PMID- 26423813
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20151229
LR  - 20220318
IS  - 2352-3018 (Electronic)
IS  - 2352-3018 (Linking)
VI  - 1
IP  - 1
DP  - 2014 Oct
TI  - Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men 
      who have sex with men in the UK: results from the cross-sectional ASTRA study.
PG  - e22-31
LID - S2352-3018(14)70001-3 [pii]
LID - 10.1016/S2352-3018(14)70001-3 [doi]
AB  - BACKGROUND: Recreational drug use in men who have sex with men (MSM) is of 
      concern because it might be linked to the transmission of HIV and other sexually 
      transmitted infections. Evidence about drug use in HIV-diagnosed MSM in the UK is 
      limited by representativeness of the study populations. We describe patterns of 
      drug use and associations with sexual behaviours in HIV-diagnosed MSM in the UK. 
      METHODS: We used data from the cross-sectional ASTRA study, which recruited 
      participants aged 18 years or older with HIV from eight HIV outpatient clinics in 
      the UK between Feb 1, 2011, and Dec 31, 2012. We examined data for MSM, assessing 
      the prevalence of recreational drug use and polydrug use in the previous 3 months 
      and associations with sociodemographic and HIV-related factors. We examined the 
      association of polydrug use with measures of condomless sex in the previous 3 
      months and with other sexual behaviours. FINDINGS: Our analysis included data for 
      2248 MSM: 2136 (95%) were gay, 1973 (89%) were white, 1904 (85%) were on 
      antiretroviral treatment (ART), and 1682 (76%) had a viral load of 50 copies per 
      mL or lower. 1138 (51%) used recreational drugs in the previous 3 months; 608 
      (27%) used nitrites, 477 (21%) used cannabis, 460 (21%) used erectile dysfunction 
      drugs, 453 (20%) used cocaine, 280 (13%) used ketamine, 258 (12%) used 
      3,4-methylenedioxy-N-methylamphetamine (MDMA), 221 (10%) used 
      gamma-hydroxybutyrate or gamma-butyrolactone, 175 (8%) used methamphetamine, and 
      162 (7%) used mephedrone. In the 1138 individuals who used drugs, 529 (47%) used 
      three or more drugs and 241 (21%) used five or more. Prevalence of injection drug 
      use was 3% (n = 68). Drug use was independently associated with younger age (p < 
      0.0001), not being religious (p = 0.001), having an HIV-positive stable partner 
      (p = 0.0008), HIV-serostatus disclosure (p = 0.009), smoking (p < 0.0001), 
      evidence of harmful alcohol drinking (p = 0.0001), and ART non-adherence (p < 
      0.0001). Increasing polydrug use was associated with increasing prevalence of 
      condomless sex (prevalence range from no drug use to use of five or more drugs 
      was 24% to 78%), condomless sex with HIV-seroconcordant partners (17% to 69%), 
      condomless sex with HIV-serodiscordant partners (10% to 25%), and higher-HIV-risk 
      condomless sex after taking viral load into account (4% to 16%; p </= 0.005 for 
      all). Associations were similar after adjustment for sociodemographic and 
      HIV-related factors. Methamphetamine was more strongly associated with 
      higher-HIV-risk condomless sex than were other commonly used drugs. 
      INTERPRETATION: Polydrug use is prevalent in HIV-diagnosed MSM and is strongly 
      associated with condomless sex. Specialist support services for MSM with HIV who 
      use recreational drugs might be beneficial in the reduction of harm and 
      prevention of ongoing transmission of HIV and other sexually transmitted 
      infections. FUNDING: National Institute for Health Research.
CI  - Copyright (c) 2014 Daskalopoulou et al. Open Access article distributed under the 
      terms of CC BY. Published by Elsevier Ltd.. All rights reserved.
FAU - Daskalopoulou, Marina
AU  - Daskalopoulou M
AD  - Research Department of Infection and Population Health, University College 
      London, London, UK. Electronic address: m.daskalopoulou@ucl.ac.uk.
FAU - Rodger, Alison
AU  - Rodger A
AD  - Research Department of Infection and Population Health, University College 
      London, London, UK.
FAU - Phillips, Andrew N
AU  - Phillips AN
AD  - Research Department of Infection and Population Health, University College 
      London, London, UK.
FAU - Sherr, Lorraine
AU  - Sherr L
AD  - Research Department of Infection and Population Health, University College 
      London, London, UK.
FAU - Speakman, Andrew
AU  - Speakman A
AD  - Research Department of Infection and Population Health, University College 
      London, London, UK.
FAU - Collins, Simon
AU  - Collins S
AD  - HIV i-Base, London, UK.
FAU - Elford, Jonathan
AU  - Elford J
AD  - City University London, London, UK.
FAU - Johnson, Margaret A
AU  - Johnson MA
AD  - Royal Free London NHS Foundation Trust, London, UK.
FAU - Gilson, Richard
AU  - Gilson R
AD  - Research Department of Infection and Population Health, University College 
      London, London, UK.
FAU - Fisher, Martin
AU  - Fisher M
AD  - Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
FAU - Wilkins, Ed
AU  - Wilkins E
AD  - Pennine Acute Hospitals NHS Trust, Manchester, UK.
FAU - Anderson, Jane
AU  - Anderson J
AD  - Homerton University Hospital NHS Trust, London, UK.
FAU - McDonnell, Jeffrey
AU  - McDonnell J
AD  - Research Department of Infection and Population Health, University College 
      London, London, UK.
FAU - Edwards, Simon
AU  - Edwards S
AD  - Central and North West London Community Foundation Trust, London, UK.
FAU - Perry, Nicky
AU  - Perry N
AD  - Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
FAU - O'Connell, Rebecca
AU  - O'Connell R
AD  - Barts Health NHS Trust, London, UK.
FAU - Lascar, Monica
AU  - Lascar M
AD  - Barts Health NHS Trust, London, UK.
FAU - Jones, Martin
AU  - Jones M
AD  - East Sussex Healthcare NHS Trust, Eastbourne, UK.
FAU - Johnson, Anne M
AU  - Johnson AM
AD  - Research Department of Infection and Population Health, University College 
      London, London, UK.
FAU - Hart, Graham
AU  - Hart G
AD  - Research Department of Infection and Population Health, University College 
      London, London, UK.
FAU - Miners, Alec
AU  - Miners A
AD  - London School of Hygiene & Tropical Medicine, London, UK.
FAU - Geretti, Anna-Maria
AU  - Geretti AM
AD  - Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.
FAU - Burman, William J
AU  - Burman WJ
AD  - Denver Public Health, Denver, CO, USA.
FAU - Lampe, Fiona C
AU  - Lampe FC
AD  - Research Department of Infection and Population Health, University College 
      London, London, UK.
LA  - eng
PT  - Journal Article
DEP - 20140907
PL  - Netherlands
TA  - Lancet HIV
JT  - The lancet. HIV
JID - 101645355
CIN - Lancet HIV. 2014 Oct;1(1):e4-5. PMID: 26423815
EDAT- 2015/10/02 06:00
MHDA- 2015/10/02 06:01
CRDT- 2015/10/02 06:00
PHST- 2015/10/02 06:00 [entrez]
PHST- 2015/10/02 06:00 [pubmed]
PHST- 2015/10/02 06:01 [medline]
AID - S2352-3018(14)70001-3 [pii]
AID - 10.1016/S2352-3018(14)70001-3 [doi]
PST - ppublish
SO  - Lancet HIV. 2014 Oct;1(1):e22-31. doi: 10.1016/S2352-3018(14)70001-3. Epub 2014 
      Sep 7.