Patterns of injecting and non-injecting drug use by sexual behaviour in people who inject drugs attending services in England, Wales and Northern Ireland, 2013-2016.

Int J Drug Policy

HIV & STI Department, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, United Kingdom. Electronic address:

Published: May 2018

AI Article Synopsis

  • Higher levels of drug use, particularly related to chemsex, were observed in LGBT communities, prompting a study on the drug use patterns among people who inject drugs (PWID) in the UK.
  • An anonymous survey from 2013-2016 included sexually active PWID, comparing drug use between MSM, WSW, and their heterosexual counterparts, while excluding GHB/GBL and methamphetamine.
  • Results showed MSM and WSW had higher rates of drug use linked with chemsex, such as mephedrone and ketamine, compared to heterosexual individuals; revealing distinct injecting and non-injecting drug behaviors between the groups.

Article Abstract

Background: Higher levels of drug use have been reported in lesbian, gay, bisexual and transgender (LGBT) communities, some of which can be explained by sexualised drug use, including 'chemsex'; the use of drugs before or during planned sexual activity to sustain, enhance, disinhibit or facilitate sex. We explored injecting and non-injecting drug use by sexual behaviour among people who inject drugs (PWID) in England, Wales and Northern Ireland.

Methods: Data were used from an unlinked-anonymous survey of PWID (2013-2016), where participants recruited through services self-completed a questionnaire. We included sexually active participants who had injected in the previous year, and compared injecting and non-injecting drug use between men reporting sex with men (MSM) and heterosexual men, and between women reporting sex with women (WSW) and heterosexual women. The questionnaire did not include GHB/GBL and methamphetamine use.

Results: There were 299 MSM, 3215 heterosexual male, 122 WSW and 1336 heterosexual female participants. MSM were more likely than heterosexual men to use drugs associated with chemsex: injected or non-injected mephedrone (adjusted OR (AOR) 2.22, 95%CI 1.54-3.22; AOR 2.15, 95%CI 1.48-3.11) and injected or non-injected ketamine (AOR 1.98, 95%CI 1.29-3.05; AOR 2.57, 95%CI 1.59-4.15). MSM were also more likely to inject methadone, inhale solvents, take ecstasy, cocaine or speed. WSW were more likely than heterosexual women to use non-injected mephedrone (AOR 2.19, 95%CI 1.20-3.99) and use injected or non-injected ketamine (AOR 5.58, 95%CI 2.74-11.4; AOR 3.05, 95%CI 1.30-7.19). WSW were also more likely to inject methadone, inject cocaine, use non-injected cocaine, crack, benzodiazepines or ecstasy, inhale solvents, or smoke cannabis.

Conclusion: Injecting and non-injecting drug use differed between MSM/WSW and heterosexual men and women. The use of drugs that have been associated with chemsex and sexualised drug use is more common among both MSM and WSW than heterosexual men and women.

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http://dx.doi.org/10.1016/j.drugpo.2018.02.017DOI Listing

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