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Lasco G, Yu VG. Taking Flight: Narratives, Logistics, and Risks of Chemsex Scenes in the Philippines. JOURNAL OF SEX RESEARCH 2024; 61:799-810. [PMID: 37042837 DOI: 10.1080/00224499.2023.2197426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Chemsex - the use of specific, illicit substances to facilitate and enhance sexual encounters - has been documented extensively across the Global North using qualitative methodologies. Elsewhere, however, little is known about the phenomenon. Our article addresses this gap in the scholarly literature by exploring how chemsex encounters transpire in the Philippines. Through semi-structured interviews, we demonstrate the spatiotemporal nature of chemsex scenes, showing how people move between physical and virtual domains across time as they find sexual partners, procure drugs, and organize and attend the actual encounter. Consequently, the risks faced by chemsex practitioners - to health and to security - are also spatiotemporally plotted within intersecting physical and virtual risk environments, and best mitigated by a form of experiential expertise that is likewise temporally determined. Ultimately, chemsex scenes in the Philippines are distinguished from the rest of the world by the state-led "war on drugs." We consider our findings in the context of this war, showing how its very real and often fatal threats have shaped the way people navigate chemsex scenes and mitigate the risks through "counterpublic health" measures, and how its prominent ideologies and discourses are reflected in the ways by which people make sense of their drug use.
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Affiliation(s)
- Gideon Lasco
- Development Studies Program, Ateneo de Manila University
- Department of Anthropology, University of the Philippines Diliman
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Huang P, Du SCS, Ku SWW, Li CW, Bourne A, Strong C. An object-oriented analysis of social apps, syringes and ARTs within gay Taiwanese men's chemsex practices. CULTURE, HEALTH & SEXUALITY 2024; 26:497-512. [PMID: 37435820 DOI: 10.1080/13691058.2023.2228859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 06/20/2023] [Indexed: 07/13/2023]
Abstract
Critical drug studies explore the discursive and material dimensions of sexualised drug use to overcome individualised and often pathologising notions such as risk, safety, responsibility and pleasure. This article uses an object-oriented approach-following the use and flow of social apps, syringes and antiretroviral therapy (ART)-to analyse gay and bisexual Taiwanese men's drug practices. Interview data from fourteen men are used to articulate how objects were brought into gay and bisexual men's chemsex repertoire in ways that shaped individuals' safe-sex communication, intimacy maintenance and stigma negotiation. An object-oriented approach scrutinises risk, pleasure and identities in assemblages of the human and nonhuman, and can help identify new opportunities for implementing health promotion interventions and policies.
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Affiliation(s)
- Poyao Huang
- Institute of Health Behaviors and Community Sciences and Master of Public Health Program, National Taiwan University, Taipei, Taiwan
| | | | - Stephane Wen-Wei Ku
- Division of Infectious Diseases, Department of Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan
| | - Chia-Wen Li
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Adam Bourne
- Australian Research Centre in Sex Health and Society, La Trobe University, Melbourne, VIC, Australia
- Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Carol Strong
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan
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Olding M, Boyd J, Kerr T, Fowler A, McNeil R. (Re)situating expertise in community-based overdose response: Insights from an ethnographic study of overdose prevention sites (OPS) in Vancouver, Canada. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 111:103929. [PMID: 36529032 PMCID: PMC10184134 DOI: 10.1016/j.drugpo.2022.103929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/20/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022]
Abstract
Overdose Prevention Sites (OPS) are low-barrier services where people may use illicit drugs under the monitoring of staff trained to provide life-saving care in the event of an overdose. In British Columbia (BC), Canada, OPS have been rapidly scaled-up as a community-based response to the overdose crisis and are staffed primarily by community members who are also people who use drugs (PWUD). While it is known that PWUD perform vital roles in OPS and other community-based overdose interventions, the expertise and expert knowledge of PWUD in this work remains under-theorised. This study draws on 20 months of ethnographic fieldwork in Vancouver, BC (July 2018 to March 2020), to explore how OPS responders who are PWUD developed and enacted expertise in overdose response. Ethnographic fieldwork focused on four OPS located in Vancouver's Downtown Eastside (DTES) and Downtown South neighbourhoods. Methods included 100 hours of observation in the sites and surrounding areas, three site-specific focus groups with OPS responders (n=20), and semi-structured interviews with OPS responders (n=14) and service users (n=23). Data was analysed with the aim of characterizing the knowledge underpinning responders' expertise, and the arrangements which allow for the formation and enactment of expertise. We found that OPS responders' expertise was grounded in experiential knowledge acquired through their positionality as PWUD and members of a broader community of activists engaged in mutual aid. Responders became skilled in overdose response through frequent practice and drew on their experiential and embodied knowledge of overdose to provide care that was both technically proficient and responsive to the broader needs of PWUD (e.g. protection from criminalization and stigmatizing treatment). Responders emphasized that the spatial arrangements of OPS supported the development of expertise by facilitating more specialized and comprehensive overdose care. OPS became sites of collective expertise around overdose management as responder teams developed shared understandings of overdose management, including processes for managing uncertainty, delegating team responsibilities, and sharing decision-making. This research re-situates theoretical understandings of expertise in community-based overdose response with implications for overdose prevention interventions. Findings underscore the experiential and embodied expertise of PWUD as community-based responders; the importance of supportive environments and team-based approaches for overdose response; and the benefits of community-driven training that extends beyond technical skills of overdose identification and naloxone administration.
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Affiliation(s)
- Michelle Olding
- British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, V6Z 1Y6, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jade Boyd
- British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, V6Z 1Y6, Canada; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Thomas Kerr
- British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, V6Z 1Y6, Canada; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Al Fowler
- East Vancouver Activist, Vancouver, BC, Canada
| | - Ryan McNeil
- British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, V6Z 1Y6, Canada; Yale School of Medicine, New Haven, CT, United States.
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Conway A, Treloar C, Crawford S, Grebely J, Marshall AD. People engaged in opioid agonist treatment as a counterpublic during the COVID-19 pandemic in Australia: A qualitative study. Drug Alcohol Rev 2022; 42:203-212. [PMID: 36054577 PMCID: PMC9538012 DOI: 10.1111/dar.13531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 06/08/2022] [Accepted: 07/31/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION People receiving opioid agonist treatment (OAT) are at higher risk of comorbidities, poverty and discrimination, which Big Events like the COVID-19 pandemic may exacerbate. The behaviours of people receiving OAT do not always align with normative behaviours as conceived by ruling institutions and laws, and so the group becomes a counterpublic, not imagined in mainstream public discourse. The aim of this study was to understand how people receiving OAT, as a counterpublic, implemented practises of care to mitigate negative health outcomes during COVID-19. METHODS Participants were recruited via eight peer-led organisations across Australia. In-depth, semi-structured interviews were completed between August and December 2020 with 40 people receiving OAT. The analysis centres practises of care, allowing interactions that influence the health of participants, to be understood in their unique contexts. RESULTS Aspects of the COVID-19 state response were designed for an idealised public, demonstrated by the increased policing that accompanied enforcement of restrictions which was detrimental to the wellbeing of people receiving OAT. Counterpublic health strategies employed by people receiving OAT were disrupted, but participants were often able to adapt to the changing context. DISCUSSION AND CONCLUSION This study elucidates how practises of care among people receiving OAT are enacted and disrupted during a Big Event, with implications beyond the COVID-19 pandemic for future Big Events. The study findings evidence the need for policies that mitigate the impact of Big Events such as supporting re-groupment within the counterpublic, legitimising counterpublic health strategies and stopping the criminalisation of people who use drugs.
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Affiliation(s)
- Anna Conway
- The Kirby InstituteUNSW SydneySydneyAustralia,Centre for Social Research in HealthUNSW SydneySydneyAustralia
| | - Carla Treloar
- Centre for Social Research in HealthUNSW SydneySydneyAustralia
| | | | | | - Alison D. Marshall
- The Kirby InstituteUNSW SydneySydneyAustralia,Centre for Social Research in HealthUNSW SydneySydneyAustralia
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Playing at the edges, navigating sexual boundaries, and narrating sexual distress; Practices and perspectives of sexuality and gender diverse people who use GHB. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 108:103811. [PMID: 35939948 DOI: 10.1016/j.drugpo.2022.103811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Research addressing sexualised use of GHB to date has largely focussed on gay and bisexual men's GHB use in the context of chemsex, this research has highlighted risks and experiences associated with sexual violence. No studies have included people of diverse sexualities and genders and documented reported practices to ensure mutually gratifying and consensual sex in the context of sexualised drug use (SDU). METHODS Semi-structured interviews were conducted with 31 people from sexuality and gender diverse communities living in Australia who reported three or more occasions of GHB use in the previous 12 months. Participants were asked about their use of GHB for sex, their experiences of GHB sex and their approaches to negotiating sexual boundaries. Data were analysed thematically. RESULTS Most participants valued the sexual possibilities enabled by disinhibitory components of GHB and were cognisant of respecting other's sexual boundaries in the context of GHB sex. Participants reported strategies to ensure communication prior to and throughout GHB sex. However, several participants narrated experiences of GHB sex that they felt were distressing and, in some circumstances, sexually violent. In most instances participant's resisted terminology of sexual violence or non-consent as descriptors of their experience and none reported accessing sexual violence services. CONCLUSION Positive strategies to facilitate sexual communication prior to and throughout GHB sex should be reflected in health promotion and service level responses to promote affirmative and continuous consent among people who use GHB for sex. Education initiatives to help people engaged in SDU to recognise and respond to sexual violence if it occurs ought to be prioritised.
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Freestone J, Prestage G, Bourne A, Ezard N, Race K, Nedanoski A, Murray J, Siefried KJ. Controlling for pleasure and risk: The experiences of sexuality and gender diverse people who use GHB. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 105:103747. [DOI: 10.1016/j.drugpo.2022.103747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/23/2022] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
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Sagoe D, Johnsen B, Lindblad B, Normann TAJ, Skogvoll V, Heierdal M, Lauritzen F. A Mixed-Method Evaluation of a Prison Anti-doping Intervention: The Hercules Prison Program. Front Sports Act Living 2022; 3:779218. [PMID: 35005620 PMCID: PMC8732770 DOI: 10.3389/fspor.2021.779218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022] Open
Abstract
The Norwegian Offender Mental Health and Addiction study denotes the need for physical activity and anti-doping interventions in Norwegian prisons. We developed and evaluated the efficacy of such intervention—the Hercules prison program. The program combines theoretical anti-doping lessons with practical strength training. The study adopts a mixed-methods approach (pretest-posttest design) comprising a longitudinal survey, observation, informal conversations, and in-depth interviews. Survey respondents were 104 male prisoners aged 18–56 (M = 34.81, SD = 9.34) years from seven Norwegian prisons. Of these, 52 provided both baseline and posttest responses. Participants completed questionnaires including demographic, doping use, and psychophysical items/measures. At the end of the intervention, in-depth interviews were conducted with 11 of the survey respondents. The survey data were analyzed using descriptive statistics, as well as independent and paired samples t-tests. The qualitative data were analyzed using Interpretative Phenomenological Analysis. A total of 7.5% and 33.3% of participants were current and former AAS users respectively, whereas 86.1% personally knew at least one current or former AAS user. Consistent with our expectation, there were increases in self-rated physical strength (t = −4.1, p < 0.001, d = 0.46) and strength training self-efficacy (t = −8.33, p < 0.001, d = 1.36), and a decrease in moral disengagement in doping (t = −4.05, p < 0.001, d = 0.52) from baseline to posttest. These findings are supported by the qualitative data. Notable success factors are relationship-building, instructors' expertise and acceptability, and gatekeepers' navigation and co-creation. The program provides valuable evidence of the potential benefits of combining anti-doping education with practical strength training in doping prevention in correctional settings.
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Affiliation(s)
- Dominic Sagoe
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Berit Johnsen
- University College of Norwegian Correctional Service (Kriminalomsorgens Høgskole og Utdanningssenter KRUS), Lillestrøm, Norway
| | - Bo Lindblad
- Department of Prevention and Public Health, Anti-doping Norway, Oslo, Norway
| | - Tom Are Jensen Normann
- University College of Norwegian Correctional Service (Kriminalomsorgens Høgskole og Utdanningssenter KRUS), Lillestrøm, Norway
| | - Vidar Skogvoll
- University College of Norwegian Correctional Service (Kriminalomsorgens Høgskole og Utdanningssenter KRUS), Lillestrøm, Norway
| | - Morten Heierdal
- Department of Prevention and Public Health, Anti-doping Norway, Oslo, Norway
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Petersen MA, Petersen IL, Poulsen C, Nørgaard LS. #studydrugs–Persuasive posting on Instagram. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 95:103100. [DOI: 10.1016/j.drugpo.2020.103100] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 12/07/2020] [Accepted: 12/28/2020] [Indexed: 12/23/2022]
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Treloar C, Hopwood M, Drysdale K, Lea T, Holt M, Dowsett GW, Aggleton P, Bryant J. Stigma as understood by key informants: A social ecological approach to gay and bisexual men's use of crystal methamphetamine for sex. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 94:103229. [PMID: 33774423 DOI: 10.1016/j.drugpo.2021.103229] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 03/07/2021] [Accepted: 03/14/2021] [Indexed: 11/16/2022]
Abstract
This paper explores the perceptions of 35 key informants (KIs) in a range of relevant health and community sectors regarding the stigmatisation of GBM's crystal methamphetamine use and sexual practice with view to informing stigma reduction efforts. A modified social ecological model was used to guide analysis and interpretation. At the individual level, KI participants indicated that crystal methamphetamine was used by some GBM to reduce the effects of internalised stigma. At the network level, KIs thought that some drugs and types of use could attract more stigma and that this could erode support from GBM networks for men who use crystal. KIs felt that few "mainstream" organisations could provide appropriate services for GBM who use crystal and furthermore, that there was significant work to "undo" misperceptions of the harms of crystal use. At the policy level, mass media anti-drug campaigns were seen to be a significant generator of stigma with irrelevant and patronising messages that lacked useful information. Efforts to reduce stigma about crystal methamphetamine use amongst GBM must address individual, network, organisation and policy issues and be underpinned by understandings of social power in relation to sex, sexuality, drug use, infectious status and sexual minorities.
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Affiliation(s)
- Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia.
| | - Max Hopwood
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Kerryn Drysdale
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Toby Lea
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Gary W Dowsett
- Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia
| | - Peter Aggleton
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Joanne Bryant
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
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Drysdale K, Bryant J, Dowsett GW, Lea T, Treloar C, Aggleton P, Holt M. Priorities and practices of risk reduction among gay and bisexual men in Australia who use crystal methamphetamine for sex. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 93:103163. [PMID: 33601217 DOI: 10.1016/j.drugpo.2021.103163] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 02/07/2023]
Abstract
Crystal methamphetamine (hereafter crystal) is associated with deleterious health outcomes, such as drug dependence and physical and mental health disorders. While some harms from crystal use can affect all users, there may be additional risks for people who combine the use of drug with sex. Compared with the broader population, gay and bisexual men in Australia report a higher prevalence of methamphetamine use, and crystal is the most commonly injected illicit drug among this population. The Crystal, Pleasures and Sex between Men research project was conducted between 2017 and 2019 and examined gay and bisexual men's crystal use in four capital cities in Australia, with the aim of identifying how to best support men who use crystal for sex. In this article, we examine how risk is understood and prioritised by gay and bisexual men who combine crystal use and sex and identify the range of risk reduction practices that they used. We classified these risks as those associated with the transmission of HIV, HCV and STIs, and those associated with dependence on either crystal or the sex it facilitated. Gay and bisexual men overwhelmingly prioritised the risk of dependence over any other risks associated with crystal-enhanced sex, and this prioritization was reflected in the risk reduction practices they employed. While some of the strategies that gay and bisexual men have adopted may contradict anticipated public health principles, they derive from a carefully considered and shared approaches to the generation of pleasure, the maintenance of a controlled form of feeling "out of control", and the negotiated reduction of risk. The consolidation of these strategies effectively constitutes a "counterpublic health" underpinned by forms of "sex-based sociality", which gives primacy to the priorities and practices of gay and bisexual men in Australia who combine crystal and sex.
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Affiliation(s)
- Kerryn Drysdale
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia; Health Equity Research and Development Unit, Sydney Local Health District & UNSW Sydney, Sydney, NSW, 2054, Australia.
| | - Joanne Bryant
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia
| | - Gary W Dowsett
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia; Australian Research Centre for Sex, Health and Society, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Toby Lea
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia
| | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia
| | - Peter Aggleton
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia
| | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia
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Bonny-Noach H, Shechory-Bitton M. Differences in substance use by sexual orientation and gender among Jewish young adults in Israel. Isr J Health Policy Res 2020; 9:52. [PMID: 33028401 PMCID: PMC7541271 DOI: 10.1186/s13584-020-00410-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 09/26/2020] [Indexed: 02/06/2023] Open
Abstract
Background This study focuses on sexual orientation and gender-based differences among Israeli young adult substance use behaviors. In addition, it evaluates young adult perception of substance use and acceptance of substances use by close friends. Methods We conducted a cross-sectional study. A self-reported anonymous questionnaire was distributed to a convenience sample of 496 young-adults (age: M = 23.14, SD = 2.48), which included 126 heterosexual males, 128 heterosexual females, 131 gay men, and 111 lesbians. Results This study revealed significant sexual orientation and gender differences in all outcomes examined. Significant substance usage differences were found for same-sex orientation as 52% reported cannabis use and 24% reported using other illegal substances during the past 12 months compared to 34 and 6% (respectively) among heterosexuals. Significant gender differences were found, as male participants reported 50% cannabis use and 19% reported other illegal substance use in the past 12 months compared to 35 and 11% (respectively) among females. Additionally, compared with heterosexuals, gay men and lesbians perceived/assessed significantly higher substance usage rates among their close friends and higher levels of substance use acceptance by close friends. Regression models indicated the important role of respondent perceived and acceptance of substance use among close friends. Binge drinking, cannabis use, and other illegal substance use were positively associated with participants’ perceived substance use and substance use acceptance level by close friends, after controlling for gender, sexual orientation, age, and level of education. Conclusions Close friends and community norms can play an important role in shaping substance usage among young adults, especially among gay men and lesbians. The results of the current study highlight the need for developing prevention and harm reduction drug policies for Israeli young adults, especially for gay men and lesbians. Interventions should also focus on young adult peers and community norms related to substance use by professionals in educational, policy-making, and therapeutic contexts.
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Abstract
Use of crystal methamphetamine (crystal) among gay and bisexual men (GBM) has been associated with condomless anal intercourse with casual partners (CLAIC) and HIV infection. Pre-exposure prophylaxis (PrEP) and undetectable viral load (UVL) are important biomedical HIV prevention strategies. We investigate the relationship between crystal use and HIV sexual risk behaviours in the context of PrEP and UVL. In 2018, 1367 GBM provided details about crystal use and HIV prevention strategies. Binary logistic regression was used to estimate associations between crystal use and behaviour. Recent crystal use was independently associated with greater social engagement with gay men and having more sexual partners. Crystal use was also independently associated with use of PrEP and UVL among GBM who engaged in CLAIC. Although GBM who used crystal were more likely to have engaged in CLAIC, they were also more likely to use biomedical HIV prevention which mitigates against the risks of HIV infection.
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Goodyear T, Mniszak C, Jenkins E, Fast D, Knight R. "Am I gonna get in trouble for acknowledging my will to be safe?": Identifying the experiences of young sexual minority men and substance use in the context of an opioid overdose crisis. Harm Reduct J 2020; 17:23. [PMID: 32228646 PMCID: PMC7106659 DOI: 10.1186/s12954-020-00365-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 03/13/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND North America and other parts of the globe are in the midst of a public health emergency related to opioid overdoses and a highly contaminated illicit drug supply. Unfortunately, there is a substantial gap in our understandings about how this crisis affects key populations not conventionally identified within overdose-related surveillance data. This gap is particularly pronounced for gay, bisexual, and other men who have sex with men (sexual minority men)-a population that experiences substance use-related inequities across adolescence and young adulthood. METHODS We draw on in-depth semi-structured interviews conducted in 2018 with a diverse sample (N = 50) of sexual minority men ages 15-30 who use substances and live in Vancouver, Canada, to identify how patterns and contexts of substance use are occurring in the context of the opioid overdose crisis. RESULTS Our analysis revealed three themes: awareness, perceptions, and experiences of risk; strategies to mitigate risk; and barriers to safer substance use. First, participants described how they are deeply impacted by the contaminated illicit drug supply, and how there is growing apprehension that fatal and non-fatal overdose risk is high and rising. Second, participants described how procuring substances from "trustworthy" drug suppliers and other harm reduction strategies (e.g., drug checking technologies, Naloxone kits, not using alone) could reduce overdose risk. Third, participants described how interpersonal, service-related, and socio-structural barriers (e.g., drug criminalization and the lack of a regulated drug supply) limit opportunities for safer substance use. CONCLUSIONS Equity-oriented policies and programming that can facilitate opportunities for safer substance use among young sexual minority men are critically needed, including community- and peer-led initiatives, access to low-barrier harm reduction services within commonly frequented social spaces (e.g., Pride, night clubs, bathhouses), nonjudgmental and inclusive substance use-related health services, the decriminalization of drug use, and the provision of a safe drug supply.
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Affiliation(s)
- Trevor Goodyear
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC, V6Z 2A9, Canada
- School of Nursing, University of British Columbia, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Caroline Mniszak
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC, V6Z 2A9, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Emily Jenkins
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Danya Fast
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC, V6Z 2A9, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Rod Knight
- British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC, V6Z 2A9, Canada.
- Department of Medicine, University of British Columbia, Vancouver, Canada.
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Drysdale K, Bryant J, Hopwood M, Dowsett GW, Holt M, Lea T, Aggleton P, Treloar C. Destabilising the 'problem' of chemsex: Diversity in settings, relations and practices revealed in Australian gay and bisexual men's crystal methamphetamine use. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 78:102697. [PMID: 32065931 DOI: 10.1016/j.drugpo.2020.102697] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/31/2020] [Accepted: 02/05/2020] [Indexed: 12/12/2022]
Abstract
In Australia, the crystalline form of methamphetamine ("crystal") is a commonly used illicit substance associated with sexual activity among gay and bisexual men. Attention to psychoactive substance use among this population is the subject of increasing global concern regarding the intentional and simultaneous combination of sex and drugs, often referred to as "chemsex". While not all gay and bisexual men who use psychoactive substances report problematic use, those who do often become representative of chemsex practices more generally, and the harms they experience become attributable to all men who use drugs for sex. The way in which these practices have been framed over the past few decades contributes to the rise of a narrow set of understandings of chemsex defined by the circumstances and behaviours presumed of drug-enhanced sexual activity. In effect, these understandings now align recognisable combinations of sexual and drug-using practices with assumed correlates of risk. The Crystal, Pleasures and Sex between Men study conducted 88 interviews with gay and bisexual men in four Australian cities between 2017 and 2018. Findings from the project revealed that men used crystal in a variety of settings and relations, which mediated their sexual practices and patterns of use. In looking at the wider context in which practices were associated with the combination of sex and drugs, we identified experiences that the contemporary discourse of chemsex-in its rhetorical proposition of at-risk behaviours and circumstances-may leave out of consideration. Our findings indicate that researchers should remain open to the variability and contingency of settings, relations and practices in gay and bisexual men's different networks when recommending public health responses to their engagement in drug-enhanced sexual activity. Accordingly, we seek to destabilise the definition of chemsex that precludes consideration of the influence of experiences beyond pre-determined risk parameters.
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Affiliation(s)
- Kerryn Drysdale
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2054, Australia.
| | - Joanne Bryant
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2054, Australia
| | - Max Hopwood
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2054, Australia
| | - Gary W Dowsett
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2054, Australia; Australian Research Centre for Sex, Health and Society, La Trobe University, Bundoora, VIC 3086, Australia
| | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2054, Australia
| | - Toby Lea
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2054, Australia
| | - Peter Aggleton
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2054, Australia
| | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2054, Australia
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15
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Abstract
Ecstasy (MDMA, Molly) is among the most prevalent drugs used by people who attend electronic dance music (EDM) events; however, little recent research has examined diffusion of ecstasy in this high-risk population. Methods: 1,020 EDM event-attending adults (aged 18-40) were surveyed in NYC in 2018 using time-spacing sampling. Participants were asked about past-year ecstasy use, and those reporting use were asked where they initiated use and whether their first use was planned. They were also asked whether they have ever given someone their first dose and whether they were likely to use in the future. Prevalence and correlates of these outcomes were estimated among those reporting past-year use. Results: An estimated 31.0% of participants used ecstasy in the past year. Of these, 42.9% used ecstasy for the first time in an unplanned manner and initiation most commonly occurred at EDM festivals (33.4%), followed by nightclubs (24.3%). An estimated 39.4% reported having given someone their first dose of ecstasy and 60.2% reported being likely to use again. Hispanic and Asian participants were at higher risk for their first dose being unplanned, and those who used LSD in the past year were at higher risk for giving someone their first dose (aPR = 1.78, 95% CI = 1.20-2.65). Older participants (aPR = 1.03, 95% CI = 1.01-1.06), females (aPR = 1.46, 95% CI = 1.13-1.89), and those who used LSD in the past year (aPR = 1.42, 95% CI = 1.14-1.76) were more likely to report being likely to use again in the future. Conclusions: Results provide insight regarding diffusion and initiation of ecstasy in the EDM scene. Findings can inform prevention and harm reduction efforts.
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Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
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16
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Hammoud MA, Bourne A, Maher L, Jin F, Haire B, Lea T, Degenhardt L, Grierson J, Prestage G. Intensive sex partying with gamma-hydroxybutyrate: factors associated with using gamma-hydroxybutyrate for chemsex among Australian gay and bisexual men - results from the Flux Study. Sex Health 2019; 15:123-134. [PMID: 29268075 DOI: 10.1071/sh17146] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 09/27/2017] [Indexed: 11/23/2022]
Abstract
Background Gamma-hydroxybutyrate (GHB) use among gay and bisexual men (GBM) has increased in recent years. It is commonly cited as a sexual-enhancement drug. There is, however, little evidence for factors associated with GHB use or the consequences of its use among GBM. AIM Factors associated with GHB use, its relationship to sexual risk behaviour, and the contexts, consequences, and motivations for its use were examined. METHODS The Following Lives Undergoing Change (Flux) Study is an online prospective observational study of Australian GBM. At baseline, a total of 3190 GBM provided details about their use of GHB. Data on frequency, methods, pleasures and consequences of their drug use, alongside key demographic variables were collected. RESULTS Mean age was 35.0 years. One in five men (19.5%) had a history of GHB use and 5.4% reported use within the past 6 months, with 2.7% having used it monthly or more frequently. Overdose had been experienced by 14.7%, this was more common among men who used GHB at least monthly. Being HIV-positive, having more gay friends, greater social engagement with gay men who use drugs, a greater number of sexual partners, group sex, and condomless anal intercourse with casual partners were independently associated with GHB use in the past 6 months. Greater social engagement with gay men who use drugs and group sex were independently associated with at least monthly use. More frequent GHB use was independently associated with experiencing overdose among GHB users. CONCLUSION Most men used GHB infrequently and it was often used explicitly to enhance sexual experiences, often in the context of intensive sex partying. Men who used GHB frequently, were at greater risk of overdose and other negative health outcomes. GHB use should be considered alongside other drugs that have been implicated in sexual risk behaviour and HIV transmission. Harm-reduction interventions need to consider the particular impact of frequent GHB use.
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Affiliation(s)
- Mohamed A Hammoud
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia
| | - Adam Bourne
- Australian Research Centre in Sex Health and Society, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia
| | - Lisa Maher
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia
| | - Fengyi Jin
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia
| | - Bridget Haire
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia
| | - Toby Lea
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Louisa Degenhardt
- The National Drug and Alcohol Research Centre, UNSW Sydney, 22-32 King St, Sydney, NSW 2052, Australia
| | - Jeffrey Grierson
- Anglia Ruskin University, Cambridge Campus. East Rd, Cambridge CB1 1PT, UK
| | - Garrett Prestage
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia
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17
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Race K, Lea T, Murphy D, Pienaar K. The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men. Sex Health 2019; 14:42-50. [PMID: 27712616 DOI: 10.1071/sh16080] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 08/03/2016] [Indexed: 11/23/2022]
Abstract
There are complex historical connections between sexual minoritisation and desires to chemically alter bodily experience. For gay men, drug and alcohol use can be a creative or experimental response to social marginalisation - and not necessarily a problematic one in every instance. Numerous studies have found that infection with HIV and other sexually transmissible infections (STIs) is more likely among gay and men who have sex with men (MSM) who use recreational drugs than those who do not, but the causal nature of these relations is uncertain. Sexualised drug use is associated with a range of other problems, including dependence, mental health issues, accident and overdose. A growing body of work in the Alcohol and Other Drugs (AOD) field demonstrates the action of drugs and their purported effects to be a product of their relations with various other actors, contexts and practices. Given these contingencies, it is impossible to predict the future of drugs or their effect on the sexual health of gay and MSM with any degree of certainty. This article outlines some of the conditions most likely to mediate such futures in the medium term. Public funding for lesbian, gay, bisexual, transgender and queer drug issues should not remain restricted to questions of HIV prevention and sexual health. It should be expanded to equip sexual health and AOD service providers with the cultural and sexual literacy to mitigate stigma and allow them to respond constructively to drug problems among sexual and gender minorities as a matter of priority.
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Affiliation(s)
- Kane Race
- Gender & Cultural Studies, University of Sydney, SOPHI A14, University of Sydney, Sydney, NSW 2006, Australia
| | - Toby Lea
- Centre for Social Research in Health, The University of New South Wales, John Goodsell Building, UNSW Australia, Sydney, NSW 2052, Australia
| | - Dean Murphy
- Centre for Social Research in Health, The University of New South Wales, John Goodsell Building, UNSW Australia, Sydney, NSW 2052, Australia
| | - Kiran Pienaar
- National Drug Research Institute, Curtin University, Suite 6, 19-35 Gertrude Street, Fitzroy, Vic. 3065, Australia
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18
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Ruckenstein M. Tracing medicinal agencies: Antidepressants and life-effects. Soc Sci Med 2019; 235:112368. [PMID: 31230763 DOI: 10.1016/j.socscimed.2019.112368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 06/06/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
This article is inspired by the social life of methods approach, joining a movement among social scientists engaging with 'big data' to contribute to methodological innovation and conceptual development in research and knowledge translation. It explores human-drug associations using a computational tool, Medicine Radar, meanwhile raising questions about the ways a digital device pushes us to rethink how drugs are known in the everyday. Medicine Radar is an apparatus for exploring human-drug associations by means of Suomi24 (Finland24) data, containing 19 million health-related online posts spanning a period of 16 years. Using defined markers, Medicine Radar sorts the medicine talk in health-related discussions, thereby assisting us to 'see' the actions of the drug and human responses to them. This kind of approach distances the drug from the illness experience, drawing attention to the private details of the human-drug relationship. The empirical analysis separates three areas of antidepressant use: articulations of reactions, stabilizing the life effects of drugs and coming to terms with antidepressants. Together, the online posts urge us to think of everyday experience where the effects of drugs - intended or unintended - are always lived. The side effects of antidepressants, including drowsiness, ravenous hunger, loss of sexual desire and emotional numbness, become life effects. As will be demonstrated, the move from conceptualizing such fallout as side effects to understanding them as life effects has political ramifications. The computation tool adds collective weight to antidepressant experiences and calls for politicizing their effects on life.
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Affiliation(s)
- Minna Ruckenstein
- Center for Consumer Society Research/Helsinki/Center for Digital Humanities, PO Box 24, 00014, University of Helsinki, Finland.
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19
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20
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Enghoff O, Aldridge J. The value of unsolicited online data in drug policy research. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 73:210-218. [PMID: 30711411 DOI: 10.1016/j.drugpo.2019.01.023] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/22/2018] [Accepted: 01/16/2019] [Indexed: 12/28/2022]
Abstract
We alert readers to the value of using unsolicited online data in drug policy research by highlighting web-based content relevant to drug policy generated by distinct types of actor: people who consume, supply or produce illicit drugs, online news websites and state or civil society organisations. These actors leave 'digital traces' across a range of internet platforms, and these traces become available to researchers to use as data - although they have not been solicited by researchers, and so have not been created specifically to fulfil the aims of research projects. This particular type of data entails certain strengths, limitations and ethical challenges, and we aim to assist researchers in understanding these by drawing on selected examples of published research using unsolicited online data that have generated valuable drug policy insights not possible using other traditional data sources. We argue for the continued and increased importance of using unsolicited online data so that drug policy scholarship keep pace with recent developments in the global landscape of drug policies and illicit drug practices.
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Affiliation(s)
- Oskar Enghoff
- School of Law, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom.
| | - Judith Aldridge
- School of Law, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom.
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21
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Lea T, Hammoud M, Bourne A, Maher L, Jin F, Haire B, Bath N, Grierson J, Prestage G. Attitudes and Perceived Social Norms toward Drug Use among Gay and Bisexual Men in Australia. Subst Use Misuse 2019; 54:944-954. [PMID: 30648480 DOI: 10.1080/10826084.2018.1552302] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Gay and bisexual men (GBM) report distinctive patterns and contexts of drug use, yet little has been published about their attitudes toward drug use. OBJECTIVES We developed measures of attitudes and perceived social norms toward drug use, and examined covariates of more accepting attitudes and norms among GBM in Australia. METHODS We analyzed baseline data from the Following Lives Undergoing Change (Flux) study. Flux is an online prospective observational study of drug use among Australian GBM. We used principal components factor analysis to generate two attitudinal scales assessing "drug use for social and sexual enhancement" and "perceptions of drug risk." A third perceived social norms scale examined "acceptability of drug use among gay friends." RESULTS Among 2,112 participants, 61% reported illicit drug use in the preceding six months. Stronger endorsement of drug use for social and sexual engagement and lower perceptions of drug risk were found among men who were more socially engaged with other gay men and reported regular drug use and drug use for sex. In multivariate analyses, all three scales were associated with recent drug use (any use in the previous six months), but only the drug use for social and sexual enhancement scale was associated with regular (at least monthly) use. CONCLUSIONS Drug use and sex are difficult to disentangle for some GBM, and health services and policies could benefit from a better understanding of attitudinal and normative factors associated with drug use in gay social networks, while recognizing the role of pleasure in substance use.
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Affiliation(s)
- Toby Lea
- a German Institute for Addiction and Prevention Research (DISuP) , Catholic University of Applied Sciences , North Rhine-Westphalia , Germany.,b Centre for Social Research in Health , UNSW Sydney , New South Wales , Australia
| | - Mohamed Hammoud
- c The Kirby Institute , UNSW Sydney , New South Wales , Australia
| | - Adam Bourne
- d Australian Research Centre in Sex , Health & Society, La Trobe University, Melbourne , Australia
| | - Lisa Maher
- c The Kirby Institute , UNSW Sydney , New South Wales , Australia
| | - Fengyi Jin
- c The Kirby Institute , UNSW Sydney , New South Wales , Australia
| | - Bridget Haire
- c The Kirby Institute , UNSW Sydney , New South Wales , Australia
| | - Nicky Bath
- e National LGBTI Health Alliance , Sydney , Australia
| | - Jeffrey Grierson
- f Faculty of Health, Social Care & Education , Anglia Ruskin University , Cambridge , UK
| | - Garrett Prestage
- c The Kirby Institute , UNSW Sydney , New South Wales , Australia
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22
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Bryant J, Hopwood M, Dowsett GW, Aggleton P, Holt M, Lea T, Drysdale K, Treloar C. The rush to risk when interrogating the relationship between methamphetamine use and sexual practice among gay and bisexual men. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 55:242-248. [DOI: 10.1016/j.drugpo.2017.12.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/01/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
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23
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Aldridge J, Stevens A, Barratt MJ. Will growth in cryptomarket drug buying increase the harms of illicit drugs? Addiction 2018; 113:789-796. [PMID: 28766792 PMCID: PMC5947707 DOI: 10.1111/add.13899] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 01/10/2017] [Accepted: 06/12/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIM Cryptomarkets-on-line, anonymous market-places for illicit goods and services that specialize mainly in drugs-account for a small but rapidly growing share of the illicit drug market in many countries. Policy responses so far are based generally on the assumption that their rise will only increase drug harms. In this contribution for debate, we question this assumption. METHODS We provide a narrative review of the emerging literature connected to drug cryptomarkets. We use MacCoun & Reuter's formula to understand the effect of population-level increases in use on total harm as depending on the level of harm associated with each unit of use. We then consider the potential for cryptomarkets to increase or decrease the harms and benefits related to each unit of drug use, with specific attention to the quality of drugs sold and the non-drug-related harms and benefits for customers. RESULTS It is likely that cryptomarkets will increase both the amount and the range of substances that are sold. However, we argue that the effects on harms will depend upon whether cryptomarkets also increase the quality and safety of products that are sold, provide harm-reducing information to consumers and reduce transactional conflict involved in drug purchasing. CONCLUSIONS There is an emerging and rapidly growing evidence base connected to the macro and micro harms and benefits of cryptomarkets for drug users. Future researchers should use appropriately matched comparative designs to establish more firmly the differential harms and benefits of sourcing drugs both on- and off-line. While it is unlikely that the on-line drug trade can be eradicated completely, cryptomarkets will respond to regulation and enforcement in ways that have complex, and sometimes unanticipated, effects on both harms and benefits.
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Affiliation(s)
| | - Alex Stevens
- School of Social Policy, Sociology and Social ResearchUniversity of Kent, CanterburyUK
| | - Monica J. Barratt
- Drug Policy Modelling ProgramNational Drug and Alcohol Research Centre, UNSWSydneyAustralia,National Drug Research Institute, Faculty of Health SciencesCurtin UniversityPerthAustralia,Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
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24
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Bui H, Zablotska-Manos I, Hammoud M, Jin F, Lea T, Bourne A, Iversen J, Bath N, Grierson J, Degenhardt L, Prestage G, Maher L. Prevalence and correlates of recent injecting drug use among gay and bisexual men in Australia: Results from the FLUX study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 55:222-230. [DOI: 10.1016/j.drugpo.2018.01.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/12/2018] [Accepted: 01/26/2018] [Indexed: 10/18/2022]
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25
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Duff C. “Charging” and “Blowing Out”: Patterns and Cultures of GHB Use in Melbourne, Australia. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/009145090503200406] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Recent increases in the use of gamma hydroxybutyrate (GHB) in club and rave settings have been associated with a series of acute health problems including overdose. Drawing upon research recently completed in Melbourne, Australia among a sample of young club and rave patrons, this article explores the knowledge, attitudes and related “risk-behaviors” of individuals who use GHB, as well as the various cultures and contexts surrounding its use. A mixed quantitative and qualitative research design was utilized, comprising a detailed survey (N=923) and semistructured interviews (N=24). Almost all survey respondents reported to have consumed illicit drugs in the past, with around half reporting “lifetime” use of GHB. A quarter reported using GHB in the past year. GHB related harms were widely reported with 22% of GHB users reporting to have overdosed on the drug at least once. The article closes with recommendations for GHB specific prevention and harm reduction strategies.
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26
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Abstract
Crystal methamphetamine is used by gay men in Sydney in a variety of social and sexual contexts and by various means including injection. This paper presents detailed ethnographic data that explore some of the social and cultural characteristics of Sydney gay men's crystal use and other associated practices. The meaning of these practices is explored through a discussion of cultural boundaries and social exchange that traverses them. These boundaries help to limit drug-related harms in some ways but also generate certain risks. A nuanced understanding of the cultural meaning of various drug use practices may assist in producing culturally relevant harm-reduction education.
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27
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Hickson F. Chemsex as edgework: towards a sociological understanding. Sex Health 2018; 15:102-107. [DOI: 10.1071/sh17166] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/22/2017] [Indexed: 11/23/2022]
Abstract
Sexual sessions between men, organised through mobile technologies and combined with stimulants intended to extend and intensify the session have been reified into the phenomena of ‘chemsex’. Understanding chemsex requires multiple levels of analysis and interpretation. This paper considers chemsex through the lens of edgework, a sociological category for voluntary risk taking identified in 1990 by Stephen Lyng. Edgework activities involve a clear and present danger to the self, intense emotions and sensations and an opportunity to exercise specialist skills. Using published research and other cultural products, this paper demonstrates that chemsex fully exhibits all the defining features of edgework. Chemsex is then positioned as an activity that epitomises the (gay) citizen as consumer in a technocapitalist age of pharmacopornographic consumption.
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28
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Hammoud MA, Jin F, Lea T, Maher L, Grierson J, Prestage G. Off-Label Use of Phosphodiesterase Type 5 Inhibitor Erectile Dysfunction Medication to Enhance Sex Among Gay and Bisexual Men in Australia: Results From the FLUX Study. J Sex Med 2017; 14:774-784. [PMID: 28583339 DOI: 10.1016/j.jsxm.2017.04.670] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/16/2017] [Accepted: 04/19/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Gay and bisexual men (GBM) use oral erectile dysfunction medications (EDMs) often with little evidence of medical indication necessitating their use. AIM To investigate the prevalence, contexts, and motivations for oral EDM use and its relation to sexual risk behavior. METHODS A total of 2,250 Australian GBM completed an online survey of licit and illicit drug use and their associated behaviors. Multivariate logistic regression analysis identified factors associated with use of EDMs in the previous 6 months and, for those who had used EDMs, factors associated with use on a weekly basis. OUTCOMES Any EDM use and at least weekly use in the previous 6 months. RESULTS The median age of the sample was 33.0 years (range = 16-81). Two thirds (67.7%) reported no lifetime history of EDM use. Approximately 1 in 10 participants (11.1%) had last used an EDM more than 6 months previously. In the previous 6 months, 11.5% reported using EDMs less than monthly, 5.3% reported using EDMs approximately monthly, and 4.5% reported using EDMs at least weekly. Of men who had used EDMs in the previous 6 months, common reasons cited for its use were to maintain an erection for longer (73.3%), to make it easier to "get hard" (67.3%), and difficulty in attaining or maintain an erection (53.5%). Use of EDMs in the previous 6 months was associated with illicit drug use and higher rates of sexual risk behavior. Weekly users were more likely to have severe anxiety than less frequent users. CLINICAL TRANSLATION The use of EDMs in the context of intensive sex partying, with the associated potential for increased risk of HIV transmission and illicit drug use, indicates a need to consider the use of EDMs among GBM in HIV prevention and minimizing harm. STRENGTHS AND LIMITATIONS This large-scale study of drug use among GBMs includes comprehensive detailed data on their history of use and rationales for use. Our online methodology potentially decreases social desirability bias in reporting illegal or stigmatized behaviors. This volunteer online convenience sample might not be representative of all GBMs in Australia. CONCLUSION GBMs who used an oral EDM in the previous 6 months often used it for recreational purposes, but many of those who used it on a weekly basis also might have used it for therapeutic reasons. GBMs often use EDMs to enhance their sexual experiences often in the context of intensive sex partying (which can include risky sexual behavior). Hammoud MA, Jin F, Lea T, et al. Off-Label Use of Phosphodiesterase Type 5 Inhibitor Erectile Dysfunction Medication to Enhance Sex Among Gay and Bisexual Men in Australia: Results From the FLUX Study. J Sex Med 2017;14:774-784.
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Affiliation(s)
- Mohamed A Hammoud
- The Kirby Institute, University of New South Wales, Kensington, NSW, Australia.
| | - Fengyi Jin
- The Kirby Institute, University of New South Wales, Kensington, NSW, Australia
| | - Toby Lea
- Centre for Social Research in Health, University of New South Wales, Kensington, NSW, Australia
| | - Lisa Maher
- The Kirby Institute, University of New South Wales, Kensington, NSW, Australia
| | | | - Garrett Prestage
- The Kirby Institute, University of New South Wales, Kensington, NSW, Australia
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29
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Mental health in non-heterosexuals: Minority stress theory and related explanation frameworks review. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.mhp.2016.10.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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30
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Exploring the social lives of image and performance enhancing drugs: An online ethnography of the Zyzz fandom of recreational bodybuilders. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 39:78-85. [DOI: 10.1016/j.drugpo.2016.08.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 08/26/2016] [Accepted: 08/29/2016] [Indexed: 11/23/2022]
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31
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Sharma R, Wigginton B, Meurk C, Ford P, Gartner CE. Motivations and Limitations Associated with Vaping among People with Mental Illness: A Qualitative Analysis of Reddit Discussions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 14:ijerph14010007. [PMID: 28025516 PMCID: PMC5295258 DOI: 10.3390/ijerph14010007] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 11/27/2016] [Accepted: 12/19/2016] [Indexed: 02/06/2023]
Abstract
This study aims to understand the nature and significance of online lay discussions about e-cigarettes and mental illness. We systematically searched the website Reddit.com using keywords related to e-cigarettes and mental illness. We coded relevant posts into themes under the framework of motivations for and limitations of vaping for people with mental illness. The thematic analysis included 3263 comments from 133 discussion threads. Six themes were classified as motivations to vape for people with mental illness: Self-medication; Quitting smoking; Freedom and control; Hobby; Social connectedness; and Motivation from caregivers and online communities. The limitations of vaping included: Unsatisfactory substitute for cigarettes and psychiatric medicines; Drug interactions; Nicotine addiction; Risks of e-liquid; Practical difficulties and Cost. People with mental illness; and their carers; use online discussion boards like Reddit to discuss the benefits and limitations of e-cigarettes for people with mental illness. Both positive and negative views exist. Media platforms like Reddit may shape the opinions of stakeholders and generate lay expertise about contentious health topics such as e-cigarettes. These findings have implications for policy and practice concerning assisting smokers with mental illness to reduce their health risk through switching to e-cigarettes.
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Affiliation(s)
- Ratika Sharma
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia.
| | - Britta Wigginton
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia.
| | - Carla Meurk
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia.
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, QLD 4018, Australia.
| | - Pauline Ford
- School of Dentistry, The University of Queensland, Herston, QLD 4006, Australia.
| | - Coral E Gartner
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia.
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32
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Abstract
Club drugs present a range of risks similar to the range of psychoactive effects resulting from the use of the substances in this classification. These drugs remain in wide use amongst those in rave and club subcultures. This paper explores a range of risk management practices used by youth who utilize club drugs within rave and club subcultures. Through the use of ethnographic methods during a two-year period of fieldwork, the author collected data on club drug use and risk taking among “Bridge and Tunnel” youth. The resulting paper provides a descriptive typology of a series of risk management practices and explores how these practices are strategically deployed in an effort to maximize enjoyment and minimize danger.
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33
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Fraser S. ‘It’s Your Life!’: Injecting Drug Users, Individual Responsibility and Hepatitis C Prevention. Health (London) 2016; 8:199-221. [PMID: 15068637 DOI: 10.1177/1363459304041070] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Health promotion materials on hepatitis C prevention and safe injecting enjoin injecting drug users to produce ethical selves through relatively rigid social and hygiene-related conduct. This article examines a sample of safe injecting and hepatitis C prevention health promotion materials, and interview data gathered from injecting drug users, to consider the ways in which the notion of individual responsibility functions within them. I argue that the primacy of the individual in western culture is indeed reflected in hepatitis C and safe injecting materials and, that for a range of reasons, injecting drug users also make use of notions of individual responsibility. The article concludes by considering the social and health implications of this individualist approach to injecting drug use and health promotion, and by suggesting ways in which effective materials which do not focus solely on the individual can be created.
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Affiliation(s)
- Suzanne Fraser
- National Centre in HIV Social Research, Sydney, NSW 2052, Australia.
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Bancroft A, Scott Reid P. Concepts of illicit drug quality among darknet market users: Purity, embodied experience, craft and chemical knowledge. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 35:42-9. [PMID: 26777135 DOI: 10.1016/j.drugpo.2015.11.008] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/30/2015] [Accepted: 11/20/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Users of darknet markets refer to product quality as one of the motivations for buying drugs there, and vendors present quality as a selling point. However, what users understand by quality and how they evaluate it is not clear. This article investigates how users established and compared drug quality. METHODS We used a two-stage method for investigating users' assessments. The user forum of a darknet market that we called 'Merkat' was analysed to develop emergent themes. Qualitative interviews with darknet users were conducted, then forum data was analysed again. To enhance the applicability of the findings, the forum was sampled for users who presented as dependent as well as recreational. RESULTS Quality could mean reliability, purity, potency, and predictability of effect. We focused on the different kinds of knowledge users drew on to assess quality. These were: embodied; craft; and chemical. CONCLUSION Users' evaluations of quality depended on their experience, the purpose of use, and its context. Market forums are a case of indigenous harm reduction where users share advise and experiences and can be usefully engaged with on these terms.
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Sexual identity and prevalence of alcohol and other drug use among Australians in the general population. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 28:76-82. [PMID: 26691433 DOI: 10.1016/j.drugpo.2015.11.005] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 11/03/2015] [Accepted: 11/09/2015] [Indexed: 01/15/2023]
Abstract
BACKGROUND International research assessing differences in the prevalence of alcohol and other drug (AOD) use among Lesbian Gay Bisexual and Transgender (LGBTI) and heterosexual populations shows elevated prevalence rates of substance use among LGBTI people. To date no research has been published investigating these differences at a population level among both men and women in Australia. METHODS The 2013 National Drug Strategy Household Survey, a multistage stratified population sample collecting data on AOD use in the Australian population over 14 years of age, was analysed for differences between gay and bisexual (GB) men and lesbian/gay and bisexual (LGB) women and their heterosexual counterparts in: (1) the prevalence of lifetime and past year tobacco and AOD use; (2) age of initiation of tobacco and AOD use; and (3) frequency of alcohol and cannabis use, and history of AOD treatment. RESULTS There were elevated rates of past year cannabis (22.4%), ecstasy (11.8%) and methamphetamine (9.7%) use among GB men compared to heterosexual men (12.4%, 2.9% and 2.5%). LGB women also reported elevated rates of past year use (tobacco - 23.7%; cannabis - 24.6%) compared to heterosexual women (10.6% and 7.1%). LGB women initiated tobacco (15.2 years) and alcohol (15.5 years) at an earlier age than heterosexual women (16.6 and 17.7 years), and were significantly more likely to report daily alcohol consumption (OR 3.2, 95% CI: 2.1, 5.1), and weekly or more frequent cannabis use (OR 1.7, 95%CI: 1.1, 3.1). CONCLUSIONS These findings are indicative of the need for more responsive and targeted AOD harm reduction and treatment services for LGBTI communities in Australia. Of concern is the elevated risk among LGB women for earlier initiation of substance use, and the development of problematic consumption patterns. Further research, investigating the risk and protective factors for AOD use among LGB women is warranted.
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Lea T, Hopwood M, Aggleton P. Hepatitis C knowledge among gay and other homosexually active men in Australia. Drug Alcohol Rev 2015; 35:477-83. [PMID: 26369759 DOI: 10.1111/dar.12333] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/13/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS Gay and other homosexually active men (hereafter 'gay men') are at elevated risk of becoming infected with hepatitis C virus (HCV) via injecting drug use and sexual risk practices. This paper aimed to measure HCV knowledge among gay men in Australia and whether knowledge differed according to HCV risk. DESIGN AND METHODS In 2013, a cross-sectional, online survey of 405 Australian gay men explored the social aspects of HCV. Bivariate and multivariate linear regressions were used to examine factors associated with higher HCV knowledge. RESULTS The mean age of respondents was 39.2 years (SD = 13.3), and most men (75.3%) were born in Australia. According to self-report, 32.1% were HIV-positive, 3.0% were HCV-positive and 8.9% were HIV/HCV co-infected. The mean number of correct HCV knowledge items was 8.2 (SD = 3.9; range 0-15). In a multivariate analysis, higher HCV knowledge was associated with higher educational attainment, being HCV-positive, being HIV-positive and injecting drug use. DISCUSSION AND CONCLUSIONS HCV knowledge among gay men was moderately good, although knowledge of testing, treatment and natural history of HCV was generally quite poor. Encouragingly, higher knowledge was reported among men at highest HCV risk. Viral hepatitis and HIV organisations, together with general practitioners and other health services, should continue to target gay men at a high risk of acquiring HCV with education and health promotion. [Lea T, Hopwood M, Aggleton P. Hepatitis C knowledge among gay and other homosexually active men in Australia. Drug Alcohol Rev 2016;35:477-483].
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Affiliation(s)
- Toby Lea
- Centre for Social Research in Health, UNSW Australia (The University of New South Wales), Sydney, Australia
| | - Max Hopwood
- Centre for Social Research in Health, UNSW Australia (The University of New South Wales), Sydney, Australia
| | - Peter Aggleton
- Centre for Social Research in Health, UNSW Australia (The University of New South Wales), Sydney, Australia
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Wilson H, Bryant J, Ellard J, Howard J, Treloar C. Sexual identity and its relationship to injecting in a sample of disadvantaged young drug users. Drug Alcohol Rev 2015; 35:218-22. [DOI: 10.1111/dar.12281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 04/06/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Hannah Wilson
- Centre for Social Research in Health, Faculty of Arts and Social Sciences; University of New South Wales; Sydney Australia
| | - Joanne Bryant
- Centre for Social Research in Health, Faculty of Arts and Social Sciences; University of New South Wales; Sydney Australia
| | - Jeanne Ellard
- The Australian Research Centre in Sex, Health and Society, Faculty of Health Sciences; La Trobe University; Melbourne Australia
| | - John Howard
- National Drug and Alcohol Research Centre, Faculty of Medicine; University of New South Wales; Sydney Australia
| | - Carla Treloar
- Centre for Social Research in Health, Faculty of Arts and Social Sciences; University of New South Wales; Sydney Australia
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Marshall Z, Dechman MK, Minichiello A, Alcock L, Harris GE. Peering into the literature: A systematic review of the roles of people who inject drugs in harm reduction initiatives. Drug Alcohol Depend 2015; 151:1-14. [PMID: 25891234 DOI: 10.1016/j.drugalcdep.2015.03.002] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 02/20/2015] [Accepted: 03/01/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND People who inject drugs have been central to the development of harm reduction initiatives. Referred to as peer workers, peer helpers, or natural helpers, people with lived experience of drug use leverage their personal knowledge and skills to deliver harm reduction services. Addressing a gap in the literature, this systematic review focuses on the roles of people who inject drugs in harm reduction initiatives, how programs are organized, and obstacles and facilitators to engaging people with lived experience in harm reduction programs, in order to inform practice and future research. METHODS This systematic review included searches for both peer reviewed and gray literature. All titles and abstracts were screened by two reviewers. A structured data extraction tool was developed and utilized to systematically code information concerning peer roles and participation, program characteristics, obstacles, and facilitators. RESULTS On the basis of specific inclusion criteria 164 documents were selected, with 127 peer-reviewed and 37 gray literature references. Data extraction identified key harm reduction program characteristics and forms of participation including 36 peer roles grouped into five categories, as well as obstacles and facilitators at systemic, organizational, and individual levels. CONCLUSIONS Research on harm reduction programs that involve people with lived experience can help us better understand these approaches and demonstrate their value. Current evidence provides good descriptive content but the field lacks agreed-upon approaches to documenting the ways peer workers contribute to harm reduction initiatives. Implications and ten strategies to better support peer involvement in harm reduction programs are identified.
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Affiliation(s)
- Z Marshall
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, Health Sciences Centre, 300 Prince Philip Drive, St. John's, NL, Canada A1B 3V6.
| | - M K Dechman
- Department of Anthropology and Sociology, Cape Breton University, PO Box 5300, 1250 Grand Lake Road, Sydney, NS, Canada B1P 6L2.
| | - A Minichiello
- Department of Anthropology and Sociology, Cape Breton University, PO Box 5300, 1250 Grand Lake Road, Sydney, NS, Canada B1P 6L2.
| | - L Alcock
- Health Sciences Library, Memorial University, St John's, NL, Canada A1B 3V6.
| | - G E Harris
- Faculty of Education, G. A. Hickman Building, Memorial University, St. John's, NL, Canada A1B 3X8.
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Lea T, de Wit J, Reynolds R. "Post-Gay" Yet? The Relevance of the Lesbian and Gay Scene to Same-Sex Attracted Young People in Contemporary Australia. JOURNAL OF HOMOSEXUALITY 2015; 62:1264-1285. [PMID: 25927352 DOI: 10.1080/00918369.2015.1037139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In recent years, the lesbian and gay "scene" of bars, nightclubs, and dance parties has been undergoing a structural decline in many Western cities. This article aimed to examine the relevance of the scene to same-sex attracted young adults amid these changes. An online survey was conducted with 572 same-sex attracted young women and men in Sydney. Only a minority of respondents participated in the scene at least weekly (16%), and the majority did not regard the scene as important to their leisure time (60%). However, respondents valued the scene as a space to connect with other same-sex attracted people and display same-sex affection without fear of hostility. Lesbian and gay identified respondents tended to be more socially engaged with the scene compared to other same-sex attracted respondents. The findings suggest that while the scene continues to be valued by many same-sex attracted young people, improved social attitudes have made participating in the scene less of an imperative.
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Affiliation(s)
- Toby Lea
- a Centre for Social Research in Health , UNSW Australia , Sydney , Australia
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40
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Van Hout MC, Hearne E. “Word of Mouse”: Indigenous Harm Reduction and Online Consumerism of the Synthetic Compound Methoxphenidine. J Psychoactive Drugs 2015; 47:30-41. [DOI: 10.1080/02791072.2014.974002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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41
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Hopwood M, Lea T, Aggleton P. Multiple strategies are required to address the information and support needs of gay and bisexual men with hepatitis C in Australia. J Public Health (Oxf) 2015; 38:156-62. [PMID: 25626415 DOI: 10.1093/pubmed/fdv002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) infection is increasingly reported among gay and bisexual men. However, little is known about the personal and social dimensions of HCV-related experience among these men in Australia. METHODS An online survey of 474 Australian gay and bisexual men was conducted from August to December 2013. A subsample of 48 HCV mono-infected and HIV/HCV co-infected men was analysed to explore HCV knowledge, sources of information, unmet information needs and use of HCV-related services. RESULTS More than half of respondents in the subsample were unaware that HIV infection increases the risk of sexually acquired HCV and most wanted information about how to prevent the sexual transmission of HCV. A majority of respondents requested gay-specific HCV services, and approximately similar proportions of men indicated that they would like these services delivered by a hepatitis organization, a lesbian, gay, bisexual, transgender and intersex (LGBTI) organization and a HIV organization. Men in receipt of HIV antiretroviral treatments were most likely to request that gay-specific HCV information and support services be delivered by a LGBTI or HIV organization (OR = 8.63). CONCLUSION These findings suggest that a variety of organizations are required to address the information and support needs of Australian gay and bisexual men with HCV.
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Affiliation(s)
- Max Hopwood
- Centre for Social Research in Health, University of New South Wales Australia, Sydney 2052, Australia
| | - Toby Lea
- Centre for Social Research in Health, University of New South Wales Australia, Sydney 2052, Australia
| | - Peter Aggleton
- Centre for Social Research in Health, University of New South Wales Australia, Sydney 2052, Australia
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Nod and wave: An Internet study of the codeine intoxication phenomenon. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:67-77. [DOI: 10.1016/j.drugpo.2014.06.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 06/18/2014] [Accepted: 06/23/2014] [Indexed: 11/21/2022]
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43
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Van Hout MC, Hearne E. Confessions of contemporary English opium-eaters: a netnographic study of consumer negotiation of over-the-counter morphine for misuse. JOURNAL OF SUBSTANCE USE 2014. [DOI: 10.3109/14659891.2014.980861] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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44
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Hopwood M, Lea T, Aggleton P. Drug, sex and sociality: factors associated with the recent sharing of injecting equipment among gay and bisexual men in Australia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2014; 26:210-3. [PMID: 25480395 DOI: 10.1016/j.drugpo.2014.10.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 09/16/2014] [Accepted: 10/31/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Max Hopwood
- Centre for Social Research in Health, UNSW-Australia, Sydney 2052, Australia.
| | - Toby Lea
- Centre for Social Research in Health, UNSW-Australia, Sydney 2052, Australia
| | - Peter Aggleton
- Centre for Social Research in Health, UNSW-Australia, Sydney 2052, Australia
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45
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Duff C, Moore D. Counterpublic health and the design of drug services for methamphetamine consumers in Melbourne. Health (London) 2014; 19:51-66. [DOI: 10.1177/1363459314530740] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article is interested in how notions of the ‘public’ are conceived, marshalled and enacted in drug-treatment responses to methamphetamine use in Melbourne, Australia. After reviewing qualitative data collected among health-care providers and methamphetamine consumers, we draw on the work of Michael Warner to argue that services for methamphetamine consumers in Melbourne betray ongoing tensions between ‘public’ and ‘counterpublic’ constituencies. Our analysis indicates that these tensions manifest in two ways: in the management of ‘street business’ in the delivery of services and in negotiating the meaning of health and the terms of its restoration or promotion. Reflecting these tensions, while the design of services for methamphetamine consumers is largely modelled on public health principles, the everyday experience of these services may be more accurately characterised in terms of what Kane Race has called ‘counterpublic health’. Extending Race’s analysis, we conclude that more explicit focus on the idea of counterpublic health may help local services engage with methamphetamine consumers in new ways, providing grounds for novel outreach, harm-reduction and treatment strategies.
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Deacon RM, Mooney-Somers J, Treloar C, Maher L. At the intersection of marginalised identities: lesbian, gay, bisexual and transgender people's experiences of injecting drug use and hepatitis C seroconversion. HEALTH & SOCIAL CARE IN THE COMMUNITY 2013; 21:402-410. [PMID: 23465052 DOI: 10.1111/hsc.12026] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/07/2012] [Indexed: 06/01/2023]
Abstract
Although the levels of injecting drug use among lesbian, gay, bisexual and transgender (LGBT) populations are high, we know little about their experiences of injecting drugs or living with hepatitis C virus (HCV) infection. The loss of traditional family and cultural ties means connection to community is important to the well-being of LGBT populations. Although some kinds of drug use are normalised within many LGBT communities, injecting drug use continues to be stigmatised. This exploratory qualitative study of people with newly acquired HCV used semi-structured interviews to explore participants' understandings and awareness of HCV, seroconversion, testing, diagnosis and treatment. We present a secondary thematic analysis of eight LGBT participants of the experience of injecting drugs, living with HCV and having a marginalised sexual or gender identity. Community was central to the participants' accounts. Drug use facilitated connection to a chosen community by suppressing sexual or gender desires allows them to fit in to the mainstream; enacting LGBT community norms of behaviour; and connection through shared drug use. Participants also described feeling afraid to come out about their drug use to LGBT peers because of the associated stigma of HCV. They described a similar stigma associated with HIV within the people who inject drugs (PWID) community. Thus, the combination of being LGBT/living with HIV (a gay disease) and injecting drugs/living with HCV (a junkie's disease) left them in a kind of no-man's-land. Health professionals working in drug and HCV care services need to develop capacity in providing culturally appropriate health-care for LGBT PWID.
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Affiliation(s)
- Rachel M Deacon
- The Kirby Institute, The University of New South Wales, Sydney, NSW, Australia.
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Injecting drug use among gay and bisexual men in Sydney: prevalence and associations with sexual risk practices and HIV and hepatitis C infection. AIDS Behav 2013; 17:1344-51. [PMID: 23321949 DOI: 10.1007/s10461-013-0409-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Injecting drug use is commonly reported among gay and bisexual men in Australia. We examined the prevalence and covariates of injecting drug use among men participating in the Sydney Gay Community Periodic Survey between 2004-06 and 2011. In 2004-06, data was collected about which drugs were injected, while in 2011, data was collected about hepatitis C (HCV) and esoteric sexual practices. In 2004-06, 5.6 % of men reported injecting drugs in the previous 6 months; 3.4 % reported methamphetamine injection and 0.4 % heroin injection. In 2011, men who injected drugs were less likely to be employed full-time, and more likely to be HCV-positive, HIV-positive, to have used party drugs for sex, and to have engaged in esoteric sexual practices. The strong associations between injecting drug use, sexual risk practices and blood-borne virus infection suggests the need for combined sexual health and harm reduction services for gay and bisexual men who inject drugs.
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48
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Lea T, Reynolds R, de Wit J. Alcohol and club drug use among same-sex attracted young people: associations with frequenting the lesbian and gay scene and other bars and nightclubs. Subst Use Misuse 2013; 48:129-36. [PMID: 23127199 DOI: 10.3109/10826084.2012.733904] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study aimed to determine whether the lesbian and gay "scene" of bars and nightclubs is a more common site for club drug use than other bars and clubs. A cross-sectional, online survey was conducted with 254 same-sex attracted women and 318 men aged 18-25 in Sydney, Australia. Drug use was more likely in those who attended any venue type more frequently. Men, but not women, were more likely to report drug use in lesbian and gay venues than other venues. Club drug use may be more normalized within the lesbian and gay scene than elsewhere, particularly among young men. The study's limitations are noted.
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Affiliation(s)
- Toby Lea
- National Centre in HIV Social Research, The University of New South Wales, Sydney, Australia.
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49
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Lea T, Prestage G, Mao L, Zablotska I, de Wit J, Holt M. Trends in drug use among gay and bisexual men in Sydney, Melbourne and Queensland, Australia. Drug Alcohol Rev 2012; 32:39-46. [DOI: 10.1111/j.1465-3362.2012.00494.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 07/10/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Toby Lea
- National Centre in HIV Social Research; The University of New South Wales; Sydney; Australia
| | - Garrett Prestage
- The Kirby Institute; The University of New South Wales; Sydney; Australia
| | - Limin Mao
- National Centre in HIV Social Research; The University of New South Wales; Sydney; Australia
| | - Iryna Zablotska
- The Kirby Institute; The University of New South Wales; Sydney; Australia
| | - John de Wit
- National Centre in HIV Social Research; The University of New South Wales; Sydney; Australia
| | - Martin Holt
- National Centre in HIV Social Research; The University of New South Wales; Sydney; Australia
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50
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Fisher DG, Wilson H, Bryant J. Harm reduction knowledge and information exchange among secondary distributors in Sydney, Australia. DRUGS-EDUCATION PREVENTION AND POLICY 2012. [DOI: 10.3109/09687637.2012.687793] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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