Addiction trajectories and the gay life course experience: when two trajectories intersect
Background and objective Gay and bisexual men use more psychoactive substances than their heterosexual peers do. However, few studies have analyzed the links between all the dimensions of the gay life-course experience and problematic substance use (SU). The objective of this study is to describe and understand the interrelations between certain dimensions of the gay life-course experience and SU trajectories of gay and bisexual men. Methods A qualitative study based on a symbolic interactionist perspective was conducted. Semi-structured interviews were conducted with 35 gay/bisexual men whose use of psychoactive substances was problematic, and who were 18 years of age or more, born in Canada and living in the Greater Montreal area. A thematic analysis was performed. Results For gay and bisexual men, SU trajectories and the gay life-course experience intersect at various points in time: when they discover and accept their homoerotic desires; when they engage in sexual experimentation; when they meet a sexual/romantic partner or are in a couple relationships; and when they socialize in the gay community, notably in sexualized social settings. According to them, SU in these settings is trivialized, or even encouraged. Discussion The results show the need to foster a supportive social environment for the development of sexual orientation identity. In terms of preventing problematic substance use and offering sensitive services for people living with these problems, it is necessary to integrate the different dimensions of the gay life-course experience.