Sexualised drug use among sexual minority young adults in the United States: The P18 cohort study

Ristuccia, Annie; LoSchiavo, Caleb; Halkitis, Perry N.; Kapadia, Farzana

doi:10.1016/j.drugpo.2018.03.014

Cited by 24 publications

(13 citation statements)

References 48 publications

(59 reference statements)

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“…A hierarchical organization of multiple stigma has also been described among PLHIV and highlighted in the context of HCV/HIV co‐infection , confirming that HCV infection can be experienced as more stigmatizing than HIV among GBM. This has clear implications for HCV risk through the non‐disclosure of HCV infection, compromising the perceived “safety” of HIV‐serosorted and condomless sexual practices commonly found within chemsex communities . With the relatively recent emergence of HCV as a sexually transmitted infection in the context of HIV, it is unclear whether discrimination by HIV healthcare professionals played a role in stigma experienced by co‐infected GBM.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C risk perceptions and attitudes towards reinfection among HIV‐diagnosed gay and bisexual men in Melbourne, Australia

et al. 2019

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Introduction Gay and bisexual men ( GBM ) are at increased risk of hepatitis C/ HIV co‐infection. In Australia, the availability of subsidized direct‐acting antiviral treatment for hepatitis C has rendered eliminating co‐infection possible. High reinfection rates in subgroups with continued exposure may compromise elimination efforts. To inform the development of hepatitis C risk reduction support in GBM , we explored reinfection risk perceptions and attitudes among GBM living with HIV recently cured from hepatitis C. Methods Between April and August 2017, 15 GBM living with diagnosed HIV were recruited from high caseload HIV primary care services in Melbourne following successful hepatitis C treatment. In‐depth interviews were conducted exploring understandings of hepatitis C risks, experiences of co‐infection and attitudes towards reinfection. Constructivist grounded theory guided data aggregation. Results Participants’ understandings of their hepatitis C infection and reinfection trajectories were captured in three categories. Hepatitis C and HIV disease dichotomies: Hepatitis C diagnosis was a shock to most participants and contrasted with feelings of inevitability associated with HIV seroconversion. While HIV was normalized, hepatitis C was experienced as highly stigmatizing. Despite injecting drug use, interviewees did not identify with populations typically at risk of hepatitis C. Risk environments and avoiding reinfection : Interviewees identified their social and sexual networks as risk‐perpetuating environments where drug use was ubiquitous and higher risk sex was common. Avoiding these risk environments to avoid reinfection resulted in community disengagement, leaving many feeling socially isolated. Hepatitis C care as a catalyst for change : Engagement in hepatitis C care contributed to a better understanding of hepatitis C risks. Interviewees were committed to applying their improved competencies around transmission risk reduction to avoid reinfection. Interviewees also considered hepatitis C care as a catalyst to reduce their drug use. Conclusions Hepatitis C/ HIV co‐infection among GBM cannot be understood in isolation from co‐occurring drug use and sex, nor as separate from their HIV infection. Hepatitis C prevention must address subcultural heterogeneity and the intersectionality between multiple stigmatized social identities. Hepatitis C care presents an opportunity to provide support beyond cure. Peer support networks could mitigate social capital loss following a commit...

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Section: Discussionmentioning

confidence: 99%

Hepatitis C risk perceptions and attitudes towards reinfection among HIV‐diagnosed gay and bisexual men in Melbourne, Australia

et al. 2019

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“…Chemsex drug use has been associated with a number of harms including; sexual and other behaviours carrying HIV and hepatitis C risk (such as CAI, group sex and multiple partners, fisting and injecting) (Bourne et al., 2015; Daskalopoulou et al., 2017; Glynn et al., 2018; Hegazi et al., 2017; Maxwell, Shahmanesh & Gafos, 2019; Ristuccia, LoSchiavo, Halkitis & Kapadia, 2018; Tomkins et al., 2019), HIV diagnosis (Halkitis, Levy, Moreira & Ferrusi, 2014; Kenyon, Wouters, Platteau, Buyze & Florence, 2018; Pakianathan et al, 2018; White et al, 2019) and suboptimal adherence to ART among people living with HIV (Daskalopoulou et al., 2014; Perera, Bourne & Thomas, 2017; Stuart, 2013). The evidence on chemsex impacting ART adherence includes a systematic review published in 2017, reporting chemsex drug users as having 23% higher odds of ART non-adherence than non-chemsex drug users (OR 1.23, 95%CI 1.10–1.38, I2 0%, p = 0.372) (Perera et al., 2017).…”

Section: Introductionmentioning

confidence: 99%

Chemsex is not a barrier to self-reported daily PrEP adherence among PROUD study participants

O’Halloran

Rice

White

et al. 2019

International Journal of Drug Policy

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BackgroundPre-exposure prophylaxis (PrEP) is a novel HIV prevention method whereby HIV-negative individuals take the drugs tenofovir and emtricitabine to prevent HIV acquisition. Optimal adherence is critical for PrEP efficacy. Chemsex describes sexual activity under the influence of psychoactive drugs, in the UK typically; crystal methamphetamine, gamma-hydroxybutyrate(GHB) and/or mephedrone. Chemsex drug use has been associated with increased HIV transmission risk among gay, bisexual and other men who have sex with men (GBM) and poor ART adherence among people living with HIV. This study assessed whether self-reported chemsex events affected self-reported daily PrEP adherence among PROUD study participants.MethodsThe PROUD study was an open-label, randomised controlled trial, conducted in thirteen English sexual health clinics, assessing effectiveness of TruvadaⓇ-PrEP among 544 HIV-negative GBM. The study reported an 86% risk-reduction of HIV from daily PrEP. Participants were asked about chemsex engagement at follow-up visits. Monthly self-reports of missed PrEP tablets were aggregated to assess adherence between visits. Univariable and multivariable regression analyses were performed to test for associations between chemsex and reporting less than seven out of seven intended doses(<7/7ID) in the 7 days before and/or after last condomless anal intercourse(CAI).Results1479 follow-up visit forms and 2260 monthly adherence forms from 388 participants were included in the analyses, with 38.5% visit forms reporting chemsex since last visit and 29.9% follow-up periods reporting <7/7ID. No statistically significant associations were observed between reporting <7/7ID and chemsex (aOR=1.29 [95% CI 0.90–1.87], p = 0.168). Statistically significant associations were seen between reporting <7/7ID and participants perceiving that they would miss PrEP doses during the trial, Asian ethnicity, and reporting unemployment at baseline.ConclusionsThese analyses suggest PrEP remains a feasible and effective HIV prevention method for GBM engaging in chemsex, a practise which is prevalent in this group and has been associated with increased HIV transmission risk.

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“…W celu zwiększenia aktywności seksualnej zażywane są leki stosowane w zaburzeniach erekcji (sildenafil, tadalafil, wardenafil), a odbycie stosunku analnego ułatwiają alkilowe azotany [3,13,14]. Ponadto, podczas "chemsex party" powszechne jest picie alkoholu i palenie marihuany [15].…”

Section: Motywacje Leżące U Podłoża Uprawiania Chemseksuunclassified

“…Uprawianie chemseksu często związane jest z ryzykownymi zachowaniami seksualnymi: świadomym seksem analnym bez prezerwatyw ("boreback") [1,11,15,20,21], seksem grupowym [2,3,21], seksem z partnerem zakażonym wirusem HIV lub WZW-C, seksem z wieloma partnerami (>5 w ciągu ostatnich 3 miesięcy), seksem transakcyjnym [2,3,14,21], oraz wymienianiem pomiędzy partnerami zabawek seksualnych [21]. Duże międzynarodowe badania AURAH wykazały, że wśród badanej grupy 1484 mężczyzn MSM aż 57,5% osób uprawiało seks bez zabezpieczenia w ostatnich trzech miesiącach, 29% miało dwóch lub więcej partnerów seksualnych w ostatnich trzech miesiącach, 35,5% uprawiało seks grupowy w ostatnich trzech miesiącach, 31,9% badanych nie wiedziało, czy ich partner był nosicielem wirusa HIV.…”

Section: Skutki Zdrowotne I Społeczne Związane Z Chemseksemunclassified

Psychoactive substances used to increase sexual activity: chemsex

Zawilska¹,

Tomaszewska²

2019

Farm Pol.

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Psychoactive substances used to increase sexual activity: chemsex • The term "chemsex" refers to use of illicit psychoactive drugs, before or during sex with the intention to facilitate, initiate, prolong, sustain and intensify the encounter. Chemsex is increasingly popular among gay, bisexual, and other men who have sex with men. Certain drugs have been associated with chemsex behavior, including mephedrone, methamphetamine and γ-hydroxybutyrate (GHB)/γbutyrolactone (GBL); ketamine, cocaine and ecstasy are less popular. In addition, erectile enhancers and alkyl nitrites ("poppers") are used to increase sexual activity and to ease an anal sex, respectively. Accumulating epidemiological data indicate that "chemsex" is associated with a risky sexual behavior leading to increased risk of contracting HIV and other sexually transmitted diseases. In addition, prolonged use of psychoactive substances of abuse can result in the development of addition, psychiatric disturbances/illness, loss of job, homeless, and even crime activity.

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Sexualised drug use among sexual minority young adults in the United States: The P18 cohort study

Cited by 24 publications

References 48 publications

Hepatitis C risk perceptions and attitudes towards reinfection among HIV‐diagnosed gay and bisexual men in Melbourne, Australia

Hepatitis C risk perceptions and attitudes towards reinfection among HIV‐diagnosed gay and bisexual men in Melbourne, Australia

Chemsex is not a barrier to self-reported daily PrEP adherence among PROUD study participants

Psychoactive substances used to increase sexual activity: chemsex

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