Hickson F*
10484116
Illicit drug use among gay and bisexual men in 44 cities: Findings from the European MSM Internet Survey (EMIS)
BACKGROUND Anecdotal evidence suggests that men who have sex with men (MSM) are increasingly combining sex and illicit drugs (an activity referred to as 'chemsex' in particular GHB/GBL, ketamine, crystal meth, or mephedrone (here called 4 chems) Use of such drugs has been associated with mental health and sexual health harms. We aim to compare patterns of illicit drug use among MSM in 44 European urban centres. METHODS In 2010, EMIS recruited 174,209 men from 38 countries to an anonymous online questionnaire in 25 languages. As harm reduction services for drugs and sex are organised at a local level, we chose to compare cities rather than countries. We defined 44 cities based on region/postal code and settlement size. For multivariable regression analyses, three comparison groups of MSM not living in these cities were applied: MSM living in Germany, the UK, and elsewhere in Europe. RESULTS Data from 55,446 MSM living in 44 urban centres were included. Use of 4 chems (past 4 weeks) was highest in Brighton (16.3% Manchester (15.5% London (13.2% Amsterdam (11.2% Barcelona (7.9% Zurich (7.0% and Berlin (5.3% It was lowest in Sofia (0.4% The rank order was largely consistent when controlling for age, HIV diagnosis, and number of sexual partners. City of residence was the strongest demographic predictor of chemsex drug use. CONCLUSION Use of drugs associated with chemsex among MSM varies substantially across European cities. As city is the strongest predictor of chemsex drug use, effective harm reduction programmes must include structural as well as individual interventions.
The International journal on drug policy
Axel Jeremias Schmidt Adam Bourne Peter Weatherburn David Reid Ulrich Marcus Ford Hickson
6452366
Hidden from health: structural stigma, sexual orientation concealment, and HIV across 38 countries in the European MSM Internet Survey
Objective:Substantial country level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV prevention services, needs and behaviours have rarely been examined, however. Design:Data come from the European MSM Internet Survey (EMIS) which was administered between June and August 2010 across 38 European countries (N 174 209) Methods:Country level stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of attitudes held by the citizens of each country. We also assessed concealment, HIV status, number of past 12 month male sex partners, and eight HIV preventive services, knowledge, and behavioural outcomes. Results:MSM living in countries with higher levels of stigma had reduced odds of diagnosed HIV and fewer partners but higher odds of sexual risk behaviour, unmet prevention needs, not using testing services, and not discussing their sexuality in testing services. Sexual orientation concealment mediated associations between country level stigma and these outcomes. Conclusion:Country level stigma may have historically limited HIV transmission opportunities among MSM, but by restricting MSM's public visibility, it also reduces MSM's ability to access HIV preventive services, knowledge and precautionary behaviours. These findings suggest that MSM in European countries with high levels of stigma are vulnerable to HIV infection. Although they have less opportunity to identify and contact other MSM, this might change with emerging technologies.
AIDS
John E Pachankis Mark L Hatzenbuehler Ford Hickson Peter Weatherburn Rigmor C Berg Ulrich Marcus Axel Jeremias Schmidt
22792082
"Chemsex" and harm reduction need among gay men in South London.
BACKGROUND Chemsex is a colloquial term used by gay men in some parts of the UK to describe the use of psychoactive substances (typically mephedrone, GHB/GBL or crystal methamphetamine) during sex. Use of these drugs by gay men in London appears to have risen sharply from relatively low levels and, as yet, there is little data to inform appropriate harm reduction services. This study sought to understand the personal and social context of chemsex and the nature of harm reduction need. METHODS In depth interviews were conducted with 30 self identifying gay men (age range 21 53) who lived in three South London boroughs, and who had used either crystal methamphetamine, mephedrone or GHB/GBL either immediately before or during sex with another man during the previous 12 months. Data were subjected to a thematic analysis. RESULTS While around half of participants had utilised a range of drugs over many years, others had only recently been introduced to drugs, often by sexual partners who wished to enhance the sexual session. As relatively new drugs on the gay scene, understanding of appropriate dosing was lacking and a majority described overdoses, particularly in relation to GHB/GBL. Negotiation of sex, especially in group sex environments, was complicated by the effects of the drugs and a small number of men reported concerns relating to sexual consent. While a significant proportion of men had experienced a range of physical and mental health harms, few had accessed professional support for fear of judgement or concern about chemsex expertise. CONCLUSION Findings from this study indicate a substantial degree of harm in the usage of relatively new psychoactive substances in highly sexual circumstances. Generic drug services, typically designed to address the needs of opiate users, may not be sufficiently resourced to address the specific and acute needs of gay men engaging in chemsex.
The International journal on drug policy
Adam Bourne David Reid Ford Hickson Sergio Torres-Rueda Paul Steinberg Peter Weatherburn
37572743
Illicit drug use in sexual settings 'chemsex' and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study
Background 'Chemsex' is a colloquial term used in the UK that describes sex under the influence of psychoactive substances (typically crystal methamphetamine, mephedrone and gamma hydroxybutyric acid (GHB)/gamma butyrolactone (GBL) Recently, concern has been raised as to the impact of such behaviour on HIV/sexually transmitted infection (STI) transmission risk behaviour, which this qualitative study aimed to explore via semistructured interviews with gay men living in three South London boroughs. Methods Interviews were conducted with 30 community recruited gay men (age range 21 53) who lived in the boroughs of Lambeth, Southwark and Lewisham, and who had used crystal methamphetamine, mephedrone or GHB/GBL either immediately before or during sex with another man during the previous 12 months. Data were subjected to a thematic analysis. Results Chemsex typically featured more partners and a longer duration than other forms of sex, and the relationship between drug use and HIV/STI transmission risk behaviour was varied. While some men believed that engaging in chemsex had unwittingly led them to take risks, others maintained strict personal rules about having safer sex. Among many participants with diagnosed HIV, there was little evidence that the use of drugs had significantly influenced their engagement in condomless anal intercourse (primarily with other men believed to be HIV positive) but their use had facilitated sex with more men and for longer. Conclusions Analysis revealed that, within this sample, chemsex is never less risky than sex without drugs, and is sometimes more so. Targeted clinic based and community based harm reduction and sexual health interventions are required to address the prevention needs of gay men combining psychoactive substances with sex.
Sexually Transmitted Infections
Adam Bourne David Reid Ford Hickson Sergio Torres-Rueda Peter Weatherburn
1646048
The KInetic Database for Astrochemistry (KIDA)
We present a novel chemical database for gas phase astrochemistry. Named the KInetic Database for Astrochemistry (KIDA) this database consists of gas phase reactions with rate coefficients and uncertainties that will be vetted to the greatest extent possible. Submissions of measured and calculated rate coefficients are welcome, and will be studied by experts before inclusion into the database. Besides providing kinetic information for the interstellar medium, KIDA is planned to contain such data for planetary atmospheres and for circumstellar envelopes. Each year, a subset of the reactions in the database (kida.uva) will be provided as a network for the simulation of the chemistry of dense interstellar clouds with temperatures between 10 K and 300 K. We also provide a code, named Nahoon, to study the time dependent gas phase chemistry of zero dimensional and one dimensional interstellar sources.
Valentine Wakelam Eric Herbst J C Loison Ian W M Smith Vijayanand Chandrasekaran B Pavone Nigel G Adams M -C Bacchus-Montabonel Astrid Bergeat K Bero Veronica M Bierbaum Alexander Dalgarno E F van Dishoeck A Faure Wolf Dietrich Geppert Dieter Gerlich E Hebrard F Hersant Kevin M Hickson Pascal Honvault Stephen J Klippenstein Sebastien D Le Gunnar Nyman Pascal Pernot Stephan Schlemmer Franck Selsis Ian R Sims Dahbia Talbi Jurgen Troe Roland Wester Laurent Wiesenfeld
68407313
The Chemsex study: drug use in sexual settings among gay and bisexual men in Lambeth, Southwark and Lewisham
The Chemsex Study: drug use in sexual settings among gay and bisexual men in Lambeth, Southwark Lewisham was the driving force behind the conception of this study and he provided significant practical and intellectual support at every stage. It could not have happened without him. A large number of other people also contributed to the success of this project. (Chemsex community forums) the Vauxhall One business association, Uli Lenart and Jimmy MacSweeney (Gay's the Word) Christopher Camplin, and Matthew Hodson (GMFA) We particularly wish to acknowledge the support of the Metro Centre staff and volunteers (especially David Naylor, Rob Wardle and Tony Furlong) for helping to inform the study, as well as hosting and participating in focus groups. Thanks to Kathie Granger for her expert project administration, to Gary Hammond for proofreading and to Sian Cook for her design of this report. Finally, this study would not have been possible without thirty men stepping forward to talk openly and honestly with us about their experiences. We are greatly indebted to them. We also sincerely thank all those who took part in focus groups, as well as the staff and volunteers from community based organisations and sexual health clinics who gave up their time to share their thoughts and experiences. (2014) The Chemsex study: drug use in sexual settings among gay bisexual men in Lambeth, Southwark Lewisham.
Adam Bourne David Reid Ford Hickson S Torres Rueda Peter Weatherburn
11316876
Rituximab therapy in idiopathic membranous nephropathy: a 2 year study.
BACKGROUND AND OBJECTIVES It was postulated that in patients with membranous nephropathy (MN) four weekly doses of Rituximab (RTX) would result in more effective B cell depletion, a higher remission rate, and maintaining the same safety profile compared with patients treated with RTX dosed at 1 g every 2 weeks. This hypothesis was supported by previous pharmacokinetic (PK) analysis showing that RTX levels in the two dose regimen were 50% lower compared with nonproteinuric patients, which could potentially result in undertreatment. DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS Twenty patients with MN and proteinuria >5 g/24 h received RTX (375 mg/m(2) x 4) with re treatment at 6 months regardless of proteinuria response. PK analysis was conducted simultaneously with immunological analyses of T and B cells to ascertain the effect of RTX on lymphocyte subpopulations. RESULTS Baseline proteinuria of 11.9 g/24 h decreased to 4.2 and 2.0 g/24 h at 12 and 24 months, respectively, whereas creatinine clearance increased from 72.4 ml/min per 1.73 m(2) at baseline to 88.4 ml/min per 1.73 m(2) at 24 months. Of 18 patients who completed 24 month follow up, 4 are in complete remission, 12 are in partial remission, 1 has a limited response, and 1 patient relapsed. Serum RTX levels were similar to those obtained with two doses of RTX. CONCLUSIONS Four doses of RTX resulted in more effective B cell depletion, but proteinuria reduction was similar to RTX at 1 g every 2 weeks. Baseline quantification of lymphocyte subpopulations did not predict response to RTX therapy.
Clinical journal of the American Society of Nephrology CJASN
Fernando C Fervenza Roshini S Abraham Stephen B Erickson Maria V Irazabal Alfonso Eirin Ulrich Specks Patrick H Nachman Eric J Bergstralh Nelson Leung Fernando G Cosio Marie C Hogan John J Dillon LaTonya J Hickson Xujian Li Daniel C Cattran
3726595
Mental health inequalities among gay and bisexual men in England, Scotland and Wales: a large community based cross sectional survey
Background Sexual minorities suffer worse mental health than the sexual majority but little is known about differences in mental health within sexual minorities. We aimed to describe inequality in mental health indicators among gay and bisexual men. Methods Using multi channel community based opportunistic sampling we recruited 5799 eligible men aged 16 years and over, living in England, Scotland and Wales and who were sexually attracted to other men, to a self completion Internet health survey. Mental health indicators (depression (PHQ 9) anxiety (GAD 7) suicide attempt and self harm) were examined for independent associations across common axes of inequality (age, ethnicity, migrancy, education, income, cohabitation and living in London) Results Mental ill health was common: 21.3% were depressed and 17.1% anxious, while 3.0% had experienced attempted suicide and 6.5% had self harmed within the last 12 months. All four indicators were associated with younger age, lower education and lower income. Depression was also associated with being a member of visible ethnic minorities and sexual attraction to women as well as men. Cohabiting with a male partner and living in London were protective of mental health. Conclusion Community interventions to increase mental health among gay and bisexual men should be designed to disproportionately benefit younger men and those living on lower incomes.
Journal of public health
Ford Hickson Calum Davey David Reid Peter Weatherburn Adam Bourne
53418427
THE 2014 KIDA NETWORK FOR INTERSTELLAR CHEMISTRY
Chemical models used to study the chemical composition of the gas and the ices in the interstellar medium are based on a network of chemical reactions and associated rate coefficients. These reacti
Valentine Wakelam J C Loison Eric Herbst B Pavone Astrid Bergeat K B'eroff Marin Chabot A Faure Daniele Galli Wolf Dietrich Geppert Dieter Gerlich Pierre Gratier Nanase Harada Kevin M Hickson Pascal Honvault Stephen J Klippenstein Sebastien D Le Picard Gunnar Nyman Maxime Ruaud Stephan Schlemmer Ian R Sims Dahbia Talbi Jonathan Tennyson Roland Wester
207028637
Motivations and values associated with combining sex and illicit drugs 'chemsex' among gay men in South London: findings from a qualitative study
Objectives There is considerable public health concern about the combining of sex and illicit drugs (chemsex) among gay men. With a view to inform supportive therapeutic and clinical interventions, we sought to examine the motivations for engaging in chemsex among gay men living in South London. Methods Community advertising recruited 30 gay men for qualitative semi structured interview. Aged between 21 and 53 years, all lived in South London in the boroughs of Lambeth, Southwark and Lewisham and all had combined crystal methamphetamine, mephedrone and/or g hydroxybutyric acid/g butyrolactone with sex in the past 12 months. Transcripts were subjected to a thematic analysis. Results We broadly distinguished two groups of reasons for combining sex and drugs, within which we described eight distinct motivations. The first major group of motivations for combining drugs with sex was that drugs provide the means by which men can have the sex they desire by increasing libido, confidence, disinhibition and stamina. The second major group of motivations for chemsex was that drugs enhance the qualities of the sex that men value. Drugs made other men seem more attractive, increased physical sensations, intensified perceptions of intimacy and facilitated a sense of sexual adventure. Conclusion Analysis revealed that sexualised drug use provides both motivation and capability to engage in the kinds of sex that some gay men value: sex that explores and celebrates adventurism. Those services providing (talking) interventions to men engaging in chemsex should consider these benefits of sexualised drug use alongside the harms arising.
Sexually Transmitted Infections
Peter Weatherburn Ford Hickson David Reid Sergio Torres-Rueda Adam Bourne