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A search of Medline 1966–2000 found no studies looking at the prevalence of RDU in UK genitourinary medicine (GUM) clinics. Therefore this study aimed to estimate the prevalence of RDU by attendees of the Plymouth GUM clinic and to see if the diagnosis of an STI is more common in illicit drug users.
The local research ethics committee approved the study. New patients attending the clinic between August and November 2000 completed a questionnaire which listed a number of drugs and asked about frequency of consumption and injecting drug use. Respondents were asked for their clinic number so that test results could be compared to drug use.
The completion rate was 76% (259/339). The mean age of respondents was 26 years (range 15–54) and 58% were women.
Lifetime illicit RDU was reported by 64% (166/259, confidence interval (CI) 5.8) with 28% (72/259, CI 5.5) reporting use within the past month. Of 16–24 year olds, 66% (87/132, CI 8.1) reported lifetime use while 34% (45/132, CI 8.1) reported recent use. There was no significant difference in use between men and women (66% v 62%). Figure 1 shows the proportion of clinic attendees who reported taking each drug.
Two people, 0.77% (2/259, CI 0 to 1.87) of respondents, reported injecting drug use. Most people, 64% (165/259), supplied their clinic number, and 32% (52/165) were diagnosed with an STI. Men were more likely to be diagnosed as having an STI (OR 2.72, CI 1.40 to 5.28). The diagnosis of an STI was independent of units of alcohol drunk in the preceding month (OR 1.07, CI 0.78 to 1.46), and the use of illicit drugs whether in lifetime (OR 0.82, CI 0.43 to 1.60) or in the past month (OR 1.51, CI 0.71 to 3.20). Subjects who gave their number were less likely to take illicit drugs (OR 0.44, CI 0.25 to 0.77).
This survey has revealed a high prevalence of recreational drug use by attendees at a GUM clinic. Comparing the data with the 2000 British Crime Survey (BCS) shows that the proportion of clinic 16–24 year olds who admitted to illicit drug use within the past month is greater than the same age group surveyed in the BCS (OR 2.32 CI 1.59 to 3.37). Likewise, lifetime use was more common (OR 1.86, CI 1.29 to 2.69).
There is a low prevalence of injecting drug use; this might be due to under-reporting. An alternative explanation is that this high risk group is not accessing the clinic. If this is the case it would support moves to set up an outreach clinic.
This study found that the diagnosis of an STI is independent of RDU. This might be because RDU is so common that it is no longer a useful discriminator; alternatively, a larger sample size might have found evidence of an association.
In conclusion, although RDU is common, injecting drug use appears to be rare in this group. The findings of this survey have implications for service provision.
I thank Steven Skov for his criticism of the manuscript. Conflict of interest: none.
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