Initiation of illicit drug use in the FLUX cohort of Australian gay and bisexual men
The 2018 Australian and New Zealand Addiction Conference will be held on Monday 28 and Tuesday 29 May with optional workshops on Wednesday 30 May at the QT Gold Coast.
Associate Professor Garrett Prestage, University Of New South Wales joins us at the Conference to discuss ‘Initiation of illicit drug use in the FLUX cohort of Australian gay and bisexual men’.
Background: Drug use is more prevalent among gay and bisexual men (GBM) than in the general population, but few studies have reported incidence rates in this population. In an online cohort of GBM, we report the incidence of initiation of: amyl nitrite, cannabis, ecstasy, methamphetamine, cocaine, ketamine, and gamma-hydroxybutyrate (GHB).
Methods: Between 2014-2017, 1710 men enrolled in the Flux cohort study of drug use among GBM; by Dec 2017, 1273 men reported their drug use during at least one follow-up survey round. Incidence of initiation was calculated in those with no history of use at baseline who reported recent (previous 6-month) use during follow-up, and “no-use” in those who reported recent use at baseline and no use during any of the follow-up intervals.
Results: Median age was 31 years (range:16.5-81) and 34.1% reported that half or more of their gay friends used drugs. During 24 months of follow-up, the rates of initiation per 100 person-years were: 3.1 (methamphetamine); 2.0 (ketamine); 2.5 (GHB); 3.9 (cocaine); 5.0 (ecstasy); 8.8 (amyl nitrite); 7.4 (cannabis). Initiation of each of these drugs was significantly associated with younger age. Among men aged 25 or less, initiation rates were: 4.9 (methamphetamine); 3.2 (ketamine); 3.5 (GHB); 6.0 (cocaine); 9.3 (ecstasy); 12.6 (amyl nitrite); 9.8 (cannabis). Men who initiated use of one drug type were more likely to initiate other drugs, and this was especially pronounced for methamphetamine. Among men who initiated methamphetamine use, many also initiated: cocaine (36.6%); GHB (20.8%); ketamine (25.5%); amyl (26.3%).
Conclusion: Rates of initiation of illicit drugs are high among GBM in Australia, particularly among younger men. Men who initiate methamphetamine use are very likely to also initiate other drugs. Harm reduction interventions need to target young GBM as a priority, and to consider polydrug use and minimising potential harm from drug interactions.
G.P. Prestage, PhD is an associate professor at the Kirby Institute, University of New South Wales, where he has worked since 1992. He has been active in gay community life in Australia since the mid-1970s, pioneered Australia’s behavioural surveillance work and led many of Australia’s major cohort studies among gay and bisexual men, as well as the Seroconversion Study. He was responsible for the Positive Health and Health in Men (HIM) cohort studies. He currently leads the FLUX cohort study of drug use among gay and bisexual men.
For more information on the upcoming 2018 Australian and New Zealand Addiction Conference please visit the conference website.