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INTRODUCTION: The misuse of prescription drugs for their psychoactive effects is an international problem. To date, there is a paucity of quantitative data on prescription drug misuse (PDM) in New Zealand, especially data investigating the experiences of general practitioners (GPs). AIM: To quantify GPs’ experiences regarding PDM in New Zealand in terms of the extent of the problem, challenges faced, problem drugs, and actions taken by GPs once PDM is suspected. METHOD: A cross-sectional postal survey of a random sample of 300 GPs in New Zealand was undertaken. RESULTS: A 45.7% response rate was achieved. Approximately two-thirds of GPs (65.9%) had diagnosed at least one patient with a PDM problem in the last 12 months. Thirty percent of respondents indicated that they had been faced with at least one challenge in the past 12 months, with ‘verbal threats’ being the most common of these (16.3%). Benzodiazepines and opioids were identified as the most problematic drug classes. The action usually taken by the greatest number of GPs once they suspected PDM was to ‘document it’ (97.9%) followed closely by ‘suggest an alternative drug’ (96.7%) and ‘refrain from prescribing the drug’ (91.9%). DISCUSSION: PDM is an issue for GPs. The findings from this study have highlighted the need for further research into this concerning issue, specifically further quantification of the size of the problem in the New Zealand general population. There is also a need for the development and implementation of interventions to help minimise and better manage PDM in New Zealand. KEYWORDS: Prescription drugs; pharmaceutical; drug abuse; drug misuse; general practitioners; New Zealand; questionnaires; quantitative

Sexual health data on transgender and non-binary (TNB) people in the United Kingdom are limited. TNB individuals experience significant socioeconomic and stigma-related disadvantages. Sexual health morbidity and unmet need is likely to be significant. We compared the sexual health outcomes of TNB and cisgender users of London’s online sexual health service. Of 119329 users that registered with the e-service between 30.4.19 and 31.12.19, 504 (0.42%) identified as TNB: 302 TNB users requested 463 kits. 78.4% (363/463) of kits were returned. 99.4% of dispatched kits included throat and rectal swabs for gonorrhoea and chlamydia testing. STI/HIV test positivity was: 5.5% syphilis, 4.8% chlamydia, 3.4% gonorrhoea and 0.7% HIV positive. HIV prevalence amongst TNB individuals was: 4.3%. 19.9% of TNB individuals engaged in chemsex, group sex, or fisting and were more likely to engage in sex work (95% CI 4.35-8.95, p-value <0.0001). 97.7% gave the service 4/5 or 5/5 star rating. We observed high positivity rates of HIV/STIs amongst TNB individuals and significant levels of high-risk sexual activity. Service users rated the service highly. Given TNB often have complex healthcare needs, some of which cannot be met entirely online, physical clinics must work collaboratively with e-services to support and protect this marginalised population.

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