Reported Polydrug Use Research Articles

‘It was like coming back from the clouds’: a qualitative analysis of the lived experience of overdose consequent to drug use among a cohort of people who use drugs in Scotland

BackgroundGlobally, non-fatal overdose (NFOD) rates consequent to drug use, typically opioids, continue increasing at a startling rate. Existing quantitative research has revealed myriad factors and characteristics linked to experiencing NFOD, but it is critically important to explore the lived context underlying these associations. In this qualitative study, we sought to understand the experiences of NFOD among people who use drugs in a Scottish region in order to: enhance public policy responses; inform potential intervention development to mitigate risk; and contribute to the literature documenting the lived experience of NFOD.MethodsFrom June to July 2021, two peer researchers conducted face-to-face semi-structured interviews with people who use drugs who had experienced recent NFOD attending harm reduction services in Tayside, Scotland. These were transcribed verbatim and evaluated using thematic analysis with an inductive approach which had an experiential and essentialist orientation.ResultsTwenty people were interviewed across two sites. Of those, 15 (75%) were male and mean age was 38.2 (7.7) years. All had experienced at least one NFOD in the prior six months, and all reported polydrug use. Five themes were identified, within which 12 subthemes were situated. The themes were: social context; personal risk-taking triggers; planned and impulsive consumption; risk perception; and overdose reversal. The results spoke to the environmental, behavioural, cognitive, economic, and marketplace, factors which influence the context of NFOD in the region.ConclusionsA complex interplay of behavioural, psychological, and situational factors were found to impact the likelihood of experiencing NFOD. Structural inequities which policy professionals and civic leaders should seek to remedy were identified, while service providers may seek to reconfigure healthcare provision for people who use drugs to account for the interpersonal, psychological, and social factors identified, which appear to precipitate NFOD.Trial registrationNot applicable.

Prevalence and factors associated with polydrug use among clients seeking treatment for alcohol misuse.

The aim of this paper was to examine the client and psychosocial characteristics associated with polydrug use in patients with alcohol misuse as their primary drug of concern (PDC) seeking treatment from substance use treatment centres. Self-report surveys were undertaken with clients attending 1 of 34 community-based substance use treatment centres across Australia with alcohol as their PDC. Survey items included client's socio-demographic characteristics, level of alcohol dependence, use of other drugs including tobacco, health and wellbeing factors including health-related quality of life. The factors associated with polydrug use (alcohol use concurrent with at least one other drug) were examined. In a sample of 1130 clients seeking treatment primarily for alcohol problems, 71% reported also using another drug. The most frequently used drug was tobacco (50%) followed by cannabis (21%) and benzodiazepines (15%). Excluding tobacco use, 35% of participants reported polydrug use. Factors associated with any polydrug use were younger age, lower education levels, lower levels of mental health related quality of life and housing risk (i.e., risk of eviction or experienced homelessness in past 4 weeks). When tobacco was excluded, factors associated with polydrug use were age, lower physical and mental health-related quality of life, and housing risk. Most adults seeking treatment for alcohol misuse as their PDC reported using another drug in addition to alcohol. Treatment services should be designed accordingly to maximise the likelihood of treatment engagement and success.

HIV risk perception, pre-exposure prophylaxis (PrEP) awareness, and PrEP initiation intention among women who use drugs

IntroductionWomen who use drugs (WWUD) are prime candidates for pre-exposure prophylaxis (PrEP) due to their elevated risk of acquiring HIV through biological, behavioral, and contextual factors. However, PrEP uptake among WWUD remains low. The relationship between unhealthy drug use and correlates of PrEP uptake in this vulnerable population is not well defined. The purpose of this study is to characterize the relationships between specific types and routes of drug use and several precursors of PrEP uptake among WWUD. MethodsThe study collected data via a computer-based survey from 233 women living in New York City and Philadelphia who participated in a study designed to develop and pilot a women-focused intervention for PrEP uptake. The sample of cisgender, HIV-negative women were not currently taking PrEP but considered PrEP eligible. This analysis is focused on women's HIV risk perception, PrEP awareness, PrEP initiation intention, and any use of the following drugs: barbiturates, benzodiazepines, crack cocaine, powder cocaine, hallucinogens, heroin, methamphetamines, and prescription opioids. ResultsWithin the three months prior to study enrollment, 63.1 % of participants reported any drug use; 42 % reported polydrug use; 19.8 % had injected drugs; 75 % reported getting high or drunk before sex; and 44 % had been enrolled in drug treatment. Of our total sample, 41.2 % perceived themselves at risk for HIV infection, 41.6 % were aware of PrEP prior to the study, and 62.7 % intended to initiate PrEP after they were informed. When compared to other PrEP-eligible women, women who reported prescription opioid use and polydrug use perceived themselves at higher risk for HIV infection and had higher intention to start PrEP. However, they and women who reported injecting drugs also reported lower awareness of PrEP. ConclusionThese findings have implications for increasing education about PrEP and the various modes of HIV exposure to support PrEP uptake in this vulnerable population.

The Normalization of Leisure Sex and Recreational Drugs: Exploring Associations Between Polydrug Use and Sexual Practices by English Festival-Goers

The relationship between drug use and sexual practice is complex. Significant focus has been placed on risky practices, yet the broader associations between drug use and sexual activities remain elusive outside such contexts. This is despite similar trends of liberalizing attitudes and practices being identified in each area, theorized as the normalization of recreational drug use and the liberalization of consensual sexual practice. In this article, we draw on convenience sample surveys of 966 festival-goers at an English music festival in 2016 and 2019 to assess prevalence of polydrug use and to examine whether people who consume illicit drugs are more likely to engage in sexual behaviors considered more liberal than the traditional norm. We show that people who reported polydrug use in the last 12 months were significantly more likely to engage in non-traditional sexual behaviors, including sex with a friend and anal sex, in that same time period. In combining and comparing two usually distinct discourses, this exploratory study suggests that the normalization of drugs and the liberalization of consensual sexual practices are related and can be conceptualized as part of a broader societal acceptance and cultural accommodation of illicit drug use and particular sexual practices as leisure activities, despite markedly different policy and legal contexts for each activity. We conclude that the concept of “normalization” may be more appropriate to understanding changes in sexuality than “liberalization” in the context of “leisure sex” and call for further cross-disciplinary research on drugs and sex using this approach.

Longitudinal Analysis of Syndemic Psychosocial Problems Predicting HIV Risk Behavior Among a Multicity Prospective Cohort of Sexually Active Young Transgender Women in the United States.

Worldwide, young transgender women (YTW) contend with exceptionally high risks of HIV infection. Cross-sectional studies have suggested that co-occurring epidemics or "syndemics" of psychosocial problems may accelerate HIV acquisition and transmission through elevated sexual risk behavior among transgender women. We aimed to examine how a syndemic of 7 psychosocial problems potentiates HIV sexual risk behavior among a multicity, longitudinal cohort of sexually active YTW in the United States. Between 2012 and 2015, 233 YTW from Boston, MA, and Chicago, IL, completed behavioral surveys at baseline, 4, 8, and 12 months. We used generalized estimating equations to examine the prospective relationship of overlapping psychosocial problems and HIV sexual risk behavior (ie, condomless anal or vaginal sex) among YTW. The prevalence of 7 psychosocial syndemic problems was substantial at baseline and remained high at each time point: 6.4% reported polydrug use in the past 4 months (excluding stimulants); 7.7% reported heavy alcohol use in the past 4 months; 10% reported a history of childhood sexual abuse; 15.9% reported stimulant use in the past 4 months; 41.7% reported experiencing lifetime intimate partner violence; 42.1% reported clinically significant depressive symptoms; and 68.6% reported lifetime transgender-specific victimization. We identified a statistically significant positive "dose-response" relationship between the number of psychosocial syndemic problems and condomless anal or vaginal sex over time. The accumulation of "syndemic" psychosocial problems predicted HIV sexual risk behavior in a prospective cohort of YTW. Given the high prevalence of psychosocial problems and HIV sexual risk behavior, as well as having the highest HIV incidence among any risk group, the HIV prevention agenda requires a shift toward improved assessment of psychosocial comorbidities and stronger integration with gender-affirming and supportive mental health, violence recovery, and addiction treatment services for this population.

Relationship Dynamics in the Context of Binge Drinking and Polydrug Use Among Same-Sex Male Couples in Atlanta, Boston, and Chicago.

An estimated one- to two-thirds of incident HIV infections among U.S. men who have sex with men (MSM) occur within the context of a primary relationship. The existing, yet limited, literature on sexual risk behavior among same-sex couples suggests that MSM with main partners are more often to report having lower perceived HIV risk, higher unrecognized HIV infection, and increased frequency of condomless anal intercourse with their primary partner. Furthermore, numerous studies document the strong relationship between polydrug use and binge drinking with HIV infection among MSM. However, more research is needed that identifies how individual- and relationship-level factors are related to polydrug use and binge drinking in the context of same-sex male relationships. We used baseline data collected as part of a prospective randomized controlled trial of 160 same-sex male couples (total N = 320 individuals). In 2015, recruitment commenced in three U.S. cities: Atlanta, GA, Boston, MA, and Chicago, IL. Participants completed a self-report assessment using an audio-computer-assisted self-interview system during their baseline enrollment visit. We collected information on participants' sociodemographic characteristics, drug and alcohol use, individual- and relationship-level variables of interest, as well as relationship quality. Multinomial logistic regression models were fit for three different categories of polydrug use and of binge drinking for which (1) both partners exhibited the behavior, (2) only the respondent exhibited the behavior, or (3) only the partner exhibited the behavior. Participants' age ranged from 18 to 69 (M = 35.9). The sample majority (77.5%) was White (248/320), with 12.2% Black (39/320) and 10.3% Multiracial (33/320); 68.4% had completed a college degree; and 9.6% were unemployed. A high proportion (62.2%) reported any drug use, including marijuana; 45% reported using drugs other than marijuana; and 18.1% reported polydrug use. Overall, 22.2% reported current binge drinking. Age discordance and being in a long-term relationship (6 or more years) were associated with a decreased odds of polydrug use among couples; being in an interracial dyad, recent history of arrest, living with HIV, and self-reported clinically significant depressive symptoms were associated with an increased odds of polydrug use. Additionally, being the older partner and reporting higher levels of internalized homophobia decreased odds for binge drinking, while recent history of arrest, living with HIV, and feeling more loved in their relationship were associated with an increased odds of binge drinking. Findings have implications for developing interventions to reduce substance use and promote health among same-sex male couples. Future research would benefit by using longitudinal study designs to understand the individual-, relationship-, and structural-level factors that potentiate polydrug use and binge drinking among same-sex male couples.

“I love having benzos after my coke shot”: The use of psychotropic medication among cocaine users in downtown Montreal

BackgroundCocaine abuse is a major public health issue due to its role in the HIV and hepatitis C virus (HCV) epidemics in North America. A significant area of concern among people who use cocaine (PWUC), injected or smoked, is their frequent misuse of prescription drugs, particularly psychotropic medication (PM), such as tranquilizers, sedatives, stimulants, and antipsychotics. This paper aims to describe and understand practices of PM use among PWUC in downtown Montreal. MethodEthnographic methods including participant observation and semi-structured interviews were used in an iterative manner. ResultsTwo thirds of the 50 participants were male. They ranged in age from 20 to 60 and most were homeless. A significant proportion of them reported polydrug use patterns that included frequent concomitant opioid use (heroin and/or prescription opioids (PO)). Benzodiazepine-based tranquilizers and the atypical antipsychotic quetiapine were the most frequently used PM. Routes of PM administration were oral, nasal and, to a lesser degree, intravenous. Five main PM use practices were identified: 1) “downers” from cocaine high (benzodiazepines and quetiapine); 2) enhancers of heroin/PO effects (benzodiazepines); 3) reducers or suppressors of heroin/PO withdrawal symptoms (benzodiazepines); 4) enablers of a different type of “trip” (benzodiazepines); and 5) treatment for mental and physical problems (benzodiazepines and quetiapine). ConclusionPM use practices showed several complementary functions that PM fulfill in a context of polydrug use. The soothing and stimulating effects of PM reinforce the patterns of drug use among participants, posing various risks including overdose, HIV/HCV transmission, PM dependence and accidents. The results highlight the need for clinicians to assess clients’ substance use patterns when prescribing PM and to question PWUC about PM use. The findings also underline certain unmet service needs in relation to overdose, HIV/HCV and mental health prevention/treatment among cocaine users.

Syndemic Conditions Reinforcing Disparities in HIV and Other STIs in an Urban Sample of Behaviorally Bisexual Latino Men.

Syndemics research has made great contributions to understanding sexual risk among Latino men who have sex with men. However, such work often combines data for behaviorally bisexual men with data for men with exclusively same-sex partners. Using cross-sectional data from 148 behaviorally bisexual Latino men, this study explored the impact of syndemic factors-polydrug use, childhood sexual abuse, and depression-on sexual risk behaviors and STI incidence. Approximately one-third of participants reported polydrug use, 22% reported childhood sexual abuse, and 26% screened for clinically significant depressive symptoms. An increase in syndemic factors was associated with increased odds of lifetime STI incidence and condomless receptive anal intercourse with men; however, the model did not predict condomless insertive anal intercourse with men or condomless vaginal intercourse. More efforts are needed to explore the varying mechanisms, including but not restricted to the combined impact of syndemic conditions, that influence sexual risk in this population.

Poly drug use, chemsex drug use, and associations with sexual risk behaviour in HIV-negative men who have sex with men attending sexual health clinics

BackgroundRecreational drug use and associated harms continue to be of significant concern in men who have sex with men (MSM) particularly in the context of HIV and STI transmission. MethodsData from 1484 HIV-negative or undiagnosed MSM included in the AURAH study, a cross-sectional, self-completed questionnaire study of 2630 individuals from 20 sexual health clinics in the United Kingdom in 2013–2014, was analysed. Two measures of recreational drug use in the previous three months were defined; (i) polydrug use (use of 3 or more recreational drugs) and (ii) chemsex drug use (use of mephedrone, crystal methamphetamine or GHB/GBL). Associations of socio-demographic, health and lifestyle factors with drug use, and associations of drug use with sexual behaviour, were investigated. ResultsOf the 1484 MSM, 350 (23.6%) reported polydrug use and 324 (21.8%) reported chemsex drug use in the past three months. Overall 852 (57.5%) men reported condomless sex in the past three months; 430 (29.0%) had CLS with ≥2 partners, 474 (31.9%) had CLS with unknown/HIV+ partner(s); 187 (12.6%) had receptive CLS with an unknown status partner. For polydrug use, prevalence ratios (95% confidence interval) for association with CLS measures, adjusted for socio-demographic factors were: 1.38 (1.26, 1.51) for CLS; 2.11 (1.80, 2.47) for CLS with ≥2 partners; 1.89 (1.63, 2.19) for CLS with unknown/HIV+ partner(s); 1.36 (1.00, 1.83) for receptive CLS with an unknown status partner. Corresponding adjusted prevalence ratios for chemsex drug use were: 1.38 (1.26, 1.52); 2.07 (1.76, 2.43); 1.88 (1.62, 2.19); 1.49 (1.10, 2.02). Polydrug and chemsex drug use were also strongly associated with previous STI, PEP use, group sex and high number of new sexual partners. Associations remained with little attenuation after further adjustment for depressive symptoms and alcohol intake. ConclusionThere was a high prevalence of polydrug use and chemsex drug use among HIV negative MSM attending UK sexual health clinics. Drug use was strongly associated with sexual behaviours linked to risk of acquisition of STIs and HIV.

Sexual and reproductive health risks amongst female adolescents who use amphetamine-type stimulants and sell sex: a qualitative inquiry in Yunnan, China.

BackgroundChina, as other Southeast Asian countries, has witnessed an increased use in amphetamine-type stimulants (ATS) amongst urban youth. Amongst female adolescents who both sell sex and use ATS, risk behaviours are compounded resulting in even poorer health outcomes. However, limited knowledge exists on ATS use patterns and ATS-related risk behaviours, particularly in this context. This research aimed to improve the understanding of these issues amongst female adolescents who use ATS and sell sex, and to inform future programming.MethodThis study utilised monthly focus group discussions (four in total) with the same study participants in Yunnan, China. From within a drug-treatment programme, female adolescents who reported both a history of drug use and selling sex were purposively enrolled in the study.ResultsParticipating adolescent females were aged 17–19 years and were all internal-migrants with low literacy. All reported polydrug use (mainly methamphetamine and heroin, whereas ecstasy and ketamine have been infrequently employed). Being less informed about risks of drug use and lack of sexual and reproductive health knowledge seemed to contribute to problematic drug use, rough and prolonged sexual intercourse, inconsistent condom use and ineffective contraceptive practice. For their income, participants largely relied on selling sex, which was frequently coupled with drug sharing services to clients. However, despite the practices, women did not self-identify as sex workers, and therefore did not think that existing intervention services targeting female sex workers were relevant to them. Moreover, criminalization and stigmatisation of drug use and selling sex impeded their access to care services.ConclusionCurrent harm reduction and HIV/sexually transmitted infection (STI) prevention services are unlikely to address the demand of female adolescents engaged in drug use and commercial sex. Our findings highlight that a comprehensive and coordinated harm reduction and sexual and reproductive health response should be conducted involving these most vulnerable adolescents.

A social network-informed latent class analysis of patterns of substance use, sexual behavior, and mental health: Social Network Study III, Winnipeg, Manitoba, Canada.

We assessed whether a meaningful set of latent risk profiles could be identified in an inner-city population through individual and network characteristics of substance use, sexual behaviors, and mental health status. Data came from 600 participants in Social Network Study III, conducted in 2009 in Winnipeg, Manitoba, Canada. We used latent class analysis (LCA) to identify risk profiles and, with covariates, to identify predictors of class. A 4-class model of risk profiles fit the data best: (1) solitary users reported polydrug use at the individual level, but low probabilities of substance use or concurrent sexual partners with network members; (2) social-all-substance users reported polydrug use at the individual and network levels; (3) social-noninjection drug users reported less likelihood of injection drug and solvent use; (4) low-risk users reported low probabilities across substances. Unstable housing, preadolescent substance use, age, and hepatitis C status predicted risk profiles. Incorporation of social network variables into LCA can distinguish important subgroups with varying patterns of risk behaviors that can lead to sexually transmitted and bloodborne infections.

Substance Use Among HIV-Infected Patients Engaged in Primary Care in the United States: Findings From the Centers for AIDS Research Network of Integrated Clinical Systems Cohort

The purpose of this study was to better understand substance use behaviors and deleterious health consequences among individuals with HIV. We examined a multicenter cohort of HIV-infected patients (n = 3,413) receiving care in 4 US cities (Seattle, Birmingham, San Diego, Boston) between December 2005 and April 2010 in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS). We used generalized estimating equations to model specific substance use outcomes. Overall, 24% of patients reported recent use of marijuana; 9% reported amphetamine use, 9% reported crack-cocaine use, 2% reported opiate use, 3.8% reported injection drug use, and 10.3% reported polydrug use. In adjusted multivariable models, those who reported unprotected anal sex had higher odds of marijuana, amphetamine, injection drug, and polydrug use. An increased number of distinct vaginal sexual partners was associated with polydrug and crack-cocaine use. Nonadherence to antiretroviral therapy was associated with the use of all substances other than marijuana. The co-occurrence of substance use, unprotected intercourse, and medication nonadherence could attenuate the public health benefits of test, treat, and link to care strategies. Prevention programs are needed that address these coprevalent conditions.

Concurrent and simultaneous polydrug use: latent class analysis of an Australian nationally representative sample of young adults.

Background: Alcohol use and illicit drug use peak during young adulthood (around 18–29 years of age), but comparatively little is known about polydrug use in nationally representative samples of young adults. Drawing on a nationally representative cross-sectional survey (Australian National Drug Strategy Household Survey), this study examines polydrug use patterns and associated psychosocial risk factors among young adults (n = 3,333; age 19–29).Method: The use of a broad range of licit and illicit drugs were examined, including alcohol, tobacco, cannabis, cocaine, hallucinogens, ecstasy, ketamine, GHB, inhalants, steroids, barbiturates, meth/amphetamines, heroin, methadone/buprenorphine, other opiates, painkillers, and tranquilizers/sleeping pills. Latent class analysis was employed to identify patterns of polydrug use.Results: Polydrug use in this sample was best described using a 5-class solution. The majority of young adults predominantly used alcohol only (52.3%), alcohol and tobacco (34.18%). The other classes were cannabis, ecstasy, and licit drug use (9.4%), cannabis, amphetamine derivative, and licit drug use (2.8%), and sedative and alcohol use (1.3%). Young adult males with low education and/or high income were most at risk of polydrug use.Conclusion: Almost half of young adults reported polydrug use, highlighting the importance of post-high school screening for key risk factors and polydrug use profiles, and the delivery of early intervention strategies targeting illicit drugs.

Types of polydrug use among Spanish adolescents

ObjectiveThis study examined the types of polydrug use among Spanish adolescents. Method1501 high school students (50.6% female) aged 12 to 17years old (mean age=14.03, SD=1.28), from public schools in the city of Girona (Catalonia, Spain), completed the survey. ResultsIn the previous six months 20.9% of the Spanish adolescents used alcohol, 18.8% tobacco, 10.5% cannabis and 0.7% cocaine. Specifically, 28.6% of the sample (n=429; 29% males and 28.2% females) used at least one drug and 13.9% reported polydrug use (n=208; 12.6% males and 15.1% females). The present research also found that the most critical ages for starting polydrug use were 14 and 15years old. More than one quarter (27.9%) of the adolescent polydrug users were type A (tobacco and alcohol), 67.8% were type B (cannabis together with tobacco and/or alcohol) and 3.4% were type C (cannabis together with tobacco and/or alcohol, and cocaine). ConclusionsThese results suggest that Spanish adolescents, particularly males, commence polydrug use at an earlier age than other European adolescents. Early preventative strategies and a multisubstance perspective are greatly needed in Spain to avoid the initiation of polydrug use or to prevent progress onto heavier drugs.

Drug Checking: A prevention measure for a heterogeneous group with high consumption frequency and polydrug use - evaluation of zurich's drug checking services

BackgroundThe increasing party culture in Zurich presents new challenges, especially regarding the consumption of alcohol and so-called party drugs. Streetwork, the youth advisory service of the city of Zurich, has provided onsite and stationary Drug Checking facilities since 2001 and 2006, respectively. Drug Checking always involves filling out an anonymous questionnaire, which allows the collection of important information about a largely unknown group of users and their consumption patterns.MethodsThe questionnaires assessed sociodemographic characteristics, consumption patterns, Drug Checking experiences, information behavior and social support. The collected data were statistically analyzed by the Research Institute for Public Health and Addiction (RIPHA).ResultsThe majority of Drug Checking service patrons were male and between 20 and 35 years old. These patrons reported high lifetime prevalences and high consumption frequencies of legal and illegal substances, and they often reported polydrug use. Aside from tobacco and alcohol, the most consumed drugs during typical party nights were ecstasy, amphetamines, cannabis and cocaine. Party drug consumers using Drug Checking services form a heterogeneous group with respect to sociodemographic characteristics and consumption patterns. Users of the onsite Drug Checking facilities were significantly younger, were less experienced with drug testing, and reported more polydrug use than users of the stationary Drug Checking service.ConclusionsDrug Checking combined with a consultation appears to be an important harm reduction and prevention measure that reaches a group of consumers with high consumption frequency and polydrug use. Because of the heterogeneity of the target group, different prevention measures must be offered and embedded in an overall local concept.

Mephedrone use among same-sex attracted young people in Sydney, Australia

Mephedrone (4-methylmethcathinone) is a synthetic stimulant that has recently emerged as a recreational drug. There is currently no Australian data on prevalence and patterns of mephedrone use. This paper aims to explore patterns of mephedrone use among a large sample of same-sex attracted young people in Sydney, Australia. An online survey was conducted with 572 same-sex attracted men (n= 318) and women (n = 254) aged 18 to 25 years, who lived or regularly spent time in Sydney. Data on mephedrone were collected as part of a larger study exploring sexuality and nightlife. Mephedrone had been used by 4.0% (n = 23) of respondents, 2.1% (n = 12) in the preceding 6 months, 1.4% (n = 8) in the preceding month. Typical routes of use were intranasal (n = 8) and ingestion (n = 6). No respondent reported ever injecting mephedrone. Three respondents reported polydrug use with mephedrone. The most common contexts of use were respondents' homes or friends' homes (n = 8) and gay bars and clubs (n = 7). This paper reports low levels of mephedrone use among a large sample of same-sex attracted young people. The proportion of respondents who had used mephedrone was much lower than reported in recent UK research. This may suggest that mephedrone has not infiltrated the Australian market to the same extent as in Europe. However, data from annual surveillance of drug users are required to better determine this.

High Rates of Club Drug Use and Risky Sexual Practices Among Hispanic Men Who Have Sex with Men in Miami, Florida

This study measured use of club drugs among 262 Hispanic men who have sex with men (MSM) recruited at community venues in Miami-Dade County, Florida in 2001. More than 50% of men used club drugs, and 36% used them in the last 3 months. Lifetime and 3-month rates were: ecstasy (36% and 20%), cocaine (34% and 12%), amyl nitrates (28% and 9%), and crystal methamphetamine (20% and 15%). Thirty-six percent had used two or more drugs (polydrug use) in their lifetime and 20% reported polydrug use in the last 3 months. Club drug users had significantly more sex partners in the last 12 months than nonclub drug users. High rates (35%) of unprotected anal sex in the last 3 months were reported by both groups. Men who reported polydrug use in the last 3 months were significantly more likely than men who used a single club drug to have had sex under the influence of club drugs (83% vs. 57%; X2 = 7.4, p = 0.006). At the multivariate level, a significant association between preference for use of English and lifetime club drug use emerged. Effective interventions to reduce club drug use and risky sex for Hispanic MSM are needed.

Correlates of heavy substance use among young gay and bisexual men: The San Francisco Young Men's Health Study

Correlates of heavy substance use among a household-based sample of young gay and bisexual men ( n=428) were identified and the odds ratio (OR) was calculated. A total of 13.6% reported frequent, heavy alcohol use and 43% reported polydrug use. Compared with men employed in professional occupations, men in service positions (OR=3.77) and sales positions (OR=2.51) were more likely to be heavy alcohol consumers. Frequent gay bar attendance and multiple sex partners were related to heavy alcohol use, as well as to polydrug use. Polydrug users were more likely to be HIV seropositive (OR=2.05) or of unknown HIV serostatus (OR=2.78). HIV serostatus was similarly related to frequent drug use. These correlates of heavier substance use among young gay and bisexual men could be used to identify and intervene early with members of this population who are at risk of substance misuse, as well as HIV/AIDS risk.

Drug use, HIV risk-taking and psychosocial correlates of benzodiazepine use among methadone maintenance clients

Methadone maintenance clients who used benzodiazepines were compared with other methadone maintenance clients on a range of drug use and psychosocial treatment outcome measures. Despite being on higher methadone doses, benzodiazepine users were more likely to have recently injected, to have used cocaine and amphetamines, to have borrowed or lent used needles and syringes, and to have reported polydrug use in the preceding month. Benzodiazepine users also exhibited higher levels of psychopathology and social dysfunction than other methadone maintenance clients. It is concluded that benzodiazepine-using methadone maintenance clients are a dysfunctional subgroup of the methadone population, who may require more clinical intervention than other clients.