A community-led, harm-reduction approach to chemsex: case study from Australia’s largest gay city

Sexual Health ◽  
2018 ◽  
Vol 15 (2) ◽  
pp. 179 ◽  
Author(s):  
Zahra Stardust ◽  
Johann Kolstee ◽  
Stefan Joksic ◽  
James Gray ◽  
Siobhan Hannan
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
New South ◽  
New South Wales ◽  
Gay And Bisexual Men ◽  
Sexual Pleasure ◽  
People Living With Hiv ◽  
Bisexual Men ◽  
South Wales ◽  
And Bisexual

Rates of drug use remain substantially higher among gay and bisexual men (GBM) and people living with HIV (PLHIV) in Sydney, New South Wales, Australia. The use of drugs to enhance sexual pleasure within cultures of Party and Play creates opportunities to discuss sexual health, mental health, consent and wellbeing. Community organisations with a history of HIV prevention, care, treatment are well-placed to respond. ACON’s (formerly the AIDS Council of New South Wales) multi-dimensional response to ‘chemsex’ includes: direct client services support for individuals seeking to manage or reduce their use; health promotion activities that support peer education; partnerships with research institutions to better understand cultures of chemsex; and policy submissions that call for drug use to be approached as a health, rather than a criminal, issue. The approach speaks the language of Party and Play subcultures; employs culturally relevant terminology and imagery; uses content designed, created and delivered by peers; and operates within a pleasure-positive, harm-reduction and community-led framework. These interventions have led to increased service uptake, strong community engagement, robust research partnerships and the recognition of GBM as a priority population in relevant strategies.

Changing pattern of sexually transmissible infections and HIV diagnosed in public sexual health services compared with other locations in New South Wales, 2010–14

Sexual Health ◽  
2018 ◽  
Vol 15 (4) ◽  
pp. 366 ◽  
Author(s):  
Christopher Bourne ◽  
Meeyin Lam ◽  
Christine Selvey ◽  
Rebecca Guy ◽  
Denton Callander
Keyword(s):  
Young People ◽  
Sexual Health ◽  
New South ◽  
New South Wales ◽  
People Living With Hiv ◽  
Bisexual Men ◽  
South Wales ◽  
Sexually Transmissible Infections ◽  
Annual Proportion ◽  
Priority Population

Background In Australia, testing and treatment for HIV and other sexually transmissible infections (STIs) is usually managed in general practice, while publicly funded sexual health clinics (PFSHC) attract people at higher risk for infection. The proportion of HIV and STI diagnoses in New South Wales (NSW) occurring in PFSHC stratified by priority population was investigated. Methods: From 2010 to 2014, NSW notification frequencies for chlamydia, gonorrhoea, infectious syphilis, and HIV were compared with the number of diagnoses in PFSHC. The annual proportion of diagnoses at PFSHC was calculated and Wilcoxon rank-sum tests assessed trends. Diagnoses from PFSHC were also organised by priority population, including gay and bisexual men (GBM), people living with HIV, Aboriginal and Torres Strait Islander people, people who use injecting drugs, sex workers and young people. Results: The annual proportion of HIV and STIs diagnosed at PFSHC increased (all P < 0.001): chlamydia from 12% to 15%, gonorrhoea 23% to 38%, infectious syphilis 21% to 40% and HIV 22% to 30%. Overall, the majority of all infections diagnosed at PFSHC were among GBM, with the proportional distribution of chlamydia increasing from 32% to 46% among GBM (P < 0.001) and decreasing among young people (50% to 40%; P < 0.001). There were no other significant changes by population or infection at PFSHC. Conclusions: Increasing proportions of STI and HIV are being diagnosed at NSW PFSHC, mostly among GBM. PFSHC reorientation to priority populations continues to make a large and increasing contribution to STI and HIV control efforts in NSW.

Sex, drugs and social connectedness: wellbeing among HIV-positive gay and bisexual men who use party-and-play drugs

Sexual Health ◽  
2018 ◽  
Vol 15 (2) ◽  
pp. 135 ◽  
Author(s):  
Jennifer Power ◽  
Gosia Mikołajczak ◽  
Adam Bourne ◽  
Graham Brown ◽  
William Leonard ◽  
...  
Keyword(s):  
Drug Use ◽  
Drug Users ◽  
Social Connectedness ◽  
Gay And Bisexual Men ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Bisexual Men ◽  
Related Stigma ◽  
And Bisexual ◽  
Living With Hiv

Background This paper explores associations between use of party-and-play drugs, including crystal methamphetamine, and wellbeing among HIV positive gay and bisexual men (GBM) in Australia. This study considers whether use of drugs in a social or sex-based setting facilitates access to social and support networks, which may in turn support wellbeing. Methods: A cross-sectional survey of Australian people living with HIV (PLHIV) was conducted. There were 714 participants (79.7%) who identified as GBM. Differences between party-and-play drug users and non-users were examined using bivariate and multinomial logistic regressions. Mediation analysis examined the indirect effect of drug use on wellbeing via social connectedness and support. Results: One in three participants (29.7%) reported party-and-play drug use within the past 12 months. Only 5% reported regular use. There were no differences between users and non-users on self-reported measures of general health, wellbeing or general social support. Compared with non-users, party-and-play drug users reported higher levels of resilience and lower levels of perceived HIV-related stigma. This was associated with spending more time with other people living with HIV and friends in the gay and lesbian community. Conclusions: While party-and-play drug use poses risks to the health of GBM, the social contexts in which these drugs are used may provide wellbeing benefits, particularly for HIV-positive GBM who may be subject to HIV-related stigma in other settings. Further research is needed to determine whether drug-use facilitates access to social networks or if people with more active social ties are more likely to engage in drug use.

Substantial increase in yield of Neisseria gonorrhoeae testing 2008–2013 at a Sydney metropolitan sexual health clinic: an observational study

Sexual Health ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 79
Author(s):  
Preethi Rajagopal ◽  
Sian L. Goddard ◽  
David J. Templeton
Keyword(s):  
Sexual Health ◽  
Sex Workers ◽  
New South ◽  
Gay And Bisexual Men ◽  
Health Clinic ◽  
Bisexual Men ◽  
South Wales ◽  
And Bisexual ◽  
Generalised Estimating Equations ◽  
Hiv Negative

Background A substantial increase in gonorrhoea notifications in New South Wales has been observed in recent years. Methods: We assessed yield of testing and characteristics of those diagnosed with gonorrhoea from January 2008 to December 2013 at RPA Sexual Health in the inner-west of Sydney. Yield was defined as the proportion of testing occasions which were positive for gonorrhoea. Generalised estimating equations were used to calculate trends in yield over time. Results: During the 6-year study period, 6456 individuals (4308 males, 2124 females, 24 transgender individuals) were tested on 12 799 occasions; this included 2441 gay and bisexual men (GBM) who were tested on 6945 occasions. Over the study period there was a significant increase in testing at genital, anorectal and pharyngeal sites (P-trend <0.001 for all). In total, gonorrhoea was detected on 668 testing occasions among 536 individuals (5.2%). Overall, 254/12765 (2.0%) of genital tests, 251/7326 (3.4%) of anorectal tests and 342/8252 (4.1%) of pharyngeal tests were positive. There was a significant increase in overall gonorrhoea yield from 2.2% in 2008 to 7.1% in 2013 (P-trend <0.001). This temporal increase in gonorrhoea yield was observed in heterosexual males (P < 0.001), heterosexual females (P-trend = 0.008), female sex workers (P-trend = 0.006), HIV-positive GBM and HIV-negative GBM (both P < 0.001) and at all anatomical sites (P-trend <0.001 for all). Conclusions: From 2008 to 2013, we observed a greater than threefold increase in yield of gonorrhoea testing disproportionately affecting GBM, although the increase also occurred in other subpopulations and at all anatomic sites. More frequent and comprehensive testing could potentially reduce the high and increasing community prevalence of gonorrhoea.

scholarly journals Attitudes and Perceived Social Norms toward Drug Use among Gay and Bisexual Men in Australia

2019 ◽  
Vol 54 (6) ◽  
pp. 944-954 ◽  
Author(s):  
Toby Lea ◽  
Mohamed Hammoud ◽  
Adam Bourne ◽  
Lisa Maher ◽  
Fengyi Jin ◽  
...  
Keyword(s):  
Drug Use ◽  
Social Norms ◽  
Gay And Bisexual Men ◽  
Bisexual Men ◽  
Perceived Social Norms ◽  
And Bisexual
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