Sex, drugs and social connectedness: wellbeing among HIV-positive gay and bisexual men who use party-and-play drugs
Jennifer Power A B , Gosia Mikołajczak A , Adam Bourne A , Graham Brown A , William Leonard A , Anthony Lyons A , Gary W. Dowsett A and Jayne Lucke A
+ Author Affiliations
- Author Affiliations
A Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic. 3086, Australia.
B Corresponding author. Email: jennifer.power@latrobe.edu.au
Sexual Health 15(2) 135-143 https://doi.org/10.1071/SH17151
Submitted: 17 August 2017 Accepted: 5 December 2017 Published: 16 March 2018
Abstract
Background: This paper explores associations between use of party-and-play drugs, including crystal methamphetamine, and wellbeing among HIV positive gay and bisexual men (GBM) in Australia. This study considers whether use of drugs in a social or sex-based setting facilitates access to social and support networks, which may in turn support wellbeing. Methods: A cross-sectional survey of Australian people living with HIV (PLHIV) was conducted. There were 714 participants (79.7%) who identified as GBM. Differences between party-and-play drug users and non-users were examined using bivariate and multinomial logistic regressions. Mediation analysis examined the indirect effect of drug use on wellbeing via social connectedness and support. Results: One in three participants (29.7%) reported party-and-play drug use within the past 12 months. Only 5% reported regular use. There were no differences between users and non-users on self-reported measures of general health, wellbeing or general social support. Compared with non-users, party-and-play drug users reported higher levels of resilience and lower levels of perceived HIV-related stigma. This was associated with spending more time with other people living with HIV and friends in the gay and lesbian community. Conclusions: While party-and-play drug use poses risks to the health of GBM, the social contexts in which these drugs are used may provide wellbeing benefits, particularly for HIV-positive GBM who may be subject to HIV-related stigma in other settings. Further research is needed to determine whether drug-use facilitates access to social networks or if people with more active social ties are more likely to engage in drug use.
References
[1] Roxburgh A, Lea T, de Wit J, Degenhardt L. Sexual identity and prevalence of alcohol and other drug use among Australians in the general population. Int J Drug Policy 2016; 28 76–82.| Sexual identity and prevalence of alcohol and other drug use among Australians in the general population.Crossref | GoogleScholarGoogle Scholar |
[2] Lea T, Prestage G, Mao L, Zablotska I, Wit J, Holt M. Trends in drug use among gay and bisexual men in Sydney, Melbourne and Queensland, Australia. Drug Alcohol Rev 2013; 32 39–46.
| Trends in drug use among gay and bisexual men in Sydney, Melbourne and Queensland, Australia.Crossref | GoogleScholarGoogle Scholar |
[3] Lyons A, Pitts M, Grierson J. Methamphetamine use in a nationwide online sample of older Australian HIV‐positive and HIV‐negative gay men. Drug Alcohol Rev 2013; 32 603–10.
| Methamphetamine use in a nationwide online sample of older Australian HIV‐positive and HIV‐negative gay men.Crossref | GoogleScholarGoogle Scholar |
[4] Leonard W, Dowsett GW, Slavin S, Mitchell A, Pitts M. Crystal clear: the social determinants of gay men’s use of crystal methamphetamine in Victoria. Melbourne: The Australian Research Centre in Sex, Health and Society, La Trobe University; 2008.
[5] Lea T, Mao L, Hopwood M, Prestage G, Zablotska I, de Wit J, Holt M. Methamphetamine use among gay and bisexual men in Australia: trends in recent and regular use from the Gay Community Periodic Surveys. Int J Drug Policy 2016; 29 66–72.
| Methamphetamine use among gay and bisexual men in Australia: trends in recent and regular use from the Gay Community Periodic Surveys.Crossref | GoogleScholarGoogle Scholar |
[6] Slavin S. Crystal methamphetamine use and HIV risk, Social Research Briefs no 4. Sydney: National Centre in HIV Social Research, University of NSW; 2004.
[7] Hammoud MA, Jin F, Degenhardt L, Lea T, Maher L, Grierson J, Mackie B, Pastorelli M, Bath N, Bradley J, Prestage G. Following Lives Undergoing Change (Flux) study: implementation and baseline prevalence of drug use in an online cohort study of gay and bisexual men in Australia. Int J Drug Policy 2017; 41 41–50.
| Following Lives Undergoing Change (Flux) study: implementation and baseline prevalence of drug use in an online cohort study of gay and bisexual men in Australia.Crossref | GoogleScholarGoogle Scholar |
[8] 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 2017; 14 42–50.
| The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[9] Weatherburn P, Hickson F, Reid D, Torres-Rueda S, Bourne A. Motivations and values associated with combining sex and illicit drugs (‘chemsex’) among gay men in South London: findings from a qualitative study. Sex Transm Infect 2017; 93 203–6.
| Motivations and values associated with combining sex and illicit drugs (‘chemsex’) among gay men in South London: findings from a qualitative study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC2szgtlyrtA%3D%3D&md5=0fb5dca6d581719792c5a488f34536edCAS |
[10] Ross MW, Mattison AM, Franklin DR. Club drugs and sex on drugs are associated with different motivations for gay circuit party attendance in men. Subst Use Misuse 2003; 38 1173–83.
| Club drugs and sex on drugs are associated with different motivations for gay circuit party attendance in men.Crossref | GoogleScholarGoogle Scholar |
[11] Bourne A, Weatherburn P. Substance use among men who have sex with men: patterns, motivations, impacts and intervention development need. Sex Transm Infect 2017;
| Substance use among men who have sex with men: patterns, motivations, impacts and intervention development need.Crossref | GoogleScholarGoogle Scholar |
[12] Dowsett GW, Wain D, Keys D. Good gay men don’t get “messy”: injecting drug use and gay community. Sexuality Research and Social Policy 2005; 2 22–36.
| Good gay men don’t get “messy”: injecting drug use and gay community.Crossref | GoogleScholarGoogle Scholar |
[13] Prestage G, Brown G, De Wit J, Bavinton B, Fairley C, Maycock B, Batrouney C, Keen P, Down I, Hammoud M, Zablotska I. Understanding gay community subcultures: implications for HIV prevention. AIDS Behav 2015; 19 2224–33.
| Understanding gay community subcultures: implications for HIV prevention.Crossref | GoogleScholarGoogle Scholar |
[14] Persson KI, Tikkanen R, Bergström J, Berglund T, Thorson A, Forsberg BC. Experimentals, bottoms, risk-reducers and clubbers: exploring diverse sexual practice in an Internet-active high-risk behaviour group of men who have sex with men in Sweden. Cult Health Sex 2016; 18 639–53.
| Experimentals, bottoms, risk-reducers and clubbers: exploring diverse sexual practice in an Internet-active high-risk behaviour group of men who have sex with men in Sweden.Crossref | GoogleScholarGoogle Scholar |
[15] Smit PJ, Brady M, Carter M, Fernandes R, Lamore L, Meulbroek M, Ohayon M, Platteau T, Rehberg P, Rockstroh JK, Thompson M. HIV-related stigma within communities of gay men: a literature review. AIDS Care 2012; 24 405–12.
[16] Brown G, Leonard W, Lyons A, Power J, Sander D, McColl W, Johnson R, James C, Hodson M, Carman M. Stigma, gay men and biomedical prevention: the challenges and opportunities of a rapidly changing HIV prevention landscape. Sexual Health 2017; 14 111–18.
| Stigma, gay men and biomedical prevention: the challenges and opportunities of a rapidly changing HIV prevention landscape.Crossref | GoogleScholarGoogle Scholar |
[17] de Wit JB, Murphy DA, Adam PC, Donohoe S. Strange bedfellows: HIV-related stigma among gay men in Australia. Dordrecht: Springer; 2013.
[18] Daskalopoulou M, Rodger A, Phillips AN, Sherr L, Speakman A, Collins S, Elford J, Johnson MA, Gilson R, Fisher M, Wilkins E, Anderson J, McDonnell J, Edwards S, Perry N, O’Connell R, Lascar M, Jones M, Johnson AM, Hart G, Miners A, Geretti AM, Burman WJ, Lampe FC. Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study. Lancet HIV 2014; 1 e22–31.
| Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study.Crossref | GoogleScholarGoogle Scholar |
[19] Darke S, Kaye S, McKetin R, Duflou J. Major physical and psychological harms of methamphetamine use. Drug Alcohol Rev 2008; 27 253–62.
| Major physical and psychological harms of methamphetamine use.Crossref | GoogleScholarGoogle Scholar |
[20] Bourne A, Reid D, Hickson F, Torres-Rueda S, Steinberg P, Weatherburn P. “Chemsex” and harm reduction need among gay men in South London. Int J Drug Policy 2015; 26 1171–6.
| “Chemsex” and harm reduction need among gay men in South London.Crossref | GoogleScholarGoogle Scholar |
[21] Shoptaw S, Reback CJ. Methamphetamine use and infectious disease‐related behaviors in men who have sex with men: implications for interventions. Addiction 2007; 102 130–5.
| Methamphetamine use and infectious disease‐related behaviors in men who have sex with men: implications for interventions.Crossref | GoogleScholarGoogle Scholar |
[22] Power J, Brown G, Lyons A, Thorpe R, Dowsett GW, Lucke J. HIV Futures 8: protocol for a repeated cross-sectional and longitudinal survey of people living with HIV in Australia. Front Public Health 2017; 5
| HIV Futures 8: protocol for a repeated cross-sectional and longitudinal survey of people living with HIV in Australia.Crossref | GoogleScholarGoogle Scholar |
[23] Wu AW, Hays RD, Kelly S, Malitz F, Bozzette SA. Applications of the Medical Outcomes Study health-related quality of life measures in HIV/AIDS. Qual Life Res 1997; 6 531–54.
| Applications of the Medical Outcomes Study health-related quality of life measures in HIV/AIDS.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2svntFKisA%3D%3D&md5=a254edf1bf51c3f6b68445f66687f5c5CAS |
[24] Connor KM, Davidson JR. Development of a new resilience scale: the Connor–Davidson resilience scale (CD‐RISC). Depress Anxiety 2003; 18 76–82.
| Development of a new resilience scale: the Connor–Davidson resilience scale (CD‐RISC).Crossref | GoogleScholarGoogle Scholar |
[25] Campbell‐Sills L, Stein MB. Psychometric analysis and refinement of the Connor–Davidson resilience scale (CD‐RISC): validation of a 10‐item measure of resilience. J Trauma Stress 2007; 20 1019–28.
| Psychometric analysis and refinement of the Connor–Davidson resilience scale (CD‐RISC): validation of a 10‐item measure of resilience.Crossref | GoogleScholarGoogle Scholar |
[26] Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health 2001; 24 518–29.
| Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MnpslensQ%3D%3D&md5=cf09ab1913a401f0e7b510d46885781dCAS |
[27] Baker D. All the lonely people: loneliness in Australia, 2001–2009. Canberra: The Australia Institute; 2012.
[28] Wooden M. The Household, Income and Labour Dynamics in Australia (HILDA) survey and quality of life measures. Third Australian Conference on Quality of Life, 16 November 2001; Melbourne, Australia. Melbourne: The Melbourne Institute of Applied Economic and Social Research; 2001.
[29] Preacher KJ, Hayes AF. SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behav Res Methods Instrum Comput 2004; 36 717–31.
| SPSS and SAS procedures for estimating indirect effects in simple mediation models.Crossref | GoogleScholarGoogle Scholar |
[30] Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York: Guilford Press; 2013.
[31] Australian Bureau of Statistics. Report number 6302.0 - Average weekly earnings, Australia, May 2016. Canberra: Australian Bureau of Statistics; 2016.
[32] Leonard W, Pitts M, Mitchell A, Lyons A, Smith A, Patel S, Crouch M, Barrett A. Private lives 2: the Second National Survey of the Health and Wellbeing of Gay, Lesbian, Bisexual and Transgender (GLBT) Australians, Monograph Series No. 86. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University; 2012.
[33] Holt M, Lee E, Prestage GP, Zablotska I, De Wit J, Mao L. The converging and diverging characteristics of HIV-positive and HIV-negative gay men in the Australian Gay Community Periodic Surveys, 2000–2009. AIDS Care 2013; 25 28–37.
| The converging and diverging characteristics of HIV-positive and HIV-negative gay men in the Australian Gay Community Periodic Surveys, 2000–2009.Crossref | GoogleScholarGoogle Scholar |
[34] Bourne A, Reid D, Hickson F, Torres-Rueda S, Weatherburn P. Illicit drug use in sexual settings (‘chemsex’) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study. Sex Transm Infect 2015; 91 564–68.
| Illicit drug use in sexual settings (‘chemsex’) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC28%2FitlWgtA%3D%3D&md5=e3b0e09b147c5d8fbad362b4be4a0facCAS |
[35] Knoops L, Bakker I, van Bodegom R, Zantkuijl P. Tina and slamming: MSM, crystal meth use and injecting drugs in a sexual setting. Amsterdam: Mainline & SOA AIDS; 2015. Available online at: https://www.soaaids.nl/sites/default/files/media/Tina-And-Slamming-def.-web.pdf
[36] McLaren S, Jude B, McLachlan AJ. Sexual orientation, sense of belonging and depression in Australian men. Int J Mens Health 2007; 6 259–272.
| Sexual orientation, sense of belonging and depression in Australian men.Crossref | GoogleScholarGoogle Scholar |
[37] Ahmed A-K, Weatherburn P, Reid D, Hickson F, Torres-Rueda S, Steinberg P, Weatherburn P. Social norms related to combining drugs and sex (“chemsex”) among gay men in South London. Int J Drug Policy 2016; 38 29–35.
| Social norms related to combining drugs and sex (“chemsex”) among gay men in South London.Crossref | GoogleScholarGoogle Scholar |
[38] Semple SJ, Patterson TL, Grant I. Motivations associated with methamphetamine use among HIV men who have sex with men. J Subst Abuse Treat 2002; 22 149–56.
| Motivations associated with methamphetamine use among HIV men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[39] Lyons A, Hosking W. Health disparities among common subcultural identities of young gay men: physical, mental, and sexual health. Arch Sex Behav 2014; 43 1621–35.
| Health disparities among common subcultural identities of young gay men: physical, mental, and sexual health.Crossref | GoogleScholarGoogle Scholar |
[40] Amaro R. Taking chances for love? Reflections on love, risk, and harm reduction in a gay slamming subculture. Contemp Drug Probl 2016; 43 216–27.
| Taking chances for love? Reflections on love, risk, and harm reduction in a gay slamming subculture.Crossref | GoogleScholarGoogle Scholar |
[41] 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.
| Alcohol and club drug use among same-sex attracted young people: associations with frequenting the lesbian and gay scene and other bars and nightclubs.Crossref | GoogleScholarGoogle Scholar |
[42] Lea T, de Wit J, Reynolds R. Minority stress in lesbian, gay, and bisexual young adults in Australia: associations with psychological distress, suicidality, and substance use. Arch Sex Behav 2014; 43 1571–8.
| Minority stress in lesbian, gay, and bisexual young adults in Australia: associations with psychological distress, suicidality, and substance use.Crossref | GoogleScholarGoogle Scholar |
[43] Halkitis PN, Fischgrund BN, Parsons JT. Explanations for methamphetamine use among gay and bisexual men in New York City. Subst Use Misuse 2005; 40 1331–45.
| Explanations for methamphetamine use among gay and bisexual men in New York City.Crossref | GoogleScholarGoogle Scholar |
[44] 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. Int J Drug Policy 2015; 26 210–3.
| Drug, sex and sociality: factors associated with the recent sharing of injecting equipment among gay and bisexual men in Australia.Crossref | GoogleScholarGoogle Scholar |
[45] Australian Institute of Health and Welfare. National Drug Strategy Household Survey detailed report: 2013. Drug statistics series no. 28. Cat. no. PHE 183. Canberra: Australian Institute of Health and Welfare; 2014.
[46] McNair R, Pennay A, Hughes T, Brown R, Leonard W, Lubman DI. A model for lesbian, bisexual and queer-related influences on alcohol consumption and implications for policy and practice. Cult Health Sex 2016; 18 405–21.
| A model for lesbian, bisexual and queer-related influences on alcohol consumption and implications for policy and practice.Crossref | GoogleScholarGoogle Scholar |
[47] Stall R, Mills TC, Williamson J, Hart T, Greenwood G, Paul J, Pollack L, Binson D, Osmond D, Catania JA. Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. Am J Public Health 2003; 93 939–42.
| Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[48] Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia: Annual Surveillance Report 2016. Sydney: Kirby Institute, University of NSW; 2016.
[49] Degenhardt L, Larney S, Chan G, Dobbins T, Weier M, Roxburgh A, Hall WD, McKetin R. Estimating the number of regular and dependent methamphetamine users in Australia, 2002–2014. Med J Aust 2016; 204
| Estimating the number of regular and dependent methamphetamine users in Australia, 2002–2014.Crossref | GoogleScholarGoogle Scholar |
[50] Degenhardt L, Sara G, McKetin R, Roxburgh A, Dobbins T, Farrell M, Burns L, Hall WD. Crystalline methamphetamine use and methamphetamine‐related harms in Australia. Drug Alcohol Rev 2017; 36 160–70.
| Crystalline methamphetamine use and methamphetamine‐related harms in Australia.Crossref | GoogleScholarGoogle Scholar |
