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 | 
| | | | | 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 use | N | % with outcome | aOR [95%CI], overall p-value | % with outcome | aOR [95%CI], overall p-value | % with outcome | aOR [95%CI], overall p-value | | No | 1,108 | 8.5 | 1.00 | 9.7 | 1.00 | 11.9 | 1.00 | | Yes | 1,140 | 19.4 | 2.54 [1.95,3.31], p<0.001 | 32.4 | 4.46 [3.50,5.69], p<0.001 | 34.0 | 3.57 [2.85,4.46] | | Number of recreational drugs used (n=1,140) | | | | | | | | | 1 | 369 | 13.0 | 1.00 | 16.8 | 1.00 | 18.6 | 1.00 | | 2 | 242 | 20.6 | 1.71 [1.10,2.65] | 25.8 | 1.73 [1.15,2.60] | 31.0 | 1.94 [1.32,2.85] | | 3 | 175 | 20.2 | 1.68 [1.04,2.73] | 29.5 | 2.12 [1.38,3.27] | 33.5 | 2.17 [1.43,3.27] | | 4 | 113 | 26.6 | 2.40 [1.42,4.03] | 46.0 | 4.37 [2.73,7.01] | 48.7 | 4.05 [2.57,6.40] | | ≥5 | 241 | 24.1 | 2.08 [1.35,3.21], p<0.001 | 58.4 | 7.25 [4.91,10.70], p<0.001 | 53.6 | 4.93 [3.40,7.14], p<0.001 |
[Logistic regression adjusted for age and religion]
Assigned speakers:
Marina Daskalopoulou , University College London , London , United Kingdom
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Assigned in sessions:
18.10.2013, 14:00-16:00, Parallel Session, PS11, Sex, Drugs and Stigma, Copper Hall
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