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Journal Article

Citation

Khan SI, Khan MNM, Hasan AMR, Irfan SD, Horng LM, Chowdhury EI, Azim T. Int. J. Drug Policy 2019; 73: 64-71.

Affiliation

BRAC James P. Grant School of Public Health, BRAC University, Bangladesh.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.drugpo.2019.07.009

PMID

31344562

Abstract

BACKGROUND: Internationally, methamphetamine use is prevalent among males who have sex with males (MSM) and transgender women (hijra), with studies showing its association with risky sexual behaviours leading to HIV transmission. This study aimed to explore the underlying reasons for methamphetamine use among MSM and hijra in Bangladesh.

METHODS: We conducted 30 in-depth interviews with MSM and hijra and six focus groups with MSM, hijra and service providers. Data were thematically analysed using manual data analysis procedures. FINDING: Reasons cited for using methamphetamine varied across feminized MSM (i.e. kothis), masculine MSM (i.e. panthis), male sex workers and hijra. For sex workers, increased sexual pleasure and consequent ability to take more clients increased their income. For panthis, methamphetamine enhanced feelings of masculinity and sexual prowess. Kothis were able to feel more feminine due to their ability to receive multiple partners each night. For all participants, methamphetamine restored self-esteem and relieved the stress resulting from stigma.

CONCLUSIONS: Findings indicate that reasons for using methamphetamine are not only rooted in the individual's psyche but also grounded in the socio-cultural expectations about masculinities and femininities in Bangladeshi society. Limited knowledge about the complexities concerning methamphetamine use mean that appropriate counselling and treatment services are non-existent in Bangladesh. The study findings can be used to refine national and international harm reduction policies so as to incorporate and address methamphetamine use.

Copyright © 2019 Elsevier B.V. All rights reserved.


Language: en

Keywords

MSM; Methamphetamine; Sexual minority; Transgender

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