Chemsex and New HIV Diagnosis in Gay, Bisexual and other Men who have Sex with Men attending Sexual Health Clinics

Objective: To analyse associations between chemsex, new HIV and STI diagnoses among gay, bisexual and other men who have sex with men (GBMSM) accessing sexual health clinics. Methods: Retrospective case notes review for all GBMSM attending two London sexual health clinics between 1/6/14 and 31/7/15. Results: Chemsex status was documented for 1734/1840 patients. Overall, 27.1% (n=463) disclosed current recreational drug use of whom 286 (16.5%) disclosed chemsex and 74/409 (18.1%) injected drugs. GBMSM already HIV positive were more likely to disclose chemsex [AOR 2.55 (1.89-3.44) p<0.001]. Those disclosing chemsex had a higher odds of being newly diagnosed with HIV infection [AOR 5.06 (2.56-10.02) p<0.001], acute bacterial STIs [AOR3.94 (3.00-5.17) p<0.001], rectal STIs [4.45 (3.37-6.06) p<0.001] and Hepatitis C [AOR 9.16 (2.31-36.27) p=0.002]. HIV negative chemsex participants were also more likely to have accessed post-exposure prophylaxis for HIV in the study period and report sex with a discordant HIV or hepatitis C infected partner (p<0.001). Conclusion: Chemsex disclosure in sexual health settings is associated with higher rates of STI diagnoses including HIV and Hepatitis C. As such GBMSM attending sexual health services should be assessed for chemsex and disclosure should prompt health promotion, harm minimisation and wellbeing interventions.