Why healthcare access matters for cannabis use prevention

Men who have sex with men (MSM) have an elevated risk of adverse outcomes associated with cannabis use. Many studies have been conducted globally; however, there is a lack of research regarding the existing status and factors associated with cannabis use among MSM in Nepal. Therefore, this study aimed to examine the characteristics and factors associated with cannabis use among MSM in Nepal. A cross-sectional respondent driven survey was conducted among MSM in Kathmandu Valley, Nepal between October and December 2022. Overall proportions were weighted in respondent driven sampling analyst software, and 95% confidence intervals (CIs) were calculated. Bivariate and multivariable logistic regression analyses were used to evaluate independent correlates of cannabis use in the last 6 months. Among 250 participants, 27.3% of them used cannabis at least once in their lifetime, and 15.6% had used it within the last 6 months. Older MSM were less likely to have used cannabis (adjusted odds ratio [aOR]: 0.8, 95% CI: 0.7-0.9). Participants who were single (aOR: 21.5; 95% CI: 2.6-175.6), detained at least once by the police (aOR: 11.4; 95% CI: 2.2-58.4), and smoked tobacco daily (aOR: 4.6; 95% CI: 1.2-17.9) had higher odds of cannabis use. Participants who had seen a doctor in the last 6 months (aOR: 0.2; 95% CI: 0.1-0.6) and had trusted healthcare provider (aOR: 0.1; 95% CI: 0.01-0.2) were less likely to use cannabis. Given the known negative health effects of cannabis use such as increased risk of HIV transmission, polydrug use, and heightened sexual health risks, special attention should be directed toward MSM who are young, single, and daily smokers. Participants who had seen a doctor in the last 6 months and had trusted healthcare provider were less likely to use cannabis. This highlights the importance of connecting individuals to regular healthcare services and building trust with providers.