Abstract BackgroundSexualised drug use refers to the use of drugs in a sexual context. This includes 'chemsex', the planned use of drugs as part of sex, more commonly reported among men who have sex with men (MSM). Here we synthesise available evidence and outline Public Health England's (PHE) actions to understand the local impact of sexualised drug use and to guide interventions. MethodsWe conducted a systematic literature review of evidence published in peer-reviewed journals up to May 2017, a review of PHE's national sexual health and drug monitoring surveillance data, and a rapid review of available 'chemsex' services in England. Results Prevalence estimates for sexualised drug use or 'chemsex' in England vary between 4.9% among MSM attending GUM clinics, 54% among high risk MSM and 29% among HIV-positive MSM. There's currently no standardised definition or recall period for sexualised drug use and 'chemsex'. Little event-level data is available. Although 'chemsex' is most commonly reported among HIV-positive MSM and MSM in urban areas, it also occurs in non-urban conurbations. 'Chemsex' is associated with a range of health harms, including increased risk of sexually transmitted infections, though causal pathways are poorly understood. Services and interventions vary geographically with more bespoke services in urban areas. ConclusionSexualised drug use including 'chemsex', its associated health harms, and optimal interventions remain poorly understood. PHE has established a cross-agency working group to strengthen data collection, disseminate information, work collaboratively with partners, and produce resources to guide commissioning decisions.
Abstract BackgroundSexualised drug use refers to the use of drugs in a sexual context. This includes 'chemsex', the planned use of drugs as part of sex, more commonly reported among men who have sex with men (MSM). Here we synthesise available evidence and outline Public Health England's (PHE) actions to understand the local impact of sexualised drug use and to guide interventions. MethodsWe conducted a systematic literature review of evidence published in peer-reviewed journals up to May 2017, a review of PHE's national sexual health and drug monitoring surveillance data, and a rapid review of available 'chemsex' services in England. Results Prevalence estimates for sexualised drug use or 'chemsex' in England vary between 4.9% among MSM attending GUM clinics, 54% among high risk MSM and 29% among HIV-positive MSM. There's currently no standardised definition or recall period for sexualised drug use and 'chemsex'. Little event-level data is available. Although 'chemsex' is most commonly reported among HIV-positive MSM and MSM in urban areas, it also occurs in non-urban conurbations. 'Chemsex' is associated with a range of health harms, including increased risk of sexually transmitted infections, though causal pathways are poorly understood. Services and interventions vary geographically with more bespoke services in urban areas. ConclusionSexualised drug use including 'chemsex', its associated health harms, and optimal interventions remain poorly understood. PHE has established a cross-agency working group to strengthen data collection, disseminate information, work collaboratively with partners, and produce resources to guide commissioning decisions.
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