Takeuchi Jumpei, Chan Curtis, MacGibbon James, Broady Timothy R, Lea Toby, Mao Limin, Bavinton Benjamin R, Holt Martin
School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, Sydney, Australia.
The Kirby Institute, Faculty of Medicine, UNSW Sydney, Sydney, Australia.
Drug Alcohol Rev. 2024 Feb;43(2):539-550. doi: 10.1111/dar.13781. Epub 2023 Nov 27.
Investigating drug trends among Australian gay and bisexual men (GBM) is crucial for understanding levels of use and the potential for harm, including HIV transmission risk.
Using repeated, national, cross-sectional survey data collected between 2012 and 2021 (69,567 surveys), trends of recent (previous 6 months) and frequent (weekly) drug use were analysed, using logistic regression models. The last round of data from each jurisdiction (6709 surveys) was used to compare GBM who reported no use, infrequent (less than weekly) use and frequent (at least weekly) use of party drugs to investigate the association between party drug use and HIV transmission risk, using multinomial logistic regression models.
There was a significant upward trend in any recent drug use (from 58.4% in 2012 to 64.1% in 2021; p < 0.001). Frequent party drug use remained a minority practice over the period (consistently less than 3%). In cross-sectional analysis, frequent party drug users were more likely to report behaviours with HIV transmission risks, such as condomless anal intercourse without biomedical prevention strategies (30.0% vs. 13.1%; adjusted relative risk ratio [aRRR], 2.08; 95% CI, 1.24-3.47), weekly group sex (16.3% vs. 0.6%; aRRR, 12.36; 95% CI, 5.75-26.56) and more than 20 recent sexual partners (42.5% vs. 5.0%; aRRR, 21.44; 95% CI, 5.82-78.89), compared with GBM who did not use party drugs.
Our findings suggest that the frequent use of party drugs remains a marker of HIV transmission risk among Australian GBM, despite the increased adoption of biomedical HIV prevention strategies over the past few years.
调查澳大利亚男同性恋者和双性恋男性（GBM）中的吸毒趋势对于了解吸毒水平以及包括艾滋病毒传播风险在内的潜在危害至关重要。
利用2012年至2021年期间收集的重复、全国性横断面调查数据（69567份调查问卷），使用逻辑回归模型分析近期（过去6个月）和频繁（每周）吸毒的趋势。来自每个司法管辖区的最后一轮数据（6709份调查问卷）用于比较报告不吸毒、偶尔（少于每周一次）吸毒和频繁（至少每周一次）使用派对药物的GBM，使用多项逻辑回归模型研究派对药物使用与艾滋病毒传播风险之间的关联。
近期任何吸毒情况均呈显著上升趋势（从2012年的58.4%升至2021年的64.1%；p<0.001）。在此期间，频繁使用派对药物的情况仍然较少（一直低于3%）。在横断面分析中，与不使用派对药物的GBM相比，频繁使用派对药物的人更有可能报告有艾滋病毒传播风险的行为，例如在没有生物医学预防策略的情况下进行无保护肛交（30.0%对13.1%；调整后相对风险比[aRRR]，2.08；95%置信区间，1.24 - 3.47）、每周进行群体性行为（16.3%对0.6%；aRRR，12.36；95%置信区间，5.75 - 26.56）以及近期有超过20个性伴侣（42.5%对5.0%；aRRR，21.44；95%置信区间，5.82 - 78.89）。
我们的研究结果表明，尽管在过去几年中生物医学艾滋病毒预防策略的采用有所增加，但频繁使用派对药物仍然是澳大利亚GBM中艾滋病毒传播风险的一个标志。
