Recreational drug use in men who have sex with men (MSM) attending UK sexual health services is significantly higher than in non-MSM

AbstractThe aim of this study is to investigate five hypothesized mechanisms of causation between depression and condomless sex with ≥ 2 partners (CLS2+) among gay, bisexual, and other men who have sex with men (GBMSM), involving alternative roles of self-efficacy for sexual safety and recreational drug use. Data were from the AURAH cross-sectional study of 1340 GBMSM attending genitourinary medicine clinics in England (2013–2014). Structural equation modelling (SEM) was used to investigate which conceptual model was more consistent with the data. Twelve percent of men reported depression (PHQ-9 ≥ 10) and 32% reported CLS2+ in the past 3 months. AURAH data were more consistent with the model in which depression was considered to lead to CLS2+ indirectly via low self-efficacy for sexual safety (indirect Beta = 0.158; p < 0.001) as well as indirectly via higher levels of recreational drug use (indirect Beta = 0.158; p < 0.001). SEM assists in understanding the relationship between depression and CLS among GBMSM.

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Syphilis associated with recreational drug use, depression and high-risk sexual behaviour in men who have sex with men: a case–control study in China

Sexually Transmitted Infections ◽

10.1136/sextrans-2018-053878 ◽

2019 ◽

Vol 95 (4) ◽

pp. 267-272

Author(s):

Huichao Wu ◽

Cuizhen Xiu ◽

Xiaojing Fu ◽

Menglong Li ◽

Zhenhong Wang ◽

...

Keyword(s):

High Risk ◽

Drug Use ◽

Case Control Study ◽

Case Control ◽

Multiple Drug ◽

Recreational Drug ◽

Syphilis Infection ◽

Recreational Drug Use ◽

Sex With Men ◽

Control Study

ObjectiveWe investigated syphilis prevalence among men who have sex with men (MSM) in China, as well as potential risk factors. Our principal hypothesis was that syphilis would be associated with the use of recreational drugs such as methamphetamines.MethodsFrom April to October 2013, we used several methods to recruit MSM in Qingdao, collecting demographic/behavioural information via self-administrated questionnaires. Trained health workers collected blood for the Treponema pallidum particle assay (TPPA) with positives confirmed by a toluidine red unheated serum test. We used an unmatched case–control study to identify factors that might predict syphilis infection using multivariable logistic regression.ResultsWe recruited 447 MSM who agreed to participate and who completed syphilis testing. Of 71 (15.9%) syphilis-positive MSM, 44 (62.0%) used drugs. Of 376 (84.1%) syphilis-negative MSM, 186 (49.5%) used drugs. We found a positive association with syphilis for any recreational drug use (crude OR (cOR) 1.7, 95 % CI 1.0 to 2.8), frequent methamphetamine use (cOR 2.4, 95% CI 1.1 to 5.3) and multiple drug use (adjusted OR (aOR) 3.4, 95% CI 1.3 to 9.2). Syphilis-positive men were more likely to have a higher physical depression score (aOR 5.2, 95% CI 1.1 to 24.4), be > 30 years old (aOR 2.7, 95% CI 1.5 to 4.8), report a prior STI (aOR 4.1, 95% CI 2.3 to 7.3) and report a sex party experience (aOR 2.2, 95% CI 1.1 to 4.4).ConclusionsRecreational drug use, depression and high-risk sexual behaviours were associated with syphilis infection among MSM in China. Only a multifaceted approach is likely be effective in control of both syphilis and HIV .

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Problematic recreational drug use: is there a role for outpatient sexual health clinics in identifying those not already engaged with treatment services?

Sexual Health ◽

10.1071/sh15052 ◽

2015 ◽

Vol 12 (6) ◽

pp. 501 ◽

Cited By ~ 5

Author(s):

Caitlyn Lovett ◽

T. Yamamoto ◽

Laura Hunter ◽

John White ◽

Paul I. Dargan ◽

...

Keyword(s):

Alcohol Use ◽

Drug Use ◽

Sexual Health ◽

Recreational Drug ◽

Problematic Use ◽

Treatment Services ◽

Health Clinics ◽

Problematic Drug ◽

Recreational Drug Use ◽

Sexual Health Clinics

Background There is an association between recreational drug use, high-risk sexual activity and sexually transmissible infections. Studies have shown a higher prevalence of drug use in those accessing sexual health services; however, there are minimal data on the proportion with problematic recreational drug use. We aimed to understand whether sexual health clinics could identify problematic drug and alcohol use as a novel referral pathway into treatment services. Methods: Males attending two sexual health clinics in London completed questionnaires. Data were collected on demographics; gender of sexual partner; use of alcohol and recreational drugs; if they felt they had problematic use of drugs, alcohol or both; and if they had sought help for their problematic use. Results: In total, 867 males completed the questionnaire; 387 (44.7%) were men who have sex with men (MSM). MSM had significantly higher lifetime use of any drug compared with non-MSM (80.6% vs. 62.5%; P < 0.0001). Thirty-five (4.7%) self-identified problematic drug or alcohol use, with no difference between MSM and non-MSM (6.3% vs. 3.5%; P = 0.08). Of those with problematic drug or alcohol use, 20 were currently or had been engaged with a treatment service and 15 had never engaged with treatment services. MSM were more likely to have ever sought help for drug or alcohol problems compared with non-MSM (P = 0.003). Conclusions: Some individuals attending sexual health clinics with problematic drug use have not engaged with treatment services. It is therefore appropriate to develop screening tools for sexual health clinics to identify these individuals and novel referral pathways to engage them in treatment services.

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