Aims: To examine patterns of drug use amongst a cohort of drug treatment-seeking drug-using gay men and other men who have sex with men (MSM), and whether these behaviours differ between, or predict, HIV status.
Design: Cross-sectional study.
Setting: Specialist club drug clinic in London.
Participants: 407 consecutive attendees who identified as MSM.
Measurements: 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. 62.1% were HIV positive, 48.9% had injected drugs, 14.9% reported needle sharing and 73.3% used drugs to facilitate sex. The most commonly reported problem drugs were GHB/GBL (54.3%), methamphetamine (47.7%) and mephedrone (37.8%). 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 (HCV) status. Use of methamphetamine, HCV infection, older age and IDU predicted HIV positive status in a logistic regression model.
Conclusions: 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. We suggest a need for greater awareness of HIV-related risk behaviours and promotion of HIV prevention strategies for MSM by both sexual health and drug treatment services.