Experts warn of rise in gay 'slamming' in London: increased HIV & HCV transmission risk
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From Jules: these slamming activities, unsafe sex, drug use & partying & HCV infection and of note multiple reinfections after being treated & crued for HCV have been recently reported in NYC through studies conducted at Mt Sinai & Cornell Hospitals & recently reported at conferences. Hepatitis C is spread mainly by the sharing of needles, though it can also be acquired during sex.....Meth use in NYC is currently centered among gay men[NYC DOH].....High-risk drug practices tighten grip on London gay scene....risk for HIV & HCV transmission ......"Around 8% of HIV-positive men in the UK are estimated to be co-infected with HCV......"slamming-is also increasing, taking place at sex parties or chill-outs where many people often share equipment without sterilizing it.....A slamming community, largely hidden to the rest of the gay scene, exists behind closed doors in London.....Users can then be high for days, reinjecting and having sex with multiple partners without protection. The result is a perfect storm for transmission of both HIV and HCV, as a well a catalogue of ensuing mental health problems. ......70% report needle sharing.....60% report not taking their antiretroviral drugs (ARVs) while high....."The existing Club Drug Clinic, based at the Chelsea and Westminster Hospital, caters for two distinct populations: MSM (70%) and heterosexual students and clubbers (30%).....People will sometimes say 'well I knew everyone in the room had HIV', but when asked about hepatitis C, they say 'well I didn't think about that'. We have a mixture of people [who are] HIV and/or HCV positive and negative people injecting and sharing needles, potentially creating a public health disaster"
Drug Use Among Gay and Bisexual Men at Weekend Dance Parties: The Role of Intentions and Perceptions of Peers' Behaviors
489 men attending weekend dance events completed an anonymous assessment asking about their own and their beliefs about other attendants' drug use intentions-47 % completed a followup assessment after the event. Forty-four percent reported intending to use ecstasy at the event; intentions to use GHB, marijuana, cocaine, unprescribed erectile dysfunction drugs, and poppers were also high....... and one in ten intended to use ketamine and/or crystal methamphetamine.
Experts warn of rise in gay 'slamming' in London: increased HIV & HCV transmission risk
Sunday 19 January 2014, http://www.independent.co.uk, Sarah Morrison Human Rights Correspondent
The number of men using drugs in a sexual context quadrupled in two years and could be linked to a disturbing rise in HIV infection rates
HIV rates are rising among gay men in London as more are injecting drugs such as crystal meth
The figures, compiled by the London School of Hygiene and Tropical Medicine (LSHTM), reinforce experts' warnings of a "meteoric" rise in the number of gay men injecting drugs such as mephedrone, GHB or crystal meth, in the capital. The trend - known as "slamming" - gives users a more intense high and commonly takes places at sex parties which can go on for several days, according to experts; they warn that the trend could be linked to a disturbing rise in HIV infection rates.
The number of men injecting in a sexual context quadrupled between 2011 and 2013, according to Antidote, the UK's only lesbian, gay, bisexual and transgender drug and alcohol support service. More than 60 per cent of their clients injected drugs last year. This is double the number who injected in 2010. Nine years ago, fewer than 1 per cent were injecting drugs.
Antidote has been "overwhelmed" by men presenting with health conditions from the sexualised use of these drugs - which increase libido while decreasing sexual inhibition. Reports of men sharing needles and sleeping with, on average, five to 10 partners per drug-using episode, have rung alarm bells.
"It's become somewhat destigmatised," said Antidote's David Stuart, who is believed to be the country's first drug counsellor specialising in sexual health. "You can go on Grindr or other apps ... and you can see the world of slamming is glamorised. A man will say: 'Yeah, I slam.' But if you ask him if he's an addicted drug user, he'll say: 'F**k off'."
The authorities - who are used to seeing very low percentages of injection use among gay men - are taking notice. Councils across London have commissioned their own studies to be carried out into the "chem-sex" trend. Lambeth, Southwark and Lewisham are funding the LSHTM to analyse European data relating to their boroughs and carry out interviews.
Anecdotally, experts believe this is a key to a trend in rising HIV infection levels. Diagnoses among men who have sex with men continue to rise and reached an all-time high in 2012; 3,250 were recorded. London had the highest number of new diagnoses (1,450).
"If you go to any heroin addict on the corner, they'll know where to get clean needles from," Mr Stuart said. "But if you ask a gay man at a sex party, he won't know. Diseases can spread through careless injecting."
Jason (not his real name), a 37-year-old gay man from London, started using crystal meth four years ago, after his 11-year relationship ended. It improved his sex life and soon he started injecting it and going on three-day sex "benders". Now he has hepatitis C and is HIV positive, which he blames on his drug use.
"Sometimes, I was having the best time of my life, for a day or so, but it always ended up being really freaky, paranoid or twisted ... I'm OK now, but I still struggle to have normal sex without [crystal meth]," he said.
Adam Bourne, lecturer in public health at LSHTM, said Antidote's research has made academics "stand up and think 'hang on a minute'". He added: "Gay men have always been prolific drug users, particularly when it comes to 'club drugs', but injecting drugs - crystal meth, GHB - is a relatively new phenomenon that we haven't really observed before."
LSHTM is analysing EMIS, the European "Men who have sex with men" internet survey. More than 180,000 participants from 38 European countries took part in 2010, including almost 18,000 men from the UK.
Preliminary analysis for The Independent on Sunday found that 2.3 per cent of men from London who completed the survey had injected drugs in the previous 12 months, compared with just 0.8 per cent of men from England. Nearly 3 per cent of men who lived in the capital used crystal meth within the previous month, compared with 0.7 per cent elsewhere in England.
Dr Bourne added that previous research indicates that drug use, and particularly crystal meth, is higher among HIV positive gay men than those who are negative or who are untested.
A spokesman for Public Health England, which has established a working group to develop guidance on the trend, said: "This is a serious health issue that is driving poor sexual and mental health, as well as the transmission and acquisition of HIV and other blood-borne viruses."
He added that the national health protection service is "concerned" about the increasing use of drugs, "in particular, in the context of sex parties, where unprotected sex may occur".
James Taylor, head of policy at gay rights campaigning group Stonewall, said that the figures are "deeply worrying". He added: "This makes it all the more vital that prevention messages and information are targeted at gay and bisexual men, to highlight the very real risks of injection drug use."
Party drugs linked to alarming rise in HIV amongst gay men
London sees 20 per cent rise in infections as charities call for better sexual health services
Thursday 25 July 2013, Charlie Cooper, http://www.independent.co.uk
HIV infections among gay men in London are soaring, with sexual health workers saying that a "chaotic and harmful" link between high-risk drug use and gay sex in the capital is fuelling the increase.
Latest figures from Public Health England show that the rate of infection in the capital leaped by more than 20 per cent in 2012. Charities have warned that the virus is once again one of the most serious public health crises in the UK today.
Across the country, rates of infection were up by 8 per cent to 3,240 new infections among men who have sex with men (MSMs). In London alone there were 1,720 new infections, with that figure likely to be revised up to nearly 2,000, figures published in The Lancet revealed. Rates of transmission are likely to have been increased by irresponsible use of needles during drug-taking, but also because of a rise in people having unprotected sex while high on drugs.
Thanks to new treatments, people with HIV can now hope to live healthy, normal lives, as long as they take daily antiretroviral tablets.
However, the virus remains a huge public health concern, as many do not know they have it and without treatment it can lead to debilitating damage to the immune system and life-threatening illness.
HIV infection rates have been rising steadily over the past decade, with health authorities concerned that the safe-sex message first publicised during the Aids epidemic of the 1980s was no longer getting through to a new generation.
Although some of this year's increase was attributed to more widespread HIV testing, with the number of tests in London up 17 per cent since 2011, Public Health England said there was "anecdotal evidence from drug and alcohol clinics in London that recreational drug use amongst gay men is a growing issue."
Concerns were raised earlier this year over increasing numbers of men smoking, snorting and injecting party drugs such as crystal methamphetamine and mephedrone, often in combination with sex parties.
David Stuart, manager of the specialist CODE clinic in Soho, run in association with the sexual health clinic 56 Dean Street, said that 99 per cent of his clients only used the drugs for sex. Emotionally vulnerable men - often HIV positive - found that they could only enjoy sex while on drugs, he said.
"There are of course lots of gay men out there who have great, long-term relationships and a great understanding of their sexuality and romantic lives. But there are an increasing number of men that are struggling with that and using drugs to manage the confusion that they're experiencing - and that number is growing and the culture is becoming more chaotic and harmful," he said.
The association of party drugs with gay sex has been observed in other cities, with large gay scenes such as San Francisco, Melbourne and Sydney.
The Lancet also reported a rise in gay men having sex without condoms, with anecdotal evidence of HIV negative men borrowing four days' worth of HIV medication from HIV positive friends in order to have sex without condoms at sex parties with HIV positive men - a preventative measure that has not been proven effective.
Sexual health charities said that more needed to be done by London local authorities to provide specialist services that could advise gay men about precautions when encountering "community norms of using drugs for sex".
"There is a need for a greater focus within London HIV prevention work on helping gay men who are encountering difficulties with drugs and safer sex and also on encouraging others to avoid these problems and resist peer pressure," said Lisa Power, Policy Director for the Terrence Higgins Trust.
Yusef Azad, director of policy and campaigns at the National Aids Trust (NAT) said that, on average, five gay men in London are diagnosed with HIV every day.
"This is one of the most serious public health issues we face in the UK and it must be treated as a public health priority," he said. "NAT recently called on London Councils to address the issue of problematic drug use amongst many gay men which is fuelling HIV transmission in the Capital. We want to see sexual health services which are better at identifying drug issues and drugs services which feel comfortable discussing the sexual context of gay men's drug use."
Case study: HIV is still a taboo among gay community
Ant, 35, works in marketing and lives in South-east London. He was diagnosed with HIV six years ago
"I do a lot of volunteering work with the Terrence Higgins Trust and Gay Men Fight Aids. They have been doing work around the issue of drug taking while having sex - known as "chem-sex". I would say it is a small sub-section of gay men involved in this culture, but there are increasing numbers.
"A lot of gay men who are involved in this scene hook up online and search for others who want to have unprotected sex and take drugs. Although I think there is awareness of HIV among the gay community, it's still a taboo and there's a real stigma surrounding it. A younger gay man in his 20s once told me that I didn't look ill - so how could I have HIV?"