Marseille 2007
Marseille 2007
Abstract book
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Abstract #133  -  Prospective study of frequent use of amphetamines among HIV-negative gay men in Sydney Australia
Session:
  6.25: Posters A (Poster) on Monday   in  Chaired by
Authors:
  Presenting Author:   Dr Garrett Prestage - University of New South Wales, Australia
 
  Additional Authors:  Prof Louisa Degenhardt, Dr Fengyi Jin, Prof Andrew Grulich, Dr John Imrie, Prof John Kaldor, Prof Susan Kippax,  
Aim:
To report factors associated with increased amphetamine (including ecstasy, speed and crystal meth) use among gay men in Sydney, Australia.
 
Method / Issue:
1427 HIV-negative men participating in Sydneys gay community were interviewed between 2001 and 2004 for the Health in Men (HIM) cohort study. All participants undergo annual HIV testing and face-to-face interviews regarding sexual behaviour, illicit drug use, demographics and gay community involvement.
 
Results / Comments:
Of 1427 HIV seronegative gay men in Sydney, 80.3 % had used illicit drugs in the six months prior to their baseline interview, including 122 men who used amphetamines at least weekly. Among 1211 men who returned for their annual follow-up interview, 84 of those who had not been frequent users of amphetamines at baseline had commenced at least weekly use of such drugs in the six months prior to follow-up. Over time, there was little difference in the proportion who used amphetamines at all, or at least weekly, in the six months prior to interview. Baseline and follow-up factors independently associated with commencing more frequent use included being younger (p<.001), drinking more alcohol (p=.001), being more socially engaged with other gay men and socialising in gay party cultures (p<.001), having engaged in esoteric sex practices (p<.001), having more casual partners (p=.002) and having engaged in unprotected anal intercourse with casual partners (p<.001).
 
Discussion:
The association between sexual risk and amphetamine use among gay men does not appear to be a simple, causal one. Individual factors, subcultural associations and personal networks influence both sexual risk and illicit drug use. There is evidence in this study that the destabilisation of safe sex behaviour is also a risk factor for the escalation of illicit drug use, but the transition from non- or less frequent drug use to more frequent drug use may also be associated with other changes in behaviour that include some destabilisation of safe sex behaviour. Harm reduction messages delivered to this group need to reflect this reality. Further, it would appear unwise to deliver overly simplistic messages about the causal influence of drug use upon sexual risk, since this study suggests there may be a bidirectional relationship.
 
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