{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:29:18Z","timestamp":1777678158996,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Promotion Practice"],"abstract":"<jats:p>Men who have sex with men (MSM) continue to experience severe health disparities despite advancements in biomedical prevention strategies such as pre-exposure prophylaxis (PrEP) and harm reduction initiatives. Systemic stigma, health care inequities, and structural neglect contribute to disproportionately high rates of HIV, sexually transmitted infections (STIs), substance use, and mental health challenges among MSM. The rise of authoritarian political movements in the United States exacerbates these disparities by restricting LGBTQIA+ health care access, defunding HIV prevention programs, and reinforcing stigmatizing narratives around MSM sexual health. In particular, chemsex\u2014sexualized drug use involving substances such as methamphetamine (meth) and Gamma-hydroxybutyrate (GHB)\u2014has emerged as a critical public health concern, significantly increasing HIV transmission risks and mental health issues. The failure of mainstream recovery programs to address the unique sociocultural and psychological drivers of chemsex contributes to persistent relapse rates. In addition, conservative political efforts to restrict PrEP access and erase LGBTQIA+ health content from federal policies further jeopardize MSM well-being. Public health professionals ought to prioritize targeted interventions that integrate culturally sensitive health care, harm reduction, and mental health support tailored to MSM needs. Future research should explore the long-term impacts of chemsex recovery, evaluate MSM-centered public health interventions, and assess the consequences of rising political repression on LGBTQIA+ health equity. Urgent policy action is required to counteract authoritarian threats to MSM health care, ensuring that public health efforts remain grounded in inclusivity, equity, and resilience. The fight for MSM health is fundamentally linked to broader struggles for democracy, bodily autonomy, and LGBTQIA+ survival.<\/jats:p>","DOI":"10.1177\/15248399251415413","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T10:50:42Z","timestamp":1769683842000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Unmet Health Needs Among Men who Have Sex With Men in an Era of Rising Authoritarianism: An Increasing Concern for Public Health"],"prefix":"10.1177","author":[{"given":"J. Aaron","family":"Waggoner","sequence":"first","affiliation":[{"name":"The University of Texas at El Paso, El Paso, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1411-5445","authenticated-orcid":false,"given":"Isabel","family":"Latz","sequence":"additional","affiliation":[{"name":"New Mexico State University, Las Cruces, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/pha0000398"},{"key":"e_1_3_2_3_1","unstructured":"Centers for Disease Control and Prevention. (2024). HIV surveillance report 2024. https:\/\/www.cdc.gov\/hiv\/statistics\/surveillance"},{"key":"e_1_3_2_4_1","unstructured":"Coffey A. Hahn H. (2025 August 7). Medicaid cuts in the One Big Beautiful Bill Act leave 3 in 10 young adults vulnerable to losing health care access. Urban Institute. https:\/\/www.urban.org\/urban-wire\/medicaid-cuts-one-big-beautiful-bill-act-leave-3-10-young-adults-vulnerable-losing"},{"key":"e_1_3_2_5_1","unstructured":"Dawson L. Kates J. (2025 September 25). Overview of President Trump\u2019s executive actions impacting LGBTQ+ health. KFF. https:\/\/www.kff.org\/other-health\/overview-of-president-trumps-executive-actions-impacting-lgbtq-health\/"},{"key":"e_1_3_2_6_1","volume-title":"The velvet rage: Overcoming the pain of growing up gay in a straight man\u2019s world","author":"Downs A.","year":"2005","unstructured":"Downs A. (2005). The velvet rage: Overcoming the pain of growing up gay in a straight man\u2019s world. Da Capo Press."},{"key":"e_1_3_2_7_1","volume-title":"The twilight of equality? Neoliberalism, cultural politics, and the attack on democracy","author":"Duggan L.","year":"2002","unstructured":"Duggan L. (2002). The twilight of equality? Neoliberalism, cultural politics, and the attack on democracy. Beacon Press."},{"key":"e_1_3_2_8_1","unstructured":"Mallory C. Brown T. N. Sears B. (2019). Discrimination harassment and violence against LGBTQIA people in the U.S. Williams Institute UCLA School of Law. https:\/\/williamsinstitute.law.ucla.edu\/publications\/LGBTQIA-discrimination-harassment"},{"key":"e_1_3_2_9_1","doi-asserted-by":"crossref","unstructured":"Maxwell S. Shahmanesh M. Gafos M. (2019). Chemsex behaviours among men who have sex with men: A systematic review of the literature. International Journal of Drug Policy 63 74\u201389. https:\/\/doi.org\/10.1016\/j.drugpo.2018.11.014","DOI":"10.1016\/j.drugpo.2018.11.014"},{"key":"e_1_3_2_10_1","doi-asserted-by":"crossref","unstructured":"Meyer I. H. (2003). Prejudice social stress and mental health in lesbian gay and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin 129(5) 674\u2013697. https:\/\/doi.org\/10.1037\/0033-2909.129.5.674","DOI":"10.1037\/0033-2909.129.5.674"},{"key":"e_1_3_2_11_1","doi-asserted-by":"crossref","unstructured":"Scheibein F. Wells J. Henriques S. Van Hout M. C. (2021). \u201cSlam sex\u201d: Sexualized injecting drug use (SIDU) amongst men who have sex with men (MSM)\u2014A scoping review. Journal of Homosexuality 68(14) 2344\u20132358. https:\/\/doi.org\/10.1080\/00918369.2021.1923805","DOI":"10.1080\/00918369.2020.1804258"},{"key":"e_1_3_2_12_1","doi-asserted-by":"crossref","unstructured":"Stuart D. (2017). Chemsex: Origins of the word a history of the phenomenon and a respectful definition. Drug and Alcohol Today 18(1) 3\u201310. https:\/\/doi.org\/10.1108\/DAT-08-2017-0030","DOI":"10.1108\/DAT-10-2018-0058"},{"key":"e_1_3_2_13_1","doi-asserted-by":"crossref","unstructured":"Wille L. Jewell T. Wolfe A. Peterson E. Shaughnessy A. Roblee C. Strader A. (2025). 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