Research Department of Infection & Population Health, University College London, London, United Kingdom.
Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom.
Int J Drug Policy. 2017 May;43:33-43. doi: 10.1016/j.drugpo.2017.01.001. Epub 2017 Feb 10.
Recreational drug use and associated harms continue to be of significant concern in men who have sex with men (MSM) particularly in the context of HIV and STI transmission.
Data from 1484 HIV-negative or undiagnosed MSM included in the AURAH study, a cross-sectional, self-completed questionnaire study of 2630 individuals from 20 sexual health clinics in the United Kingdom in 2013-2014, was analysed. Two measures of recreational drug use in the previous three months were defined; (i) polydrug use (use of 3 or more recreational drugs) and (ii) chemsex drug use (use of mephedrone, crystal methamphetamine or GHB/GBL). Associations of socio-demographic, health and lifestyle factors with drug use, and associations of drug use with sexual behaviour, were investigated.
Of the 1484 MSM, 350 (23.6%) reported polydrug use and 324 (21.8%) reported chemsex drug use in the past three months. Overall 852 (57.5%) men reported condomless sex in the past three months; 430 (29.0%) had CLS with ≥2 partners, 474 (31.9%) had CLS with unknown/HIV+ partner(s); 187 (12.6%) had receptive CLS with an unknown status partner. For polydrug use, prevalence ratios (95% confidence interval) for association with CLS measures, adjusted for socio-demographic factors were: 1.38 (1.26, 1.51) for CLS; 2.11 (1.80, 2.47) for CLS with ≥2 partners; 1.89 (1.63, 2.19) for CLS with unknown/HIV+ partner(s); 1.36 (1.00, 1.83) for receptive CLS with an unknown status partner. Corresponding adjusted prevalence ratios for chemsex drug use were: 1.38 (1.26, 1.52); 2.07 (1.76, 2.43); 1.88 (1.62, 2.19); 1.49 (1.10, 2.02). Polydrug and chemsex drug use were also strongly associated with previous STI, PEP use, group sex and high number of new sexual partners. Associations remained with little attenuation after further adjustment for depressive symptoms and alcohol intake.
There was a high prevalence of polydrug use and chemsex drug use among HIV negative MSM attending UK sexual health clinics. Drug use was strongly associated with sexual behaviours linked to risk of acquisition of STIs and HIV.
在男男性行为者（MSM）中，娱乐性药物使用及其相关危害仍然是一个严重的问题，特别是在 HIV 和性传播感染（STI）传播的背景下。
对 2013 年至 2014 年间英国 2630 名个体来自 20 个性健康诊所的 AURAH 研究中包括的 1484 名 HIV 阴性或未确诊的 MSM 中的数据进行了分析。定义了过去三个月内两种娱乐性药物使用情况：（i）多药物使用（使用 3 种或更多种娱乐性药物）和（ii）化学性行为药物使用（使用美普他酮、冰毒或 GHB/GBL）。研究了社会人口统计学、健康和生活方式因素与药物使用的关系，以及药物使用与性行为的关系。
在 1484 名 MSM 中，350 名（23.6%）报告在过去三个月内有多药物使用，324 名（21.8%）报告在过去三个月内有化学性行为药物使用。总体而言，852 名（57.5%）男性报告在过去三个月内有未使用安全套的性行为；430 名（29.0%）有与≥2 名伴侣发生的无保护性行为，474 名（31.9%）有与未知/HIV+伴侣的无保护性行为；187 名（12.6%）有与未知身份伴侣的被动无保护性行为。对于多药物使用，与 CLS 措施相关的调整后患病率比（95%置信区间）为：1.38（1.26，1.51）用于 CLS；2.11（1.80，2.47）用于 CLS 与≥2 名伴侣；1.89（1.63，2.19）用于 CLS 与未知/HIV+伴侣；1.36（1.00，1.83）用于与未知身份伴侣的被动 CLS。相应的调整后化学性行为药物使用的患病率比为：1.38（1.26，1.52）；2.07（1.76，2.43）；1.88（1.62，2.19）；1.49（1.10，2.02）。多药物使用和化学性行为药物使用也与既往性传播感染、PEP 使用、群交和新性伴侣数量较多密切相关。在进一步调整抑郁症状和饮酒量后，关联仍然存在，且几乎没有减弱。
在英国性健康诊所就诊的 HIV 阴性 MSM 中，多药物使用和化学性行为药物使用的流行率很高。药物使用与性传播感染和 HIV 获得风险相关的性行为密切相关。
