scholarly journals The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men

Sexual Health ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 42 ◽  
Author(s):  
Kane Race ◽  
Toby Lea ◽  
Dean Murphy ◽  
Kiran Pienaar
Keyword(s):  
Drug Use ◽  
Sexual Health ◽  
Service Providers ◽  
Public Funding ◽  
Sexually Transmissible Infections ◽  
The Future ◽  
Degree Of Certainty ◽  
And Gender ◽  
Sex With Men ◽  
Drug Problems

There are complex historical connections between sexual minoritisation and desires to chemically alter bodily experience. For gay men, drug and alcohol use can be a creative or experimental response to social marginalisation – and not necessarily a problematic one in every instance. Numerous studies have found that infection with HIV and other sexually transmissible infections (STIs) is more likely among gay and men who have sex with men (MSM) who use recreational drugs than those who do not, but the causal nature of these relations is uncertain. Sexualised drug use is associated with a range of other problems, including dependence, mental health issues, accident and overdose. A growing body of work in the Alcohol and Other Drugs (AOD) field demonstrates the action of drugs and their purported effects to be a product of their relations with various other actors, contexts and practices. Given these contingencies, it is impossible to predict the future of drugs or their effect on the sexual health of gay and MSM with any degree of certainty. This article outlines some of the conditions most likely to mediate such futures in the medium term. Public funding for lesbian, gay, bisexual, transgender and queer drug issues should not remain restricted to questions of HIV prevention and sexual health. It should be expanded to equip sexual health and AOD service providers with the cultural and sexual literacy to mitigate stigma and allow them to respond constructively to drug problems among sexual and gender minorities as a matter of priority.

scholarly journals Intersectional analysis of life stress, incarceration and sexual health risk practices among cisgender Black gay, bisexual and other men who have sex with men in the Deep South of the US: the MARI Study

Sexual Health ◽  
2020 ◽  
Vol 17 (1) ◽  
pp. 38
Author(s):  
Dustin T. Duncan ◽  
Denton Callander ◽  
Lisa Bowleg ◽  
Su Hyun Park ◽  
Lauren Brinkley-Rubinstein ◽  
...  
Keyword(s):  
Drug Use ◽  
Sexual Health ◽  
Health Risk ◽  
Sexual Risk ◽  
Life Stress ◽  
Black Msm ◽  
Deep South ◽  
Risk Practices ◽  
Sex With Men ◽  
Group Sex

Objectives The purpose of the present study was to examine associations between life stress and incarceration history in relation to sexual health risk practices among a sample of cisgender Black gay, bisexual and other men who have sex with men (MSM) in the Deep South. Methods: Using data from a sample of 355 cisgender Black MSM in Mississippi and Georgia, multivariable logistic regression analyses were conducted to examine associations between life stress and sexual risk practices. In addition, we assessed whether stress may interact with experiences of incarceration to influence sexual health risk practices. Results: After controlling for sociodemographic characteristics, stress was associated with some sexual risk practices (e.g. alcohol and drug use during sex and group sex). Further, when an interaction with incarceration was assessed, among participants who had been incarcerated, high compared with low levels of stress were associated with alcohol use during sex (adjusted odds ratio (aOR) 4.59, 95% confidence interval (CI) 2.11–9.99, P < 0.001), drug use during sex (aOR 3.92, 95% CI 1.79–8.60, P < 0.001), condomless sex with casual partners (aOR 2.83, 95% CI 1.31–6.12, P < 0.001), having six or more casual partners (aOR 2.77, 95% CI 1.09–7.06, P = 0.02) and participating in group sex (aOR 5.67, 95% CI 2.07–15.51, P < 0.001). Stress and incarceration produced a dose–response effect for each association; similar associations with stress were not observed among men who had not been incarcerated. Conclusions: Among people with experiences of incarceration, there are several possible ways our findings could be applied practically, including through safer sex and stress management interventions designed specifically for Black MSM following their release.

Associations between economic dependence, sexual behaviours, and sexually transmitted infections among young, Black, gay, bisexual and other men who have sex with men living with and without HIV in Jackson, Mississippi, USA

Sexual Health ◽  
2018 ◽  
Vol 15 (5) ◽  
pp. 473 ◽  
Author(s):  
Kalysha Closson ◽  
Rachel Vickers Smith ◽  
Gbolahan Olarewaju ◽  
Richard Crosby
Keyword(s):  
Sexual Health ◽  
Relationship Power ◽  
Hiv Status ◽  
Economic Dependence ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
Sexual Behaviours ◽  
Sexually Transmissible Infections ◽  
The Usa ◽  
Sex With Men

Background In the USA, young Black gay, bisexual or other men who have sex with men (YBMSM) bear the largest burden of HIV incidence. The aim of this study is to examine the independent associations between economic dependency on a sexual partner and several HIV risk behaviours and sexual health outcomes among YBMSM living in Jackson, Mississippi, USA. Methods: Baseline data from 589 YBMSM, with a median age of 22.0 years (IQR = 15–25) participating in a brief sex-positive HIV and STI prevention intervention, were used to measure the association between six sexual behaviours, sexually transmissible infections (STIs) status at baseline and economic dependence. Bivariate χ2 associations were tested and regression models adjusted for education level (≤ high school), employment and HIV-status. Results: In regressions, of the six sexual behaviours reported in the last 90 days and six STIs tested at baseline, economically dependent YBMSM were more likely to report condomless anal receptive sex (aOR = 2.19, 95%CI = 1.25–3.83), ≥3 partners as a top (aOR = 1.99, 95%CI = 1.17–340), ≥3 sex partners as a bottom (aOR = 2.07, 95%CI = 1.24–3.45), ≥3 sex acts as a bottom (aOR = 2.10, 95%CI = 1.16–3.82) and testing positive for oral gonorrhoea (aOR = 2.39, 95%CI = 1.18–4.83) after controlling for HIV status, employment and education. Conclusions: Interventions should consider how poverty, unemployment and economic dependence interact to influence relationship power imbalances, condom use and sexual positioning agency, and sexual health for key populations of MSM.

Prevalence of rectal Mycoplasma genitalium and macrolide resistance in men who have sex with men attending Sydney Sexual Health Centre

Sexual Health ◽  
2020 ◽  
Vol 17 (2) ◽  
pp. 114
Author(s):  
Isabella Bradley ◽  
Rick Varma ◽  
Vickie Knight ◽  
Dimitra Iliakis ◽  
Leon McNally ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Sexual Health ◽  
Rectal Swab ◽  
Health Centre ◽  
Mycoplasma Genitalium ◽  
Macrolide Resistance ◽  
Cross Sectional ◽  
Screening Guidelines ◽  
Sexually Transmissible Infections ◽  
Sex With Men

Background Sexually transmissible infections (STIs) have been increasing in men who have sex with men (MSM) in recent years; however, few studies have investigated the prevalence or antimicrobial resistance in rectal Mycoplasma genitalium in this group. This study aimed to determine the prevalence and predictors of rectal M. genitalium in MSM attending an urban sexual health service in Sydney, Australia, namely the Sydney Sexual Health Centre (SSHC), as well as estimate the rate of macrolide resistance. Methods: A prospective cross-sectional analysis was conducted of rectally asymptomatic MSM having a rectal swab collected as part of their routine care. Participants self-collected a rectal swab to be tested for M. genitalium and completed a 14-item questionnaire that provided information on behavioural risk factors. The prevalence of rectal M. genitalium was determined and multivariate analysis was performed to assess the associations for this infection. Positive specimens then underwent testing for macrolide-resistant mutations (MRMs) using the ResistancePlus MG assay (SpeeDx, Eveleigh, NSW, Australia). Results: In all, 742 patients were consecutively enrolled in the study. The median age was 31 years (interquartile range 27–39 years), with 43.0% born in Australia. Overall, 19.0% of men were bisexual, 22.9% were taking pre-exposure prophylaxis (PrEP) and 4.3% were HIV positive. The prevalence of rectal M. genitalium was 7.0% (95% confidence interval (CI) 5.3–9.1) overall and 11.8% in those taking PrEP. On multivariate analysis, PrEP use was significantly associated with having rectal M. genitalium (odds ratio 2.01; 95% CI 1.09–3.73; P = 0.01). MRMs were detected in 75.0% (36/48; 95% CI 60.4–86.4%) of infections. Conclusion: Rates of rectal M. genitalium infection were high among asymptomatic MSM attending SSHC and MRMs were detected in 75% of infections. PrEP use was found to be significantly associated with rectal M. genitalium infection. These data contribute to the evidence base for screening guidelines in MSM.

scholarly journals Chemsex and the city: sexualised substance use in gay bisexual and other men who have sex with men attending sexual health clinics

2016 ◽  
Vol 28 (4) ◽  
pp. 362-366 ◽  
Author(s):  
A Hegazi ◽  
MJ Lee ◽  
W Whittaker ◽  
S Green ◽  
R Simms ◽  
...  
Keyword(s):  
Substance Use ◽  
Hepatitis C ◽  
Drug Use ◽  
Sexual Health ◽  
Clinical Pathways ◽  
Post Exposure Prophylaxis ◽  
Hiv Incidence ◽  
Health Clinics ◽  
Sex With Men ◽  
Sexual Health Clinics

The objective of this study was to analyse associations between sexualised substance use (chemsex), STI diagnoses and sexual behaviour among gay bisexual and other men who have sex with men accessing sexual health clinics to better inform clinical pathways. A retrospective case notes review was undertaken following the introduction of more detailed and holistic profomas for all gay bisexual and other men who have sex with men attending two London sexual health clinics between 1 June 2014 and 31 January 2015. Chemsex status was documented for 655/818. Overall, 30% disclosed recreational drug use of whom 113 (57%) disclosed chemsex and 27 (13.5%) injecting drugs. HIV-positive gay bisexual and other men who have sex with men were more likely to disclose chemsex (AOR 6.68; 95% CI 3.91–11.42; p < 0.001). Those disclosing chemsex had a higher incidence of acute bacterial STIs (AOR 2.83 CI 1.79–4.47; p < 0.001), rectal STIs (AOR 3.10 CI 1.81–5.32; p < 0.001) or hepatitis C (AOR 15.41 CI 1.50–158.17; p = 0.021). HIV incidence in the study period was 1.8% (chemsex) vs. 0.9% (no chemsex) (p = 0.61). Chemsex was associated with having more sexual partners, transactional sex, group sex, fisting, sharing sex toys, injecting drug use, higher alcohol consumption and the use of ‘bareback’ sexual networking applications (p < 0.004). Chemsex participants were also more likely to have accessed post-exposure prophylaxis for HIV in the study period and report sex with a discordant HIV or hepatitis C-infected partner (p < 0.001). Chemsex disclosure is associated with higher risk-taking behaviours, acute bacterial STIs, rectal STIs and hepatitis C incidence. HIV incidence was higher but not significantly so in the study period. Chemsex disclosure in sexual health clinics should prompt an opportunity for prevention, health promotion and wellbeing interventions.

Early experience of implementing a national HIV pre-exposure prophylaxis service in Wales, United Kingdom 2017

Sexual Health ◽  
2019 ◽  
Vol 16 (1) ◽  
pp. 56 ◽  
Author(s):  
Laia Fina ◽  
Amy L. Phillips ◽  
Adam T. Jones ◽  
Zoë M. Couzens ◽  
Rachel Drayton ◽  
...  
Keyword(s):  
Sexual Health ◽  
Early Experience ◽  
Hiv Positive ◽  
Transgender People ◽  
Positive Individual ◽  
Sexually Transmissible Infections ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis

Background Pre-exposure prophylaxis (PrEP) was introduced in Sexual Health Services of the Welsh National Health Service (NHS Wales) in July 2017 as a 3-year pilot service. Methods: Data were collected through the pre-existing Sexual Health in Wales Surveillance System, to which codes were added to capture PrEP eligibility, outcome of offer of PrEP, reasons for declining and adherence. Eligibility categories were defined based on nationally agreed criteria: men who have sex with men (MSM) and transgender people at high risk of HIV acquisition; partners of HIV-positive individuals not known to be virally suppressed; and heterosexuals reporting condomless intercourse with a HIV-positive individual not known to be virally suppressed. Results: During the first 6 months, 516 people were eligible, 96% of which were MSM. Overall, 57% of those eligible (296/516) started PrEP. Reasons for declining PrEP were given by 88 (56%) of 157 people; 50 (57%) of whom did not believe themselves to be at risk. Of the available adherence assessments, 89% considered that all risk episodes had been covered. Persistence at 3 months was assessed for 141 people, of which 93 (66%) were still using PrEP. There were no HIV diagnoses in people taking PrEP during the first 6 months. Twenty-nine people were diagnosed with 37 episodes of sexually transmissible infections (STIs) while on PrEP. STI incidence was 105.7 per 100 person-years. Conclusions: The early trend indicates that implementation of PrEP is progressing as planned, and the service has been utilised by clients. This analysis can help refine implementation, inform planning and research around uptake, use and effect in Wales and internationally.

Are Australian sexual health clinics attracting priority populations?

Sexual Health ◽  
2013 ◽  
Vol 10 (5) ◽  
pp. 456 ◽  
Author(s):  
Hammad Ali ◽  
Basil Donovan ◽  
Christopher K. Fairley ◽  
Nathan Ryder ◽  
Anna McNulty ◽  
...  
Keyword(s):  
General Population ◽  
Sexual Health ◽  
Sex Workers ◽  
Health Clinics ◽  
Sexually Transmissible Infections ◽  
Sex With Men ◽  
Using Data ◽  
Australian Bureau Of Statistics ◽  
Sexual Health Clinics ◽  
Priority Populations

To answer a key question (‘Are Australian sexual health clinics attracting priority populations?’), we used data from 44 Australian sexual health clinics between 2004 and 2011. We assessed the proportion of patients that were from priority populations (deemed to be at risk of sexually transmissible infections) and compared this to their proportions in the general population using data from Australian Bureau of Statistics and the Australian Study of Health and Relationships. A χ2-test was used. A total of 278 154 new patients attended during 2004–2011. The proportions from each priority population were significantly higher (P < 0.01 for all) than for the general population: young people aged 15–29 years (58.1% v. 20.1%), men who have sex with men (26.0% v. 6.0%), female sex workers (10.8% v. 0.5%), and Aboriginal and Torres Strait Islander people (4.2% v. 2.3%). This study confirms that Australian sexual health clinics attract higher proportions of priority populations and are thus meeting their mandate as defined in the 2010–2013 National Sexually Transmissible Infections Strategy.

scholarly journals Changes in recreational drug use, drug use associated with chemsex, and HIV-related behaviours, among HIV-negative men who have sex with men in London and Brighton, 2013–2016

2018 ◽  
Vol 94 (7) ◽  
pp. 494-501 ◽  
Author(s):  
Janey Sewell ◽  
Valentina Cambiano ◽  
Ada Miltz ◽  
Andrew Speakman ◽  
Fiona C Lampe ◽  
...  
Keyword(s):  
Drug Use ◽  
Sexual Health ◽  
Sociodemographic Factors ◽  
Post Exposure Prophylaxis ◽  
Specific Drug ◽  
Cross Sectional ◽  
Polydrug Use ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Hiv Negative

ObjectivesThe objective of this study was to compare the prevalence of polydrug use, use of drugs associated with chemsex, specific drug use, and HIV-related behaviours, between two time periods, using two groups of HIV-negative men who have sex with men (MSM) attending the same sexual health clinics in London and Brighton, in two consecutive periods of time from 2013 to 2016.MethodsData from MSM in the cross-sectional Attitudes to and Understanding Risk of Acquisition of HIV (AURAH) study (June 2013 to September 2014) were compared with baseline data from different MSM in the prospective cohort study Attitudes to and Understanding Risk of Acquisition of HIV over Time (AURAH2) (November 2014 to April 2016). Prevalence of polydrug use, drug use associated with chemsex and specific drug use, and 10 measures of HIV-related behaviours including condomless sex, post-exposure prophylaxis (PEP) use, pre-exposure prophylaxis (PrEP) use, and HIV testing, were compared. Prevalence ratios (PRs) for the association of the study (time period) with drug use and HIV-related behaviour measures were estimated using modified Poisson regression analysis, unadjusted and adjusted for sociodemographic factors.ResultsIn total, 991 MSM were included from AURAH and 1031 MSM from AURAH2. After adjustment for sociodemographic factors, use of drugs associated with chemsex had increased (adjusted PR (aPR) 1.30, 95% CI 1.11 to 1.53) and there were prominent increases in specific drug use; in particular, mephedrone (aPR 1.32, 95% CI 1.10 to 1.57), γ-hydroxybutyric/γ-butryolactone (aPR 1.47, 95% CI 1.15 to 1.87) and methamphetamine (aPR 1.42, 95% CI 1.01 to 2.01). Use of ketamine had decreased (aPR 0.54, 95% CI 0.38 to 0.78). Certain measures of HIV-related behaviours had also increased, most notably PEP use (aPR 1.50, 95% CI 1.21 to 1.88) and number of self-reported bacterial STI diagnoses (aPR 1.24, 95% CI 1.08 to 1.43).ConclusionsThere have been significant increases in drug use associated with chemsex and some measures of HIV-related behaviours among HIV-negative MSM in the last few years. Changing patterns of drug use and associated behaviours should be monitored to enable sexual health services to plan for the increasingly complex needs of some clients.

Sign in / Sign up

Export Citation Format

Share Document