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  • Changes in recreational drug use, drug use associated with chemsex, and HIV-related behaviours, among HIV-negative men who have sex with men in London and Brighton, 2013–2016

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Behaviour
Original article
Changes in recreational drug use, drug use associated with chemsex, and HIV-related behaviours, among HIV-negative men who have sex with men in London and Brighton, 2013–2016
  1. Janey Sewell1,
  2. Valentina Cambiano1,
  3. Ada Miltz1,
  4. Andrew Speakman1,
  5. Fiona C Lampe1,
  6. Andrew Phillips1,
  7. David Stuart2,
  8. Richard Gilson1,
  9. David Asboe2,
  10. Nneka Nwokolo2,
  11. Amanda Clarke3,
  12. Graham Hart1,
  13. Alison Rodger1
  1. 1 Research Department of Infection and Population Health, Institute for Global Health, UCL, London, UK
  2. 2 Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  3. 3 Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  1. Correspondence to Janey Sewell, UCL Institute for Global Health, Royal Free Hospital, London NW3 2PF, UK; j.sewell{at}ucl.ac.uk

Abstract

Objectives The objective of this study was to compare the prevalence of polydrug use, use of drugs associated with chemsex, specific drug use, and HIV-related behaviours, between two time periods, using two groups of HIV-negative men who have sex with men (MSM) attending the same sexual health clinics in London and Brighton, in two consecutive periods of time from 2013 to 2016.

Methods Data from MSM in the cross-sectional Attitudes to and Understanding Risk of Acquisition of HIV (AURAH) study (June 2013 to September 2014) were compared with baseline data from different MSM in the prospective cohort study Attitudes to and Understanding Risk of Acquisition of HIV over Time (AURAH2) (November 2014 to April 2016). Prevalence of polydrug use, drug use associated with chemsex and specific drug use, and 10 measures of HIV-related behaviours including condomless sex, post-exposure prophylaxis (PEP) use, pre-exposure prophylaxis (PrEP) use, and HIV testing, were compared. Prevalence ratios (PRs) for the association of the study (time period) with drug use and HIV-related behaviour measures were estimated using modified Poisson regression analysis, unadjusted and adjusted for sociodemographic factors.

Results In total, 991 MSM were included from AURAH and 1031 MSM from AURAH2. After adjustment for sociodemographic factors, use of drugs associated with chemsex had increased (adjusted PR (aPR) 1.30, 95% CI 1.11 to 1.53) and there were prominent increases in specific drug use; in particular, mephedrone (aPR 1.32, 95% CI 1.10 to 1.57), γ-hydroxybutyric/γ-butryolactone (aPR 1.47, 95% CI 1.15 to 1.87) and methamphetamine (aPR 1.42, 95% CI 1.01 to 2.01). Use of ketamine had decreased (aPR 0.54, 95% CI 0.38 to 0.78). Certain measures of HIV-related behaviours had also increased, most notably PEP use (aPR 1.50, 95% CI 1.21 to 1.88) and number of self-reported bacterial STI diagnoses (aPR 1.24, 95% CI 1.08 to 1.43).

Conclusions There have been significant increases in drug use associated with chemsex and some measures of HIV-related behaviours among HIV-negative MSM in the last few years. Changing patterns of drug use and associated behaviours should be monitored to enable sexual health services to plan for the increasingly complex needs of some clients.

  • Recreational drug use
  • poly drug use
  • chemsex
  • sexual behaviour
  • condomless sex
  • HIV negative
  • men who have sex with men
  • sexual health
  • HIV prevention.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/sextrans-2017-053439

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    Footnotes

    • Handling editor Jane S Hocking

    • Contributors Design and data collection: JS, AS, AP, DS, FL, RG, DA, NN, AC, GH, AR. Analysis and interpretation: JS, VC, AR. Drafting the manuscript: JS, VC, AM, FCL, AS, AP, AR.

    • Funding Thsi manuscript summarises independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Numbers RP-PG-1212-20006 [AURAH2] and RP-PG-0608-10142 [AURAH]). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The AURAH and AURAH2 study were sponsored by the Joint Research Office, UCL. The sponsor of the study had no role in design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

    • Disclaimer The views expressed in this presentation are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

    • Competing interests None declared.

    • Ethics approval The AURAH study received ethics approval from NRES committee London–Hampstead, ref: 13/LO/0246 in April 2014. The AURAH2 study was approved by the designated research ethics committee, NRES committee London–Hampstead, ref: 14/LO/1881 in November 2014. Based on these documents, the studies subsequently received permission for clinical research at the three participating National Health Service sites: Chelsea and Westminster NHS Foundation Trust, Central and North West London NHS Foundation Trust, and the Brighton and Sussex University Hospitals NHS Trust. All participants provided written, informed consent before taking part.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Supplementary data on missing data (from table 2) have been submitted to this journal and are available upon request.