mephedrone and Hepatitis-C

Topics: Adult; Amphetamine-Related Disorders; Comorbidity; Cross-Sectional Studies; Female; Hepatitis C; Heroin; Heroin Dependence; Humans; Male; Methadone; Methamphetamine; Middle Aged; Narcotics; Opiate Substitution Treatment; Outcome Assessment, Health Care; Patient Readmission; Program Evaluation; Retrospective Studies; Sex Factors; Young Adult

Chemsex-related drug use (CDU) is an escalating public health issue among men who have sex with men (MSM), associated with significant physical, biomedical and psychosocial harm. Few interventions exist to help MSM engaging in chemsex and little data exist on which to build. This cross-sectional analysis, using data from Antidote, the UK's only lesbian, gay, bisexual, and transgender specialist drug service, aims to remedy this paucity of data.. Modified Poisson regression was used to assess associations between CDU and a range of health outcomes; CDU+ subanalysis disaggregated MSM by primary chemsex drug of concern; and HIV+ subanalysis investigated whether CDU was associated with self-reported treatment adherence, HIV seroconversion and other HIV-specific issues.. Compared with CDU- MSM, MSM presenting for CDU were more likely to be HIV+, current or previous injectors, to have used postexposure prophylaxis in the last year, and have had ≥6 sexual partners in the last 90 days, though less likely to be hazardous alcohol consumers or to have experienced previous suicidal ideation (all p<0.0005). CDU+ subanalysis revealed health outcome differences-those selecting mephedrone were less likely to be hepatitis C+, HIV+, current or previous injectors, or to have experienced previous suicidal ideation (all p<0.0005), whereas those selecting methamphetamine were more likely (all p<0.0005, except suicidal ideation p=0.009).. This analysis shows MSM presenting for CDU are a heterogeneous high-risk population with unmet health needs. There is a need for standardised chemsex surveillance and for improved intersectorial working between sexual health and drug treatment services. Future research should investigate typological differences between MSM presenting for CDU.. To date, this is the world's largest analysis of MSM seeking treatment for CDU. Further, the publication of 'real-world' service data is a valuable addition to the literature alongside surveys and recruited studies.

Topics: Adult; Amphetamine-Related Disorders; Anti-HIV Agents; Cross-Sectional Studies; Hepatitis C; HIV Infections; HIV Seropositivity; Humans; Male; Medication Adherence; Methamphetamine; Middle Aged; Sexual and Gender Minorities; Sexual Behavior; Substance Abuse, Intravenous; Substance-Related Disorders; Suicidal Ideation; United Kingdom; Young Adult

Reports of sexualised drug taking (chemsex) have increased significantly in recent years. There is currently limited intelligence on chemsex outside of London. An anonymous survey was promoted via several sources including voluntary services and a sexual health clinic in order to establish the risks associated with chemsex, and how support services can best be tailored to meet the needs of those in Greater Manchester, UK. Quantitative and qualitative data were collected on demographics, drug use, sexual practices and barriers and facilitators to accessing support. Fifty-two men who have sex with men completed the online survey. Thirty-nine (75%) were HIV-positive and 11 (21%) were hepatitis C virus (HCV) positive, all of whom were HIV/HCV co-infected. The most commonly used drugs were mephedrone (81%) and gamma hydroxybutyrate/gamma butyrolactone (79%). Nineteen (37%) reported ever injecting drugs. High-risk sexual practices were reported by respondents. Barriers to accessing support included a fear of being recognised. Findings demonstrate those engaging in chemsex are participating in a number of high-risk sexual practices, taking substances with significant risks and administering these substances in potentially high-risk ways. Results demonstrate the need for promotion of existing services, with key areas to target where chemsex sessions are most commonly arranged. Results may be useful in other metropolitan cities, both for commissioning and tailoring of chemsex support services.

Topics: 4-Butyrolactone; Adult; Coinfection; Harm Reduction; Hepatitis C; HIV Infections; Homosexuality, Male; Humans; Internet; London; Male; Methamphetamine; Middle Aged; Risk-Taking; Sexual Behavior; Sexual Partners; Sodium Oxybate; Substance-Related Disorders; Surveys and Questionnaires; Unsafe Sex; Young Adult

Formålet med undersøkelsen var å kartlegge forekomsten av rusmiddelbruk under sex (chemsex) blant et utvalg av mannlige pasienter ved Olafiaklinikken i Oslo, en poliklinikk for seksuelt overførbare infeksjoner. Vi ønsket også å se hvilke variabler innen psykisk helse, seksuelt overførbare infeksjoner og seksualatferd som var assosiert med chemsex for menn som har sex med menn og menn som har sex med kvinner.. Studien var anonym og spørreskjemabasert blant mannlige pasienter ved poliklinikken i perioden 1.7.2016-20.10.2016.. Svarprosenten var 96 (1 050 fikk utdelt skjema, 1 013 ble inkludert). Av disse rapporterte 144 (14 %) bruk av chemsex i løpet av det siste året - 87 (17 %) menn som har sex med menn og 57 (12 %) menn som har sex med kvinner. Av de som hadde hatt chemsex, oppga flere menn som har sex med menn hivinfeksjon, at de hadde hatt syfilis, over ti sexpartnere og hadde deltatt på sexfest det siste året. Flere menn som har sex med kvinner oppga psykiske plager.. Det bør utredes nærmere hvordan helsevesenet best kan møte chemsexbrukernes behov. Spesielt er det viktig med informasjon om skadereduksjonstiltak og støtte til de som ønsker å slutte eller redusere bruken av chemsex.

Topics: Adolescent; Adult; Bisexuality; Cocaine; Designer Drugs; Hepatitis C; Heterosexuality; HIV Infections; Homosexuality, Male; Humans; Illicit Drugs; Ketamine; Male; Mental Health; Methamphetamine; Middle Aged; Norway; Refugees; Sexual and Gender Minorities; Sexual Behavior; Sexual Partners; Sexually Transmitted Diseases, Bacterial; Socioeconomic Factors; Sodium Oxybate; Surveys and Questionnaires; Unsafe Sex; Young Adult