A community-led, harm-reduction approach to chemsex: case study from Australia’s largest gay city

Stardust, Zahra; Kolstee, Johann; Joksic, Stefan; Gray, James; Hannan, Siobhan

doi:10.1071/sh17145

Cited by 47 publications

(46 citation statements)

References 4 publications

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“…Specific interventions could include: direct client service support to manage or reduce the use of drugs, health promotion activities, peer education support, training healthcare providers and drug services about new recreational drugs and their role in sexual intercourse, services to address specific psychological and psychiatric problems in MSM who practice ‘chemsex’, advice about healthy leisure alternatives, harm-reduction services such as needle exchange, among others. [41,50,51]. Moreover, several study findings suggest that MSM who combine drugs with sex are more likely to engage in high-risk sexual practices when compared with MSM who do not combine drugs with sex [43].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and patterns of illicit drug use in people living with HIV in Spain: A cross-sectional study

Fuster‐RuizdeApodaca¹,

Castro-Granell

Garin

et al. 2019

PLoS ONE

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This study assessed the prevalence and patterns of drug use among people living with HIV (PLHIV) in Spain. We conducted an observational cross-sectional study including 1401 PLHIV. Data were collected through 33 sites across Spain using an online computer-assisted self-administered interview. The survey measured use of illicit drugs and other substances, treatment adherence and health-related variables. To analyse patterns of drug use we performed cluster analysis in two stages. The most frequently consumed substances were: alcohol (86.7%), tobacco (55.0%), illicit drugs (49.5%), other substances (27.1%). The most prevalent illicit drugs used were cannabis (73.8%), cocaine powder (53.9%), and poppers (45.4%). Results found four clusters of PLHIV who used drugs. Two of them were composed mainly of heterosexuals (HTX): Cluster 1 (n = 172) presented the lowest polydrug use and they were mainly users of cannabis, and Cluster 2 (n = 84) grouped mostly men who used mainly heroin and cocaine; which had the highest percentage of people who inject drugs and presented the lowest level of treatment adherence (79.8±14.2; p < .0001). The other two clusters were composed mainly of men who have sex with men (MSM), who were mostly users of recreational drugs. Cluster 3 (n = 285) reported moderate consumption, both regarding frequency and diversity of drugs used, while Cluster 4 (n = 153) was characterized by the highest drug polyconsumption (7.4±2.2; p < .0001), and 4 grouped MSM who injected recreational drugs, and who reported the highest frequency of use of drugs in a sexual context (2.6±0.8; p < .0001) and rates of sexually transmitted infections (1.8±1.1; p < .01). This is the largest multi-centre cross-sectional study assessing the current prevalence and patterns of drug use among PLHIV in Spain. The highest prevalence of drug use was found among MSM, although HTX who used heroin and cocaine (Cluster 2) had the most problems with adherence to HIV treatment and the worst health status.

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Section: Discussionmentioning

confidence: 99%

Prevalence and patterns of illicit drug use in people living with HIV in Spain: A cross-sectional study

Fuster‐RuizdeApodaca¹,

Castro-Granell

Garin

et al. 2019

PLoS ONE

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“…The distinctive patterns of drug use and risk practices reported by GBM often require tailored policy and programmatic responses, such as integrated harm reduction and sexual health services (Bourne et al, 2015;Stardust, Kolstee, Joksic, Gray, & Hannan, 2018). Drug use and sex are difficult to disentangle for some GBM, and policies and programs that respond to their needs can benefit from a better understanding of drug use norms within gay social networks.…”

Section: Discussionmentioning

confidence: 99%

Attitudes and Perceived Social Norms toward Drug Use among Gay and Bisexual Men in Australia

Lea

Hammoud

Bourne

et al. 2019

Substance Use & Misuse

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Background: Gay and bisexual men (GBM) report distinctive patterns and contexts of drug use, yet little has been published about their attitudes towards drug use. Objectives: We developed measures of attitudes and perceived social norms towards drug use, and examined covariates of more accepting attitudes and norms among GBM in Australia. Methods: We analysed baseline data from the [removed for blinded review] study. This is an online prospective observational study of drug use among Australian GBM. We used principal components factor analysis to generate two attitudinal scales assessing "drug use for social and sexual enhancement" and "perceptions of drug risk". A third perceived social norms scale examined "acceptability of drug use among gay friends". Results: Among 2,112 participants, 61% reported illicit drug use in the preceding 6 months. Stronger endorsement of drug use for social and sexual engagement and lower perceptions of drug risk were found among men who were more socially engaged with other gay men and reported regular drug use and drug use for sex. In multivariate analyses, all three scales were associated with recent drug use (any use in the previous six months), but only the drug use for social and sexual enhancement scale was associated with regular (at least monthly) use. Conclusions: Drug use and sex are difficult to disentangle for some GBM, and health services and policies could benefit from a better understanding of attitudinal and normative factors associated with drug use in gay social networks, while recognising the role of pleasure in substance use.

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“…However, in Canada, the vast majority of STI clinic clients indicated being comfortable addressing mental health and substance use concerns with an STI clinic provider [38]. In the UK, drug services tailored to gay, bisexual and other MSM have experienced an exponential rise in attendance [18] and in Australia, there are positive experiences with community-led, harm reduction approaches to chemsex, utilising support services for those seeking to manage or reduce their use, health promotion activities, peer education, and policy work [39]. Thus, such services may provide low barrier and sexual-minority competent care for the two overlapping health challenges.…”

Section: Discussionmentioning

confidence: 99%

Links between chemsex and reduced mental health among Norwegian MSM and other men: results from a cross-sectional clinic survey

2020

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Background The use of specific drugs to facilitate, enhance or prolong sexual sessions is referred to as ‘chemsex’. The popularity of the behavior seems to be growing, but there is a paucity of information on the mental health aspects associated with chemsex and no data on chemsex from Nordic countries. We investigated the link between chemsex and mental health among men who have sex with men (MSM) and other men in Norway. Methods We recruited participants from a walk-in sexually transmitted infections (STI) clinic. Participants completed a piloted, anonymous self-administered survey. It consisted of questions about men’s sociodemographic characteristics, mental health, sexual behaviors, substance use, and chemsex. The outcome we investigated was reduced mental health, measured with the validated Hopkins Symptom Check List. We obtained descriptive statistics and performed univariate and multivariate logistic regression analyses. Results 1013 (96%) of the surveys were complete and could be analysed. The mean age of the sample was 33, 51% were MSM, and 21.7% had reduced mental health. More MSM than other men engaged in chemsex in the past year (17% vs 12%). The most frequently reported chemsex drugs were cocaine and gamma hydroxybutyrate/gamma butyrolactone (GHB/GBL). Men engaged in chemsex primarily to enhance sexual pleasure and excitement, and about half reported almost never or never using condoms for chemsex. In univariate analyses, significant predictors of reduced mental health was chemsex (Odds Ratio [OR] = 1.82), being unemployed (OR = 3.54), and having sex with only women (OR = 0.58). In multivariate analyses, two variables remained significantly associated with reduced mental health: chemsex (adjusted OR = 2.18, 95%CI = 1.25–3.78) and being unemployed (adjusted OR = 4.10, 95%CI = 2.13–7.87). Conclusions In our sample of men from an STI clinic in Norway, about 14% self-reported engaging in chemsex in the past year and about a fifth of the men had reduced mental health. Men who engaged in chemsex, which more MSM engaged in than other men, had two times greater odds of reduced mental health. These findings suggest that mental health assistance should be among the interventions offered to men engaging in chemsex.

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A community-led, harm-reduction approach to chemsex: case study from Australia’s largest gay city

Cited by 47 publications

References 4 publications

Prevalence and patterns of illicit drug use in people living with HIV in Spain: A cross-sectional study

Prevalence and patterns of illicit drug use in people living with HIV in Spain: A cross-sectional study

Attitudes and Perceived Social Norms toward Drug Use among Gay and Bisexual Men in Australia

Links between chemsex and reduced mental health among Norwegian MSM and other men: results from a cross-sectional clinic survey

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