Prevalence of HIV risk-related drug use and sexual activity among men who have sex with men attending a specialist UK club drug clinic

Purpose The purpose of this paper is to examine patterns of drug use among a cohort of drug treatment-seeking drug-using gay men and other men who have sex with men (MSM), and whether these activities differ between, or predict, HIV status. Design/methodology/approach Cross-sectional study was conducted in a specialist club drug clinic in London covering 407 consecutive attendees who identified as MSM. Substance use, including injecting drug use (IDU), associated sexual activity and self-reported HIV status were measured by clinical interview and National Drug Treatment Monitoring System data tool. Findings Over a 45-month period, 407 MSM attended the clinic. In total, 62.1 per cent were HIV positive, 48.9 per cent had injected drugs, 14.9 per cent reported needle sharing and 73.3 per cent used drugs to facilitate sex. The most commonly reported problem drugs were GHB/GBL (54.3 per cent) methamphetamine (47.7 per cent) and mephedrone (37.8 per cent). HIV status was associated with methamphetamine, mephedrone, IDU, sharing equipment, using drugs to facilitate sex, older age and older age of drug initiation, as well as Hepatitis C virology (HCV) status. Use of methamphetamine, HCV infection, older age and IDU predicted HIV positive status in a logistic regression model. Practical implications The findings describe a constellation of risk factors including high levels of IDU, sharing of equipment and high-risk sexual activity in a population with high rates of HIV positive serology. They also provide further evidence for a link between HIV infection and use of methamphetamine. Social implications The authors suggest a need for greater awareness of HIV-related risk activities and promotion of HIV prevention strategies for MSM by both sexual health and drug treatment services. Originality/value This paper is amongst the very first studies of its nature.

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Food Insecurity Partially Mediates the Association Between Drug Use and Depressive Symptoms among Men who have Sex with Men in Los Angeles, California

Public Health Nutrition ◽

10.1017/s1368980021002494 ◽

2021 ◽

pp. 1-26

Author(s):

David A. Wiss ◽

Marjan Javanbakht ◽

Michael J. Li ◽

Michael Prelip ◽

Robert Bolan ◽

...

Keyword(s):

Food Security ◽

Depressive Symptoms ◽

High Risk ◽

Los Angeles ◽

Drug Use ◽

Food Insecurity ◽

Hiv Positive ◽

Sex With Men ◽

The Relationship ◽

Hiv Negative

Abstract Objective: To understand the relationship between drug use, food insecurity (FI), and mental health among men who have sex with men (MSM). Design: Cohort study (2014-2019) with at least one follow-up. Setting: Visits at 6-month intervals included self-assessment for FI and depressive symptoms. Urine testing results confirmed drug use. Factors associated with FI were assessed using multiple logistic regression with random effects for repeated measures. General structural equation modeling tested whether FI mediates the relationship between drug use and depressive symptoms. Participants: Data were from HIV-positive and high-risk HIV negative MSM in Los Angeles, CA (n=431; 1,192 visits). Results: At baseline, FI was reported by 50.8% of participants, depressive symptoms in 36.7%, and 52.7% of urine screening tests were positive for drugs (i.e., marijuana, opioids, methamphetamine, cocaine, ecstasy). A positive drug test was associated with a 96% increase in the odds of being food insecure (95% CI: 1.26-3.07). Compared to those with high food security, individuals with very low food security have a nearly 7-fold increase in the odds of reporting depressive symptoms (95% CI: 3.71-11.92). Findings showed 14.9% of the association between drug use (exposure) and depressive symptoms (outcome) can be explained by FI (mediator). Conclusion: The prevalence of FI among this cohort of HIV-positive and high-risk HIV-negative MSM was high; the association between drug use and depressive symptoms was partially mediated by FI. Findings suggest that enhancing access to food and nutrition may improve mood in the context of drug use, especially among MSM at risk for HIV-transmission.

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HIV Status Disclosure and Condom Use Among HIV-Positive Men Who Have Sex With Men andHijras(Male-to-Female Transgender People) in India: Implications for Prevention

Journal of HIV/AIDS & Social Services ◽

10.1080/15381501.2013.859113 ◽

2015 ◽

Vol 14 (1) ◽

pp. 26-44 ◽

Cited By ~ 11

Author(s):

Venkatesan Chakrapani ◽

Murali Shunmugam ◽

Peter A. Newman ◽

Trace Kershaw ◽

Robert Dubrow

Keyword(s):

Condom Use ◽

Hiv Positive ◽

Hiv Status ◽

Transgender People ◽

Sex With Men ◽

Hiv Status Disclosure ◽

Status Disclosure ◽

Male To Female ◽

Hiv Positive Men

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HIV-Related Attitudes and Intentions for High-Risk, Substance-Using Men Who Have Sex With Men: Associations and Clinical Implications for HIV-Positive and HIV-Negative MSM

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.24.4.281 ◽

2010 ◽

Vol 24 (4) ◽

pp. 281-293 ◽

Cited By ~ 6

Author(s):

Gordon Mansergh ◽

David J. McKirnan ◽

Stephen A. Flores ◽

Sharon M. Hudson ◽

Beryl A. Koblin ◽

...

Keyword(s):

Substance Use ◽

Risk Behavior ◽

Self Efficacy ◽

Safer Sex ◽

Hiv Positive ◽

Hiv Status ◽

Anal Sex ◽

Sex With Men ◽

Hiv Negative ◽

Hiv Positive Men

This study compared HIV-related attitudes and intentions by respondent HIV-status in a large sample of substance-using men who have sex with men (MSM) in the United States. Attitudes and intentions included self-efficacy for safer sex; difficulty communicating with sex partners about safer sex; intent to use condoms consistently and to not use substances before sex in the next 3 months; and less concern for HIV given effective antiviral treatments. Differences were found for behavior during the most recent anal sex encounter by HIV-status, including (a) insertive and (b) receptive anal sex risk behavior, and (c) substance use before or during the encounter. Self-efficacy for safer sex was associated with less risk behavior among HIV-negative men but not among HIV-positive men, suggesting that self-efficacy for safer sex continues to be a relevant issue to address in counseling uninfected MSM. HIV-positive men who reported less concern for HIV given treatments were more likely to report receptive risk behavior, as were HIV-negative men who reported difficulty communicating about safer sex. Implications are discussed for potentially heightened client desire and therapeutic opportunity to reduce future substance use during sex for clients who report recent substance use during sex.

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423. Self-Reported Screening for Rectal Sexually Transmitted Infections Among Men Who Have Sex with Men

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.496 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S212-S213

Author(s):

Timothy William. Menza ◽

Lauren Lipira ◽

Amisha Bhattarai ◽

Joseph Ramirez ◽

Roberto Orellana

Keyword(s):

Sexually Transmitted Infections ◽

Multivariable Analysis ◽

Prevalence Ratio ◽

Hiv Positive ◽

Sexually Active ◽

Hiv Status ◽

Sexually Transmitted ◽

Sex With Men ◽

Hiv Negative ◽

Hiv Positive Men

Abstract Background Rectal gonorrhea and Chlamydia are common and predict HIV acquisition among men who have sex with men (MSM); however, screening for rectal sexually transmitted infections (STIs) is not routine. Methods In 2017, we recruited sexually-active MSM in the Portland, Oregon metropolitan area through venue-based sampling. Our outcome of interest was self-reported rectal STI screening in the prior 12 months. Stratified by HIV status, we assessed the prevalence and demographic, healthcare, clinical, and behavioral predictors of screening. Results Of 448 participants, 168 (37.5%) reported rectal STI screening. One hundred twenty-seven (35.8%) of 355 HIV-negative men, 41 (58.6%) of 70 HIV-positive men, and none of 23 men who did not know their HIV status reported screening. Among HIV-negative men, having a healthcare provider who offered HIV testing (adjusted prevalence ratio [aPR]=2.09; 95% confidence interval [CI]: 1.43, 3.04), a syphilis diagnosis (aPR=1.32; 95% CI: 1.03, 1.69), use of pre-exposure prophylaxis (aPR=1.57; 95% CI 1.21, 2.04), and condomless anal sex with casual partners in the prior 12 months (aPR=1.74; 95% CI: 1.36, 2.22) independently predicted screening for rectal STI in multivariable analysis. HIV-positive men who reported having a provider who always or often initiates conversations about sex were significantly more likely to report screening compared with men who did not have such a provider (aPR=1.48; 95% CI: 1.06, 2.06). Conclusion Rectal STI screening is not universal in a venue-based sample of sexually-active MSM. Implementing innovative, acceptable, and accessible screening practices and improving provider comfort with talking about sex are paramount to increasing rectal STI screening. Disclosures All authors: No reported disclosures.

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Injection drug use, unknown HIV positive status, and self-reported current PrEP use among Black men who have sex with men attending U.S. Black pride events, 2014–2017

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2019.107808 ◽

2020 ◽

Vol 207 ◽

pp. 107808 ◽

Cited By ~ 1

Author(s):

Jessica L. Maksut ◽

Rachel E. Gicquelais ◽

Kevon-Mark Jackman ◽

Lisa A. Eaton ◽

M. Revel Friedman ◽

...

Keyword(s):

Drug Use ◽

Black Men ◽

Injection Drug Use ◽

Injection Drug ◽

Hiv Positive ◽

Sex With Men ◽

Black Pride

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Patterns of sexualised recreational drug use and its association with risk behaviours and sexual health outcomes in men who have sex with men in London, UK: a comparison of cross-sectional studies conducted in 2013 and 2016

Sexually Transmitted Infections ◽

10.1136/sextrans-2019-054139 ◽

2019 ◽

Vol 96 (3) ◽

pp. 197-203 ◽

Cited By ~ 2

Author(s):

Tyrone J Curtis ◽

Alison J Rodger ◽

Fiona Burns ◽

Anthony Nardone ◽

Andrew Copas ◽

...

Keyword(s):

Sexual Health ◽

Hiv Positive ◽

Risk Behaviours ◽

Hiv Status ◽

Cross Sectional ◽

The Past ◽

Unknown Status ◽

Sex With Men ◽

Hiv Negative ◽

Hiv Positive Men

ObjectiveLondon has one of the highest identified prevalence of chemsex (sexualised recreational drug use) among men who have sex with men (MSM) in Europe. We examine MSM’s patterns of chemsex and its association with HIV/STI risk behaviours, STI diagnoses and sexual healthcare-seeking behaviours, including if HIV testing behaviour met UK national guidelines (three monthly if engaging in chemsex).MethodsCross-sectional survey data from 2013 (n=905) and 2016 (n=739) were collected using anonymous, self-administered questionnaires from MSM recruited in commercial gay venues in London, UK. Descriptive and multivariable analyses, stratified by self-reported HIV status, were conducted. Adjusted prevalence ratios (aPR) with 95% CIs were calculated.ResultsComparing the 2013 and 2016 surveys, chemsex prevalence in the past year remained stable, in both HIV-negative/unknown-status MSM (20.9% in 2013 vs 18.7% in 2016, p=0.301) and HIV-positive MSM (41.6% in 2013 vs 41.7% in 2016, p=0.992). Combined 2013–2016 data showed that compared with other MSM, those reporting chemsex were more likely to report HIV/STI risk behaviours, including condomless anal intercourse with serodifferent HIV-status partners (HIV-negative/unknown-status men: aPR 2.36, 95% CI 1.68 to 3.30; HIV-positive men: aPR 4.19, 95% CI 1.85 to 9.50), and STI diagnoses in the past year (HIV-negative/unknown-status men: aPR 2.10, 95% CI 1.64 to 2.69; HIV-positive men: aPR 2.56, 95% CI 1.57 to 4.20). 68.6% of HIV-negative/unknown-status men reporting chemsex attended sexual health clinics and 47.6% had tested for HIV more than once in the past year.ConclusionsChemsex in London MSM remained stable but high, particularly among HIV-positive men. Irrespective of HIV status, chemsex was associated with engagement in HIV/STI risk behaviours. Frequency of HIV testing in the past year among HIV-negative/unknown-status men was below national recommendations. Promoting combination prevention strategies, including three monthly HIV/STI testing, access to pre-exposure prophylaxis/antiretroviral treatment and behavioural interventions among MSM reporting chemsex, remains vital to address sexual health inequalities in MSM.

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Impact of HIV Infection Status on Interpretation of Quantitative PCR for Detection of Pneumocystis jirovecii

Journal of Clinical Microbiology ◽

10.1128/jcm.02072-15 ◽

2015 ◽

Vol 53 (12) ◽

pp. 3870-3875 ◽

Cited By ~ 21

Author(s):

M. Louis ◽

J. Guitard ◽

M. Jodar ◽

T. Ancelle ◽

D. Magne ◽

...

Keyword(s):

Quantitative Pcr ◽

Biological Data ◽

Hiv Positive ◽

Immunocompromised Patients ◽

Infection Status ◽

Hiv Status ◽

Content Type ◽

Fungal Burden ◽

Specificity And Sensitivity ◽

Hiv Negative

Quantitative PCR (qPCR) is now a key diagnostic tool forPneumocystispneumonia. However, cutoffs to distinguish between infected and colonized patients according to their HIV status have not yet been determined. According to clinical, radiological, and biological data, we retrospectively classified bronchoalveolar lavage (BAL) samples subjected to qPCR over a 3-year period into four categories, i.e., definite PCP, probable PCP,Pneumocystiscolonization, and no infection. Fungal burden was then analyzed according to the HIV status of the patients. Among 1,212 episodes of pneumonia screened in immunocompromised patients, 52 and 27 HIV-positive patients were diagnosed with a definite and probable PCP, whereas 4 and 22 HIV-negative patients had definite and probable PCP, respectively. Among patients with definite or a probable PCP, HIV-negative patients had a significantly lower burden than HIV-positive patients (P< 10−4). In both groups, the median fungal burden was significantly higher in patients with definite PCP than in colonized patients. A single cutoff at 1.5 × 104copies/ml allowed to differentiate colonized and infected HIV-positive patients with 100% sensitivity and specificity. In HIV-negative patients, cutoff values of 2.87 × 104and 3.39 × 103copies/ml resulted in 100% specificity and sensitivity, respectively. Using cutoffs determined for the whole population would have led us to set aside the diagnosis of PCP in 9 HIV-negative patients with definite or probable PCP. qPCR appeared to be the most sensitive test to detectPneumocystisin BAL samples. However, because of lower inocula in HIV-negative patients, different cutoffs must be used according to the HIV status to differentiate between colonized and infected patients.

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Routine or targeted HIV screening of Indonesian prisoners

International Journal of Prisoner Health ◽

10.1108/ijph-04-2015-0012 ◽

2016 ◽

Vol 12 (1) ◽

pp. 17-26 ◽

Cited By ~ 5

Author(s):

Erni Juwita Nelwan ◽

Ahmad Isa ◽

Bachti Alisjahbana ◽

Nurlita Triani ◽

Iqbal Djamaris ◽

...

Keyword(s):

Drug Use ◽

Hiv Testing ◽

Hiv Infections ◽

Hiv Treatment ◽

Routine Screening ◽

Hiv Positive ◽

Hiv Screening ◽

Content Type ◽

Targeted Screening ◽

Routine Hiv Screening

Purpose – Routine HIV screening of prisoners is generally recommended, but rarely implemented in low-resource settings. Targeted screening can be used as an alternative. Both strategies may provide an opportunity to start HIV treatment but no formal comparisons have been done of these two strategies. The paper aims to discuss these issues. Design/methodology/approach – The authors compared yield and costs of routine and targeted screening in a narcotic prison in Indonesia. Routine HIV screening was done for all incoming prisoners from August 2007-February 2009, after it was switched for budgetary reasons to targeted (“opt-out”) HIV screening of inmates classified as people who inject drugs (PWIDs), and “opt-in” HIV testing for all non-PWIDs. Findings – During routine screening 662 inmates were included. All 115 PWIDs and 93.2 percent of non-PWIDs agreed to be tested, 37.4 percent and 0.4 percent respectively were HIV-positive. During targeted screening (March 2009-October 2010), of 888 inmates who entered prison, 107 reported injecting drug use and were offered HIV testing, of whom 31 (29 percent) chose not to be tested and 25.0 percent of those tested were HIV-positive. Of 781 non-PWIDs, 187 (24 percent) came for testing (opt-in), and 2.1 percent were infected. During targeted screening fewer people admitted drug use (12.0 vs 17.4 percent). Routine screening yielded twice as many HIV-infected subjects (45 vs 23). The estimated cost per detected HIV infection was 338 USD for routine and 263 USD for targeted screening. Originality/value – In a resource limited setting like Indonesia, routine HIV screening in prison is feasible and more effective than targeted screening, which may be stigmatizing. HIV infections that remain unrecognized can fuel ongoing transmission in prison and lead to unnecessary disease progression and deaths.

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Pilot of non-invasive (oral fluid) testing for HIV within a community setting

Sexual Health ◽

10.1071/sh09029 ◽

2010 ◽

Vol 7 (1) ◽

pp. 11 ◽

Cited By ~ 26

Author(s):

Frances Birrell ◽

Shaun Staunton ◽

Joseph Debattista ◽

Nicole Roudenko ◽

William Rutkin ◽

...

Keyword(s):

Oral Fluid ◽

Community Setting ◽

Risk Behaviour ◽

Hiv Positive ◽

Hiv Status ◽

Significant Difference ◽

Hiv Antibodies ◽

Undiagnosed Hiv ◽

Gay Bars ◽

Sex With Men

Background: The present study sought to determine the level of undiagnosed HIV infection within a community setting of men who have sex with men (MSM) and identify any associated sexual risk behaviours. Methods: A total of 427 MSM were recruited in sex-on-premises venues (SOPV) and gay bars within the inner city of Brisbane. An additional 37 MSM were recruited in a smaller, regional centre (Toowoomba). Oral fluid testing for HIV antibodies was undertaken using the Orasure collection system and assay. Each participant was invited to complete a brief behaviour questionnaire and submit an oral fluid specimen. Confirmed serology results were linked to reported sexual behaviours, testing patterns and HIV status. Results: Of the 464 men surveyed, 33 identified as HIV-positive, and all of these were reactive by the Orasure assay. A further eight people who identified as negative or unknown serostatus, had confirmed Orasure reactive results, resulting in 1.9% of the ‘non-HIV positive’ MSM sample unaware of their positive HIV status. Therefore, 19.5% of the total confirmed HIV-positive individuals were not aware of their true serostatus. Conclusions: A significant minority of HIV-positive MSM are currently unaware of their positive serostatus. However, an analysis of their risk behaviour does not seem to indicate any significant difference to those who are HIV-negative. Interestingly, 86% of those who were unaware they were HIV-positive identified that they had been tested in the previous 6 months and all of them claimed to have been tested in the previous 2 years.

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