensed CC0.

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