Unhealthy Alcohol Use Among Gay, Bisexual, and Other Men Who Have Sex with Men (GBMSM): A Concept Clarification.

Abstract

Unhealthy alcohol use includes a range of drinking behaviors that pose health risks. Among gay, bisexual, and other men who have sex with men (GBMSM), factors including minority stress exacerbate these risks. However, inconsistencies in defining unhealthy alcohol use in research hinder effective screening and intervention. A clearer conceptual understanding is essential for improving nursing care and public health strategies. This article aims to clarify the concept of unhealthy alcohol use among GBMSM using the Norris method of concept clarification. A selective literature review identified 20 sources. The Norris framework was applied to examine unhealthy alcohol use through its antecedents, attributes, and consequences. Findings were synthesized to develop an operational definition and a conceptual model. Unhealthy alcohol use among GBMSM is defined as a pattern of drinking that exceeds established low-risk guidelines and/or causes harm, often influenced by stigma, discrimination, and permissive social norms, thereby increasing vulnerability to adverse health outcomes, including co-occurring substance use, HIV risk, and chronic conditions. Nurses are well-positioned to address unhealthy alcohol use in GBMSM communities through culturally competent screening, education, and interventions. Conceptual clarity supports research, policy, and practice by integrating quantitative thresholds with sociocultural influences and guiding targeted strategies to improve GBMSM health outcomes.