Party and Play in the Closet? Exploring Club Drug Use Among Swedish Men Who Have Sex With Men

Background: Men who have sex with men (MSM) is a population that is less frequently the target of drug research in a Scandinavian context. Objectives: This study aims to explore: (1) the existence of club drug use among a sample of Swedish MSM, and (2) associations between club drug use and sociodemographic, sociosexual, and sexual risk behavior. Methods: Data were drawn from a larger European study on MSM and HIV but the analytic sample consisted of the 3,004 MSM who resided in Sweden. SPSS 20.0 statistical software was used to perform the analysis. The primary outcome variable was a dichotomous measure of having used club drugs in the past 12 months vs. not. The independent variables were categorized into three domains, sociodemographic, sociosexual, and sexual risk behavior. The analysis was undertaken as a univariable analysis. Results: Results show that club drug use exists in the Swedish MSM population and is particularly prevalent among gay identified, younger MSM from metropolitan areas, and among men with diagnosed HIV or other STIs. Moreover, club drug use was common among the men that had more sexual partners and took more sexual risks. These men were also more likely to have been diagnosed with an STI. Conclusions/Importance: MSM who use club drugs have to be acknowledged in the Swedish drug policy context, as well as within clinical practice. Further research is needed to develop an understanding of the social and contextual dimensions involved in club drug use among Swedish MSM.     

Injection and sexual risk practices among young heroin users in Hanoi,Vietnam

Abstract

Epidemiological data in Vietnam shows high HIV prevalence rates among injection drug users, especially in urban centres. However, there are limited data on specific practices used to prepare and inject drugs or on sexual practices among Vietnamese injectors. A street-based cross-sectional interview was conducted with 862 heroin injectors in Hanoi, Vietnam, to collect such data. Variability was seen in both injection and sexual risk, with 12.9% of current injectors reporting at least one unsafe method of drug sharing and 57.1% reporting unsafe sex in the past 30 days. These risks were strongly associated with those who engaged in unsafe injection significantly more likely to engage in unsafe sex (69.4% vs. 55.3%) and those engaging in unsafe sex significantly more likely to engage in unsafe injection (15.7% vs. 9.2%). These findings highlight the overlap of injection and sexual risk practices among Vietnamese heroin users and suggest the need for strong, broadly targeted HIV prevention activities among this population.     

The rise of Viagra among British illicit drug users: 5-year survey data

Viagra use among British nightclubbers, a sentinel population of illicit drug users, was first reported in 1999. There has since been little attention paid to the evolution of patterns of non-prescribed use, apart from among men who have sex with men. Beginning in 1999 an annual survey has been conducted with a specialist dance music magazine, permitting cross-sectional comparisons over time. Rising levels of lifetime and current use prevalence and data on patterns of both male and female use are reported, along with elevated prevalence levels among both gay men and women. Experimentation with Viagra appears increasingly to have become established among British nightclubbers who use recreational drugs. Ethnographic and epidemiological study and monitoring of adverse consequences is now needed to fully appreciate reasons for use and the extent of possible harms. [McCambridge J, Mitcheson L, Hunt N, Winstock A. The rise of Viagra among British illicit drug users: 5-year survey data. Drug Alcohol Rev 2006;25:111 - 113]     

Problem Solving Reduces Sexual Risk Associated with Sensation Seeking,Substance Use,and Depressive Symptoms Among African-American Adolescents

African-American adolescents experience higher rates of sexually transmitted infections (STIs) compared to same-age Caucasian peers. Substance use, sensation seeking, and depression have all been linked to risky sexual practices. Theory suggests that problem-solving skills may help to buffer against these risk factors. To test this hypothesis, we used data from African-American adolescents (N?=?1,018; M age?=?16.7, SD?=?1.1; 58% female) who participated in a prevention trial. Nearly half of the sample (47%) reported lifetime marijuana use, while 13% reported drug use prior to most recent sexual encounter. Sexual sensation seeking was directly associated with drug use prior to sex (β?=?1.13, b?=?0.13, SE?=?0.02, p?<?.001) and lower problem-solving skills (β?=?–0.08, b?=?–0.06, SE?=?0.02, p = .01). Problem-solving skills were associated with drug use prior to sex (β?=?0.92, b?=??0.08, SE?=?0.03, p?=?.004), such that those with greater problem-solving skills were less likely to report drug use prior to most recent sex. Finally, problem-solving skills mediated the association between sexual sensation seeking and drug use prior to sex, although the effect was small (β?=?0.01, 95% CI: .001, .01). Problem-solving skills can have a protective influence on risky behavior for adolescents. Future research might examine the utility of strengthening problem-solving skills in order to reduce STI/HIV risk among African-American adolescents.     

Structure and measurement of dimensions of risk for HIV transmission in injecting drug users

Dimensions of HIV infection risks were investigated in 1,245 injecting drug users (IDUs) in Sydney, Australia. Factor analysis of the degree of risk of the 33 items of risk behaviours revealed ten dimensions, which covered the domains of oral sex, withdrawal before ejaculation, protected intercourse, unprotected vaginal intercourse, saliva, blood products, manual sex, needles and syringes, unprotected anal sex, and social transmission. The perceived riskiness of particular activities closely approximated the objectively assessed risk of particular practices. Women assessed the risks of classes of activities (with the exception of oral sex) as being higher than did men. IDUs appear to have readily interpretable and consistent perceptions of HIV transmission risks, and these dimensions have utility for measuring perception and knowledge of HIV transmission risks.     

Association Between Using Smartphone Dating Applications and Alcohol and Recreational Drug Use in Conjunction With Sexual Activities in College Students

Background: The association between using smartphone dating applications (apps) and substance use in conjunction with sexual activities was only examined in homosexual men. This association was poorly understood in heterosexual samples. Objective: To explore the association between using dating apps and alcohol, and use of recreational drug in conjunction with sexual activities in college students. Design: 666 students from four universities in Hong Kong were recruited in this cross-sectional study in the year 2015. Outcome measures included the use of dating apps, sexual history, and drug and alcohol use. Multivariable logistic regressions were employed. Results: The use of dating apps for more than 1 year was found to be associated with recreational drug use in conjunction with sexual activities (adjusted odds ratio: 7.23). Other risk factors of recreational drug use in conjunction with sexual activities included being bisexual/homosexual male, a smoker, and having one's first sexual intercourse at the age of less than 16 years. The use of dating apps was not a risk factor for alcohol consumption in conjunction with sexual activities. Risk factors for alcohol consumption in conjunction with sexual activities included being older, having monthly income more than HKD5,000, and a smoker. Furthermore, risk factors for alcohol consumption in conjunction with the last sexual activity included currently being in a dating relationship, a smoker, and having sex with a casual partner. Conclusions: Using dating apps is an emerging risk factor of drug misuse. Interventions for practising safe sex and preventing drug use should be targeted at dating app users.     

Hook-Up Sexual Experiences and Problem Behaviors Among Adolescents

This study focuses on the sexual phenomenon of “hooking up.” A hook-up is defined as a single sexual encounter that may or may not include sexual intercourse with someone who is a stranger, brief acquaintance, or friend. The aim of this study was to document the prevalence of hook-ups in a sample of 1,011 urban middle and high school students and to examine the relationship between hooking up and a variety of problem behaviors, including, alcohol, cigarette, and/or illicit drug use, truancy, and school suspensions. The results revealed that 28% of the sample had engaged in at least one hook-up experience, and this percentage increased with age. Hook-ups were correlated moderately with all problem behaviors examined.     

Lifetime Doctor-Diagnosed Mental Health Conditions and Current Substance Use Among Gay and Bisexual Men Living in Vancouver,Canada

Background: Studies have found that gay, bisexual, and other men who have sex with men (GBM) have higher rates of mental health conditions and substance use than heterosexual men, but are limited by issues of representativeness. Objectives: To determine the prevalence and correlates of mental health disorders among GBM in Metro Vancouver, Canada. Methods: From 2012 to 2014, the Momentum Health Study recruited GBM (≥16 years) via respondent-driven sampling (RDS) to estimate population parameters. Computer-assisted self-interviews (CASI) collected demographic, psychosocial, and behavioral information, while nurse-administered structured interviews asked about mental health diagnoses and treatment. Multivariate logistic regression using manual backward selection was used to identify covariates for any lifetime doctor diagnosed: (1) alcohol/substance use disorder and (2) any other mental health disorder. Results: Of 719 participants, 17.4% reported a substance use disorder and 35.2% reported any other mental health disorder; 24.0% of all GBM were currently receiving treatment. A lifetime substance use disorder diagnosis was negatively associated with being a student (AOR = 0.52, 95% CI [confidence interval]: 0.27–0.99) and an annual income ≥$30,000 CAD (AOR = 0.38, 95% CI: 0.21–0.67) and positively associated with HIV-positive serostatus (AOR = 2.54, 95% CI: 1.63–3.96), recent crystal methamphetamine use (AOR = 2.73, 95% CI: 1.69–4.40) and recent heroin use (AOR = 5.59, 95% CI: 2.39–13.12). Any other lifetime mental health disorder diagnosis was negatively associated with self-identifying as Latin American (AOR = 0.25, 95% CI: 0.08–0.81), being a refugee or visa holder (AOR = 0.18, 95% CI: 0.05–0.65), and living outside Vancouver (AOR = 0.52, 95% CI: 0.33–0.82), and positively associated with abnormal anxiety symptomology scores (AOR = 3.05, 95% CI: 2.06–4.51). Conclusions: Mental health conditions and substance use, which have important implications for clinical and public health practice, were highly prevalent and co-occurring.     

Behavior Change and Health-Related Interventions for Heterosexual Risk Reduction Among Drug Users

Prevention of heterosexual transmission of HIV between and from drug users is important for controlling the local and global HIV heterosexual epidemic. Sex risk reduction interventions and health-related interventions are important for reducing the sex risk behaviors of drug users. Sex risk reduction interventions address individual-level, peer-level, and structural-level determinants of risk reduction. Health-related interventions include HIV counseling and testing, prevention and treatment of sexually transmitted diseases, and delivery of highly active antiretroviral therapy. It is important to adapt effective interventions implemented in resource-rich countries to the realities of the resource-constrained settings and to address relevant contextual factors.     

2009年至2011年儿童医院抗菌药物应用分析

目的为医院合理应用和科学管理抗菌药物提供参考。方法采用金额排序法和用药频度排序法,对医院抗菌药物应用情况进行统计、分析。结果抗菌药物用药金额占药品消耗总金额比例依次为37.74%,36.91%,33.07%,用药金额逐年下降,主要以头孢菌素类和β-内酰胺酶复方制剂为主。结论该院抗菌药物的应用存在一些问题,应规范管理。     

Sexual Behaviors Linked to Drug and Alcohol Use Among Men Who Have Sex With Men in China

Background: High-risk sexual behaviors drive the HIV epidemic among men who have sex with men (MSM). Alcohol consumption and use of club drugs may increase sexual risk behaviors. We evaluated effects of drug and alcohol use on sexual behaviors with both their male and female partners as well as on HIV and syphilis infections among MSM in China. Methods: As the part of a community randomized clinical trial that conducted among MSM in Beijing from 2013 to 2015, we recruited a total of 3,680 participants cross-sectionally. A self-administered questionnaire was employed to collect information regarding demographics, sexual behaviors, and a history of alcohol and drug use. Blood sample was collected for HIV and syphilis testing. Results: A total of 3,588 MSM completed the survey and were included in the data analysis. The mean age was 29.9 with 97.3% of Han-ethnicity and 85.0% unmarried. The HIV and syphilis prevalence was 12.7% and 7.4%, respectively. Drug use was significantly associated with higher odds of HIV infection (aOR = 1.3, 95% Confidence Interval [CI] = 1.0,1.6), but not associated with syphilis. A higher level of alcohol consumption was similarly associated with higher odds of HIV risks with both male (e.g., condomless sex acts) and female partners (e.g., numbers of sexual partners). Conclusion: The association between drug and alcohol use and high-risk behaviors is notable among MSM in China. Integrated HIV interventions that target substance use among MSM may be more effective than programs that only target HIV alone.     

我院2002—2005年肿瘤患者及抗肿瘤用药分析

目的分析抗肿瘤药物使用现状,提高临床合理用药水平。方法运用selectsample应用程序,对医院2002—2005年抗肿瘤药物临床使用情况进行分析统计。结果免疫调节剂的销售金额排第一,且均采用国产药品,其中香菇多糖占有极大的比重,这是因为其临床应用广,单价也比较高。抗肿瘤抗生素排在第2位,其中表阿霉素、柔红霉素和丝裂霉素都以进口为主。植物来源抗肿瘤药排第三,其进口药所占比例为43%。结论抗肿瘤药物的使用相对合理。     

心血管医院住院患者抗高血压药物用药分析

目的了解心血管病专科医院口服抗高血压药物的使用情况,促进合理用药。方法对心内科2008年7月至12月份住院患者口服抗高血压药的用药品种、药物利用指数（DUI）、用药频度（DDDs）及联用药物合理性等进行统计分析。结果口服抗高血压药物使用例次排序前4位为钙离子拮抗剂、利尿剂、β-受体阻滞剂、血管紧张素转换酶抑制剂（ACEI）。DDDs排序前3位是硝苯地平控释片、氢氯噻嗪片、美托洛尔片。结论该院抗高血压药物使用基本合理。     

不合理用药典型案例分析

目的：对临床药物治疗中不合理用药的典型案例进行分析和评价,为临床合理用药提供借鉴和参考。方法：通过参与临床用药实践及对住院病历医嘱合理性进行点评,对典型不合理用药案例进行分析和评价。结果：临床不合理用药主要表现在4个方面：①特殊人群用药不合理;②药物使用方法不合理;③联合用药不合理;④药物配伍禁忌。结论：通过积极参与临床用药实践,及时发现和分析临床不合理用药问题,并为个体化治疗提出相应解决方案,避免不合理用药的发生,保证患者用药安全有效。     

住院医嘱不合理药物联用案例分析

目的为临床合理联用药物提供参考。方法随机抽查住院病例医嘱,查找不合理用药问题并进行汇总分析。结果 2406份住院医嘱中,共发现不合理药物联用问题44例。结论临床药师应开展以药物相互作用为主线的药学服务,确保安全有效的药物联用。     

基本药物制度下的合理用药探讨

目的：探讨基本药物制度下的合理用药情况。方法：通过对基本药物制度的分析,目前不合理用药的原因的分析．提出促进合理用药的相应意见。结果与结论：建立并完善基本药物制度．促进合理用药。     

多拉司琼药物利用评价标准的建立及应用

目的 通过药物利用评价（DUE）方法评价复旦大学附属华东医院多拉司琼临床应用情况,为促进临床合理使用多拉司琼提供参考。方法 随机抽取医院2021年1月至2021年6月使用多拉司琼的病例794例,依据建立的DUE标准进行回顾性分析。结果 建立了多拉司琼DUE标准,包括用药指征、用药过程、用药结果和管理指标4个部分。结论 建立的多拉司琼DUE标准具有较好的实用性,在临床实践应用中可发现临床用药过程中存在的问题或不足,对促进临床合理用药具有重要指导意义。     

HIV Risk Behaviors Among Young Drug Using Women Who Have Sex With Women (WSWs) in New York City

Previous research has suggested that multiple stressors may work in tandem to affect the health of women who have sex with women (WSWs). WSWs have been a part of the HIV epidemic in New York City since the beginning, making it an ideal setting to further explore these women's risk. Among a sample of 375 heroin, crack and/or cocaine using women recruited from economically disadvantaged communities in New York City, we examined HIV seroprevalence and risk behaviors among WSWs as compared to women who have sex with men only (WSMOs). We also explore differences between WSWs and WSMOs with respect to potential stressors (i.e., decreased access to resources and health care utilization and violence victimization) that might contribute overall HIV risk. The study's limitations are noted.