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Original article
Chemsex-related drug use and its association with health outcomes in men who have sex with men: a cross-sectional analysis of Antidote clinic service data
  1. Oliver Stevens1,
  2. Monty Moncrieff2,
  3. Mitzy Gafos3
  1. 1Department for Infectious Disease Epidemiology, Imperial College London School of Public Health, London, UK
  2. 2London Friend, London, UK
  3. 3Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Oliver Stevens, Imperial College London School of Public Health, London, SW7 2AZ, UK; o.stevens{at}imperial.ac.uk

Abstract

Purpose Chemsex-related drug use (CDU) is an escalating public health issue among men who have sex with men (MSM), associated with significant physical, biomedical and psychosocial harm. Few interventions exist to help MSM engaging in chemsex and little data exist on which to build. This cross-sectional analysis, using data from Antidote, the UK’s only lesbian, gay, bisexual, and transgender specialist drug service, aims to remedy this paucity of data.

Methods Modified Poisson regression was used to assess associations between CDU and a range of health outcomes; CDU+ subanalysis disaggregated MSM by primary chemsex drug of concern; and HIV+ subanalysis investigated whether CDU was associated with self-reported treatment adherence, HIV seroconversion and other HIV-specific issues.

Findings Compared with CDU− MSM, MSM presenting for CDU were more likely to be HIV+, current or previous injectors, to have used postexposure prophylaxis in the last year, and have had ≥6 sexual partners in the last 90 days, though less likely to be hazardous alcohol consumers or to have experienced previous suicidal ideation (all p<0.0005). CDU+ subanalysis revealed health outcome differences—those selecting mephedrone were less likely to be hepatitis C+, HIV+, current or previous injectors, or to have experienced previous suicidal ideation (all p<0.0005), whereas those selecting methamphetamine were more likely (all p<0.0005, except suicidal ideation p=0.009).

Implications This analysis shows MSM presenting for CDU are a heterogeneous high-risk population with unmet health needs. There is a need for standardised chemsex surveillance and for improved intersectorial working between sexual health and drug treatment services. Future research should investigate typological differences between MSM presenting for CDU.

Originality/value To date, this is the world’s largest analysis of MSM seeking treatment for CDU. Further, the publication of ‘real-world’ service data is a valuable addition to the literature alongside surveys and recruited studies.

  • HIV
  • sexual health
  • substance misuse
  • men who have sex with men
  • injecting drug use
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Footnotes

  • Handling editor Tristan J Barber

  • Contributors OS conceived the study, conducted the analysis and wrote the manuscript. MM provided the data and reviewed the manuscript. MG conceived the study and reviewed the analysis and manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval London School of Hygiene and Tropical Medicine (Ethics No 14779).

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

  • Data sharing statement No data are available.

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