London Chemsex Network Scoping meeting January 2017
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1 London Chemsex Network Scoping meeting January 2017
2 Who are we? London Friend since 1972 Health & well-being Coming out, social groups, activity groups Mental health counselling Sexual health & HIV Prevention Antidote drugs & alcohol service One of first services in UK to identify trend we now know as chemsex
3 Partners
4 Overview Chemsex what do we know? Why now? The London Chemsex Network for drug treatment services
5 The Chemsex Phenomenon
6 What is chemsex? Most significant recent issue in LGBT drug use Having sex whilst using drugs Gay, bisexual, MSM Specific intention to meet to use and have sex Three main drugs: mephedrone, GHB/GBL, crystal methamphetamine
7 Why is it a concern? Marked change in drugs used Changing context and methods of use Increasing presentations to services (GUM, drug treatment) Backdrop of rising HIV diagnoses & infections Emerging link to consent & sexual assault Recent UK trials: Stephen Port, PC Gordon Semple
8 Drug use by LGB people Illicit drug use in past year amongst adults by sexual orientation, Crime Survey for England & Wales 2014
9 Drug use by LGB people Illicit drug use in past year amongst adults, Crime Survey for England & Wales 2014
10 Drug use by LGB people Illicit drug use in past year amongst adults by drug type & gender, Crime Survey for England & Wales 2014
11 The drugs New UK guidance for drug management Comprehensive information on NPS New LGBT/MSM supplement
12 Recent trends Antidote clients Issue 2005/6 179 clients 2013/ clients Alcohol % 79 11% Cocaine 46 26% 86 11% Ecstasy/MDMA 37 21% 9 1% Ketamine 23 13% 44 6% GHB/GBL 3 2% % Crystal meth 0 0% % Mephedrone 0 0% % Heroin 5 3% 2 >1% Crack 14 8% 6 1% Referrals from GUM, A&E, statutory drug services 8% 63%
13 Perspective Only a subset of gay, bi and MSM Not all MSM using drugs are engaged in chemsex Not all engaged in chemsex will experience problems Users can perceive it to be more widespread Disproportionate amount of harm relating to the chemsex drugs Not sufficient evidence on new trends in LB women or trans people Don t overlook the role of alcohol
14 Chemsex data The Gay Men s Sex Survey 2014 has some of the most up to date published data: Lifetime use of: crystal (8.3%); GHB/GBL (12.5%); mephedrone (16.5%) Injecting: ever (2.9%); ever in London (3.33%); HIV+ (11.3%); HIV+ in London (14.4%) In past year those who injected: crystal (59.9%); mephedrone (60.65); GHB/GBL (1.8%)
15 Chemsex data GMSS 2014 use of chemsex drugs in previous 4 weeks: England - 6.6% London % England HIV % London HIV %
16 Chemsex & HIV Of Antidote clients : 39% HIV+ 35% accessed PEP in last year (1 8 times) 46% attribute HIV to substance use 29% said substance use followed diagnosis 47% said use went up following diagnosis 40% of HIV+ said use interfered with adherence to treatment
17 Chemsex & HIV Positive Voices Study Group 2016: First nationally representative sample taken from MSM attending clinics in England 1 in 3 (29%) of HIV+ MSM engaged in chemsex (37% in London, 17% outside) 1 in 10 slammed (1 in 5 in London 19%) Clear association between chemsex & risky sexual practices Chemsex linked to HIV, Hep C and other STIs
18 G deaths Data published by Imperial in December G-related deaths Notable increase in 2015 (29 deaths, 119% rise on 2014) All but one male, age range Other chemsex drugs detected in 65% of cases 33% of sample known to be HIV+ Rise at least in part associated to chemsex
19 Recent UK responses Antidote partnership with NHS Club Drug Clinic centre of expertise approach Drug interventions in GUM clinics: Antidote sessions in 56 Dean Street, Mortimer Market, Burrell Street other GUMs developing approach Early intervention: preventative, motivational Training: drug treatment & sexual health
20 Recent UK Responses Out Of Your Mind report Chemsex Study Project NEPTUNE clinical guidance Public Health England (PHE) working groups & briefings NPS Advisory Groups to Government & PHE Training development for Public Health Wales Police training NPS Act 2016
21 Chemsex Network Examine need for network linking drug treatment services Map experience & provision Share experience & practice Highlight training needs Strategic approach
22 Group discussion What is your experience of chemsex in your services? Do you provide any specific chemsex services or interventions? What, and where, do you feel the gaps are?
23 Forming a network What would you like to get from a network? How could a network be useful for you? How would you like to work together as a network? Who needs to be involved? What other links are needed?
24 Resources LGBT drug use
25 London Friend report Appraisal of provision Practical toolkits LGBT audits and guidance Recommendations for Public Health England, local commissioners, providers, front-line staff uk/outofyourmind
26 Contact details )
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