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Sexualized drug use ('chemsex') and high-risk sexual behaviours in HIV-positive men who have sex with men

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Title: Sexualized drug use ('chemsex') and high-risk sexual behaviours in HIV-positive men who have sex with men
Authors: Pufall, EL
Kall, M
Shahmanesh, M
Nardone, A
Gilson, R
Delpech, V
Ward, H
Positive Voices study group
Item Type: Journal Article
Abstract: OBJECTIVES: The incidence of sexually transmitted infections (STIs) and HIV infection remains high in gay, bisexual, and other men who have sex with men (MSM) in the UK, and sexualized drug use ("chemsex") and injecting drug use ("slamsex") may play a part in this. We aimed to characterize HIV-positive MSM engaging in chemsex/slamsex and to assess the associations with self-reported STI diagnoses and sexual behaviours. METHODS: Data from a 2014 survey of people attending HIV clinics in England and Wales were linked to clinical data from national HIV surveillance records and weighted to be nationally representative. Multivariable logistic regression assessed the associations of chemsex and slamsex with self-reported unprotected anal intercourse (UAI), serodiscordant UAI (sdUAI) (i.e. UAI with an HIV-negative or unknown HIV status partner), sdUAI with a detectable viral load (>50 HIV-1 RNA copies/mL), hepatitis C, and bacterial STIs. RESULTS: In the previous year, 29.5% of 392 sexually active participants engaged in chemsex, and 10.1% in slamsex. Chemsex was significantly associated with increased odds of UAI [adjusted odds ratio (AOR) 5.73; P < 0.001], sdUAI (AOR 2.34; P < 0.05), sdUAI with a detectable viral load (AOR 3.86; P < 0.01), hepatitis C (AOR 6.58; P < 0.01), and bacterial STI diagnosis (AOR 2.65; P < 0.01). Slamsex was associated with increased odds of UAI (AOR 6.11; P < 0.05), hepatitis C (AOR 9.39; P < 0.001), and bacterial STI diagnosis (AOR 6.11; P < 0.001). CONCLUSIONS: Three in ten sexually active HIV-positive MSM engaged in chemsex in the past year, which was positively associated with self-reported depression/anxiety, smoking, nonsexual drug use, risky sexual behaviours, STIs, and hepatitis C. Chemsex may therefore play a role in the ongoing HIV and STI epidemics in the UK.
Issue Date: 1-Apr-2018
Date of Acceptance: 23-Oct-2017
URI: http://hdl.handle.net/10044/1/56715
DOI: https://dx.doi.org/10.1111/hiv.12574
ISSN: 1464-2662
Publisher: Wiley
Start Page: 261
End Page: 270
Journal / Book Title: HIV Medicine
Volume: 19
Issue: 4
Copyright Statement: © 2018 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Sponsor/Funder: Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Funder's Grant Number: RDC02 79560
RDF01
Keywords: Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
hepatitis C
HIV transmission
men who have sex with men
recreational drugs
sexually transmitted infections
GAY MEN
CAUSAL DIAGRAMS
HEALTH CLINICS
HARM REDUCTION
SUBSTANCE USE
BISEXUAL MEN
SOUTH LONDON
TRANSMISSION
PREVENTION
OUTCOMES
Positive Voices study group
1103 Clinical Sciences
Virology
Publication Status: Published
Open Access location: http://onlinelibrary.wiley.com/doi/10.1111/hiv.12574/abstract
Online Publication Date: 2018-01-24
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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