Introduction: Black Americans face significant inequities in substance use treatment. For young Black gay, bisexual, and other sexually minoritized men (BSMM) living with HIV, these barriers are exacerbated by stigma and discrimination related to their age, racial, sexual, and HIV-related identities. Additionally, substance use problems are prevalent among individuals living with HIV. Despite this, research on the experiences of young BSMM with substance use services, particularly in recovery groups and outpatient programs, is extremely limited. This study aims to address this gap by examining these issues among BSMM living with HIV in Atlanta, GA.

Methods: Participants were BSMM, age 18 to 29 years, and living with HIV. Recruitment occurred from April 2021-November 2022 via: (1) web-based forums, (2) community-based organization collaborations, and (3) a comprehensive HIV care center. Surveys were administered via REDCap (a HIPAA-compliant online database), and included measures of substance use treatment service utilization and satisfaction. We calculated frequencies to describe utilization of and satisfaction with addiction recovery groups and outpatient drug and/or alcohol rehabilitation programs. We ran logistic regression to identify predictors of utilization of both services.

Results: Of 200 BSMM, 27 had attended an addiction recovery group, and 19 had participated in an outpatient drug and/or alcohol rehabilitation program. Most participants who attended a recovery group reported being very satisfied (n=11) or satisfied (n=10), with only two expressing dissatisfaction. Similarly, those who participated in an outpatient rehabilitation program were mostly very satisfied (n=11) or satisfied (n=4), though one participant was very dissatisfied. Participants who were engaged in HIV care at the time of the survey were more likely to have utilized both types of services, compared to those who were not engaged in care (odds ratio: 0.075; 95% confidence interval: 0.006, 0.872).

Conclusions: Results show that while many BSMM were satisfied with their treatment, some were not. Engagement in HIV care appears to improve engagement with these services. Further qualitative research is needed to better understand barriers and facilitators of substance use treatment and service engagement from the perspective of BSMM. This is especially pertinent given the disproportionate impact of the ongoing drug overdose epidemic on Black Americans, including BSMM.