Abstract PS11/3
 
Recreational Drug Use and High Risk Sexual Behaviour among HIV-diagnosed Men who Have Sex with Men (MSM) in the UK: Results from the Antiretrovirals, Sexual Transmission Risk and Attitudes (ASTRA) Study Print
 
M. Daskalopoulou1, A. Phillips1, A. Rodger1, L. Sherr1, A. Speakman1, R. Gilson1, M.A. Johnson2, M. Fisher3, E. Wilkins4, J. Anderson5, R. O'Connell6, M. Lascar6, M. Jones7, S. Edwards1, J. McDonnell1, N. Perry3, S. Collins8, G. Hart1, A. Johnson1, J. Elford9, A. Miners10, A.M. Geretti11, B. Burman12, F. Lampe1
1University College London, London, United Kingdom, 2Royal Free Hampstead NHS Trust, London, United Kingdom, 3Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom, 4Pennine Acute Hospitals NHS Trust, Manchester, United Kingdom, 5Homerton University Hospital NHS Trust, London, United Kingdom, 6Barts Health NHS Trust, London, United Kingdom, 7East Sussex Health Care NHS Trust, Eastbourne, United Kingdom, 8HIV i-Base, London, United Kingdom, 9City University, London, United Kingdom, 10London School of Hygiene and Tropical Medicine, London, United Kingdom, 11University of Liverpool, Liverpool, United Kingdom, 12University of Colorado, Colorado, United States
 
Objectives: HIV transmission in UK MSM remains high. High risk behaviours among HIV-diagnosed individuals using recreational drugs may contribute to onward sexual transmission.
Methods
: Using data from ASTRA, a multicentre study of 3,258 UK HIV outpatients between 2011-2012, we describe the prevalence of self-reported recreational drug use among MSM in the past 3 months and associations with socio-demographic factors (age, ethnicity, employment, education, religion, housing, antiretroviral therapy[ART], time since HIV diagnosis) using logistic regression. Associations between recreational drug use and sexual risk behaviour were assessed in multivariable logistic regression models, adjusting for significant socio-demographic variables.
Results
: Of 2,248 MSM (89.3% white; mean age 45.4 years,SD 9.5), 50.7% used recreational drugs in the past 3 months, specifically: poppers (53.3%), cannabis (41.8%), Viagra/Cialis (40.4%), cocaine (39.7%), ketamine (24.6%), Ecstasy/MDMA (22.6%), GHB/GBL (19.4%), methamphetamine (15.4%), mephedrone (14.2%), other (8.2%). Polydrug use (≥2 recreational drugs in the past 3 months) was prevalent; 46.5% used 2-4 drugs (of which 16.3% used cocaine, 17.1% Viagra/Cialis, 20.1 % poppers) and 21.1% used ≥5 drugs (of which 11.1% ketamine, 11.4% poppers, 12.8% Viagra/Cialis.)Unadjusted odds of recreational drug use were greater with younger age (< 30 years versus ≥50 OR=2.67, 95%CI1.75-4.08, p< 0.001), employment (OR=1.28, 1.07-1.52, p=0.005), non-religious (OR=1.50, 1.26-1.77, p< 0.001), rental/unstable accommodation (versus owning OR=1.28, 1.08-1.51, p=0.004), not on ART (OR=1.30, 1.03-1.65, p=0.026), recent HIV diagnosis (≤2 years versus ≥10 OR=1.34, 1.01-1.77, p=0.043). Ethnicity and education were not associated with recreational drug use. Age and religion remained independently associated with drug use after adjustment. Recreational drug use and polydrug use were very strongly associated with markers of high risk sex after adjustment for age and religion. (Table).
Conclusion
: Among HIV-diagnosed MSM, prevalence of recreational drug use and polydrug use is extremely high. Prevention strategies to reduce HIV/STI transmission in MSM need to address recreational drug use and association with higher risk sexual behaviours.
  Had condomless sex with an HIV-negative or unknown HIV status partner in past 3 months (n/N=320/2,248)Participated in group sex in past 3 months(n/N=466/2,196)Had ≥ 10 new sexual partners in the past 12 months (n/N=519/2,248)
Recreational drug useN% with outcomeaOR [95%CI], overall p-value% with outcomeaOR [95%CI], overall p-value% with outcomeaOR [95%CI], overall p-value
No1,1088.51.009.71.0011.91.00
Yes1,14019.42.54 [1.95,3.31], p<0.00132.44.46 [3.50,5.69], p<0.00134.03.57 [2.85,4.46]
Number of recreational drugs used (n=1,140)       
136913.01.0016.81.0018.61.00
224220.61.71 [1.10,2.65]25.81.73 [1.15,2.60]31.01.94 [1.32,2.85]
317520.21.68 [1.04,2.73]29.52.12 [1.38,3.27]33.52.17 [1.43,3.27]
411326.62.40 [1.42,4.03]46.04.37 [2.73,7.01]48.74.05 [2.57,6.40]
≥524124.12.08 [1.35,3.21], p<0.00158.47.25 [4.91,10.70], p<0.00153.64.93 [3.40,7.14], p<0.001
[Logistic regression adjusted for age and religion]



Assigned speakers:
Marina Daskalopoulou , University College London , London , United Kingdom

Assigned in sessions:
18.10.2013, 14:00-16:00, Parallel Session, PS11, Sex, Drugs and Stigma, Copper Hall