Wednesday, September 17, 2014

The most popular drugs and human immunodeficiency virus

HIV (human immunodeficiency virus) is a virus that attacks the immune system, making it hard for the body to fight off infection and some diseases. Without treatment, HIV eventually causes AIDS (acquired immunodeficiency syndrome).

Initial HIV symptoms are similar to those of the flu and include fatigue, fever, weight loss, and swollen lymph nodes in the neck, armpits, or groin. Although there currently is no cure for HIV infection, a combination of medicines called highly active antiretroviral therapy, or HAART, helps keeps the immune system healthy for most people. Treatment can also prevent or delay the development of AIDS.

The most popular drugs (excluding alcohol and tobacco) were nitrites (poppers), used by 27% of study participants, and cannabis, cocaine and erectile dysfunction drugs (Viagra¸ Cialis), which were each used by about 20%. Ketamine and MDMA (ecstasy) were used by about 12% of participants, GHB or GBL by 9% and methamphetamine and mephedrone by 7%. All other individual drugs including various opiates, psychedelics, crack and anabolic steroids were used by less than 4% of study participants. Three per cent of the sample reported injecting drug use (68 people) of whom four reported sharing injecting equipment with persons of unknown serostatus.

The pattern for which drugs were most used stayed the same as the number of different drugs increased; in men who had used just one drug in the last three months, poppers were the most popular, closely followed by cannabis; in men who had used three, these two drugs plus cocaine and erectile dysfunction drugs predominated, and in men who had used more than five drugs there was more or less equal use of these drugs plus ketamine, GHB, MDMA and, to a slightly lesser extent, methamphetamine.

Any drug use was especially strongly associated with younger age, smoking, having disclosed they had HIV to partners, and being non-adherent to antiretroviral therapy (ART). Men who reported drug use were also somewhat more likely to have sex with other HIV-positive rather than HIV-negative partners or partners whose HIV status was unknown.

Men who reported using four or more drugs were more likely than other men who used drugs or men who did not use drugs to either not be on ART or to have a viral load over 50 copies/ml, and also to be young and to have a higher proportion of partners who also had HIV.

Compared with men over 60, men under 40 were 70% more likely to use any drug, 50% more likely to have disclosed to partners that they had HIV, 40% more likely to smoke and 30% more likely to be non-adherent to ART.

There was also a strong and consistent correlation between the numbers of different drugs used in the last three months and the various sexual behaviour indicators: the more different drugs people used, the more sex, condom-less sex, risky sex, STIs, group sex and partners they had. For instance, whereas 10% of men who had any drug use had higher-risk condom-less sex, 16% of the men who had used five or more different drugs in the last three months had done so (39 individuals), and whereas 15% of men who had any drug use had been diagnosed with an STI in the last three months, 24% of men who had used five or more drugs had had an STI. This correlation was particularly strong for group sex and number of partners.

In general, men who used drugs were about 40 to 70% more likely to have high-risk sex than men who did not use drugs, while users of ‘club drugs’ like GHB and mephedrone, erectile dysfunction drugs, nitrites (poppers) and cocaine were 90% more likely to have higher-risk sex.

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