{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T23:25:49Z","timestamp":1778887549697,"version":"3.51.4"},"reference-count":73,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Although rural sexual minority men (SMM) use substances immediately before\/during sex (i.e., sexualized drug use), the factors contributing to this behavior are unknown. We examined the factors associated with past year sexualized drug use among rural SMM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Rural SMM in the Southern region of the United States (\n                      <jats:italic>N<\/jats:italic>\n                      = 345) completed an online cross\u2010sectional survey from February to March 23, 2024. Participants answered questions about their sexualized drug use behaviors, sexual behaviors, minority stressors, and demographics. We conducted a hierarchical logistic regression to estimate the adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for factors associated with past year sexualized drug use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Over three\u2010quarters of participants (79.7%) used substances immediately before\/during sex in the past year. Sexualized drug use was associated with exposure to sexual minority stressors, polysubstance use, sexually transmitted infection testing, having oral sex, receiving drugs from a man in exchange for sex, and older age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sexualized drug use is prevalent among rural SMM, and sexual minority stressors and past year sexual risk and substance misuse behaviors were contributing factors. Rural primary care clinics, human immunodeficiency virus (HIV)\/acquired immunodeficiency syndrome (AIDS) service organizations, and outpatient and inpatient substance use organizations should implement integrative sexual and substance use screening, counseling, and referral services for their rural clients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jrh.12917","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:34:19Z","timestamp":1736382859000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Sexualized drug use factors among rural sexual minority men"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2729-151X","authenticated-orcid":false,"given":"Christopher","family":"Owens","sequence":"first","affiliation":[{"name":"Department of Health Behavior, School of Public Health Texas A&amp;M University  College Station Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3330-1323","authenticated-orcid":false,"given":"Benjamin N.","family":"Montemayor","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, School of Public Health Texas A&amp;M University  College Station Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Centers for Disease Control and Prevention.HIV surveillance report 2021.2023."},{"key":"e_1_2_12_3_1","unstructured":"Centers for Disease Control and Prevention.HIV surveillance in urban and nonurban areas 2018 (preliminary). 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