PMID- 35523571 OWN - NLM STAT- MEDLINE DCOM- 20230223 LR - 20230316 IS - 1472-3263 (Electronic) IS - 1368-4973 (Linking) VI - 99 IP - 2 DP - 2023 Mar TI - Alcohol and drug use during sex and its association with sexually transmitted infections: a retrospective cohort study among young people aged under 25 years visiting Dutch STI clinics. PG - 97-103 LID - 10.1136/sextrans-2021-055355 [doi] AB - INTRODUCTION: Alcohol use and drug use are common behaviours among young people. STI positivity is higher in young people than in people aged above 25 years. While there is an increasing amount of knowledge about drug use during sex among men who have sex with men (MSM), data on this behaviour among young women and heterosexual men are scarce. Therefore, this study aims to assess the proportion and characteristics of women and heterosexual men aged under 25 years reporting alcohol and/or drug use during sex and its association with STI positivity. METHODS: Surveillance data of heterosexual individuals younger than 25 years visiting two Dutch STI clinics between 2016 and 2019 were assessed (n=11 714). We used multivariable logistic regression analyses to assess associations between alcohol and drug use during sex and STI positivity (Chlamydia trachomatis and/or Neisseria gonorrhoeae diagnosis), adjusting for sociodemographic characteristics (sex, age, ethnicity, educational level, socioeconomic status and urbanisation) and sexual behaviour (condom use, number of sex partners). RESULTS: Alcohol use during sex was reported by 45.3% (5311/11 714; 49.5% in men vs 43.2% in women, p<0.001) and drug use during sex by 22.0% (2580/11 714; 30.7% in men vs 17.6% in women, p<0.001). The most reported drugs were cannabis (17.9%), ecstasy (XTC)/methylenedioxymethamphetamine (MDMA) (6.9%) and cocaine (4.7%). The use of at least one of the following drugs (XTC/MDMA, cocaine, speed, ketamine, gamma-hydroxybutyrate (GHB)/gamma-butyrolactone (GBL), heroin, crystal meth and/or designer drugs) was significantly associated with STI positivity after adjustment for sociodemographic characteristics (adjusted OR (aOR): 1.3, 95% CI 1.1 to 1.4), but this association did not remain significant after adjustment for sexual behaviour (aOR: 1.12, 95% CI 0.94 to 1.34). Significant associations between drug use during sex and inconsistent condom (aOR: 2.5, 95% CI 1.9 to 3.2) use and having four or more sex partners (aOR: 3.2, 95% CI 2.8 to 3.6) in the past 6 months were assessed. DISCUSSION: Alcohol and drug use during sex was highly prevalent among young women and heterosexual men visiting the STI clinic and drug use during sex was associated with an increased risk for STI, probably mediated by sexual behaviour. This indicates that a holistic health promotion strategy, addressing STI prevention and alcohol and drug use-related harm reduction, is important in this group. STI clinics should address this behaviour not only among MSM, but also among young women and heterosexual men. CI - (c) Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Evers, Ymke J AU - Evers YJ AUID- ORCID: 0000-0003-3859-0168 AD - Sexual Health, Infectious Diseases and Environmental Health, Public Health Service South Limburg, Heerlen, The Netherlands ymke.evers@ggdzl.nl. AD - Social Medicine and Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands. FAU - Op den Camp, Kiki P L AU - Op den Camp KPL AD - Sexual Health, Infectious Diseases and Environmental Health, Public Health Service South Limburg, Heerlen, The Netherlands. AD - Social Medicine and Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands. FAU - Lenaers, Mischa AU - Lenaers M AD - Sexual Health, Infectious Diseases and Environmental Health, Public Health Service South Limburg, Heerlen, The Netherlands. AD - Social Medicine and Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands. FAU - Dukers-Muijrers, Nicole H T M AU - Dukers-Muijrers NHTM AUID- ORCID: 0000-0003-4896-758X AD - Sexual Health, Infectious Diseases and Environmental Health, Public Health Service South Limburg, Heerlen, The Netherlands. AD - Health Promotion, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands. FAU - Hoebe, Christian J P A AU - Hoebe CJPA AD - Sexual Health, Infectious Diseases and Environmental Health, Public Health Service South Limburg, Heerlen, The Netherlands. AD - Social Medicine and Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands. LA - eng PT - Journal Article DEP - 20220506 PL - England TA - Sex Transm Infect JT - Sexually transmitted infections JID - 9805554 RN - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine) SB - IM MH - Male MH - Female MH - Humans MH - Adolescent MH - Homosexuality, Male MH - Retrospective Studies MH - Ethnicity MH - *N-Methyl-3,4-methylenedioxyamphetamine MH - *Sexual and Gender Minorities MH - Sexual Behavior MH - *Sexually Transmitted Diseases/diagnosis MH - Sexual Partners MH - *Substance-Related Disorders/epidemiology/complications MH - *HIV Infections/epidemiology OTO - NOTNLM OT - Chlamydia trachomatis OT - Neisseria gonorrhoeae OT - drug use during sex OT - sexually transmitted infections OT - young people COIS- Competing interests: None declared. EDAT- 2022/05/07 06:00 MHDA- 2023/02/25 06:00 CRDT- 2022/05/06 21:44 PHST- 2021/11/01 00:00 [received] PHST- 2022/04/15 00:00 [accepted] PHST- 2022/05/07 06:00 [pubmed] PHST- 2023/02/25 06:00 [medline] PHST- 2022/05/06 21:44 [entrez] AID - sextrans-2021-055355 [pii] AID - 10.1136/sextrans-2021-055355 [doi] PST - ppublish SO - Sex Transm Infect. 2023 Mar;99(2):97-103. doi: 10.1136/sextrans-2021-055355. Epub 2022 May 6.