Recreational drug use and use of drugs associated with chemsex among HIV-negative and HIV-positive heterosexual men and women attending sexual health and HIV clinics in England

Ada R Miltz; Alison J Rodger; Janey Sewell; Richard Gilson; Sris Allan; Christopher Scott; Tariq Sadiq; Paymaneh Farazmand; Jeffrey McDonnell; Andrew Speakman; Lorraine Sherr; Andrew N Phillips; Anne M Johnson; Simon Collins; Fiona C Lampe; AURAH and ASTRA Study Groups

doi:10.1016/j.drugpo.2020.103101

Recreational drug use and use of drugs associated with chemsex among HIV-negative and HIV-positive heterosexual men and women attending sexual health and HIV clinics in England

Int J Drug Policy. 2021 May:91:103101. doi: 10.1016/j.drugpo.2020.103101. Epub 2021 Jan 23.

Authors

Affiliations

¹ Institute for Global Health, University College London, London, UK. Electronic address: Ada.Miltz.11@ucl.ac.uk.
² Institute for Global Health, University College London, London, UK.
³ City of Coventry Healthcare Centre, Coventry, UK.
⁴ West London Centre for Sexual Health, London, UK.
⁵ Courtyard Clinic, St George's Healthcare NHS Trust, London, UK.
⁶ Princess Royal Community Health Centre, Huddersfield, UK.
⁷ Department of Clinical, Educational and Health Psychology, University College London, London, UK.
⁸ HIV i-Base, London, UK.

Abstract

Background: There is little information on the prevalence of recreational drug use among UK heterosexual men and women, in particular on use of drugs associated with 'chemsex' within gay communities. The aim of this study was to examine among HIV-negative and HIV-positive heterosexual men and women in England: (i) the prevalence of recreational drug use (including use of drugs associated with chemsex), (ii) socio-economic/lifestyle correlates of drug use, and (iii) the association of drug use with sexual behavior measures and mental health symptoms.

Methods: Data are from the AURAH study of HIV-negative individuals attending sexual health clinics across England (2013-2014) and the ASTRA study of HIV-positive individuals attending HIV outpatient clinics in England (2011-2012). Prevalence of recreational drug use (past three months) and associations are presented separately among the four sample groups: HIV-negative (N = 470) and HIV-positive (N = 373) heterosexual men and HIV-negative (N = 676) and HIV-positive (N = 637) women.

Results: The age standardized prevalence of any drug use was 22.9%, 17.1%, 15.3%, and 7.1% in the four sample groups respectively. In all groups, cannabis was the drug most commonly used (range from 4.7% to 17.9%) followed by cocaine (1.6% to 8.5%). The prevalence of use of drugs associated with chemsex was very low among HIV-negative participants (1.0% heterosexual men, 0.2% women) and zero among HIV-positive men and women. In age-adjusted analysis, factors linked to drug use overall and/or to cannabis and cocaine use specifically in the four sample groups included Black/mixed Caribbean and white (vs. Black/mixed African) ethnicity, lower level of education , cigarette smoking, and higher risk alcohol consumption. Associations of recreational drug use with measures of condomless sex, depression, and anxiety were observed in the four groups, but were particularly strong/apparent among women.

Conclusion: Providers need to be aware of cannabis and cocaine use and its potential link with sexual risk behavior and symptoms of depression and anxiety among heterosexual men and women attending sexual health and HIV clinics.

Keywords: Anxiety; Chemsex; Depression; Heterosexual; Recreational drug use; Sexual behavior.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
England / epidemiology
Female
HIV Infections* / epidemiology
Heterosexuality
Homosexuality, Male
Humans
Male
Pharmaceutical Preparations*
Recreational Drug Use
Risk-Taking
Sexual Behavior
Sexual Health*
Sexual Partners

Substances

Pharmaceutical Preparations