AIDS and Behavior

, Volume 20, Issue 10, pp 2372–2386 | Cite as

Patterns of Drug Use and Drug-related Hospital Admissions in HIV-Positive and -Negative Gay and Bisexual Men

  • Cecilia L. Moore
  • Heather F. Gidding
  • Fengyi Jin
  • Limin Mao
  • Kathy Petoumenos
  • Iryna B. Zablotska
  • I. Mary Poynten
  • Garrett Prestage
  • Matthew G. Law
  • Andrew E. Grulich
  • Janaki Amin
Original Paper


We aimed to compare rates of illicit drug-related hospitalisations in HIV-negative (HIV−ve) (n = 1325) and HIV-positive (HIV+ve) (n = 557) gay and bisexual men (GBM) with rates seen in the general male population and to examine the association between self-reported illicit drug use and drug-related hospitalisation. Participants were asked how often they used a range of illicit drugs in the previous 6 months at annual interviews. Drug-related hospital admissions were defined as hospital admissions for mental or behavioural disorders due to illicit drug use (ICD 10: F11–16, F18, F19), drug poisoning (T40–T45, T50) or toxic effect of gases (T53, T59, T65). Drug-related hospitalisations were 4.8 times higher in the HIV−ve cohort [SIR 4.75 (95 % CI 3.30–6.91)] and 3.5 times higher in the HIV+ve cohort [SIR 3.51 (1.92–5.88)] compared with the general population. Periods of weekly drug use [IRR 1.86 (1.01–3.46)], poly-drug use [IRR 2.17 (1.07–4.38)] and cannabis use [low use-IRR 1.95 (1.01–3.77), high use-IRR 2.58 (1.29–5.16)] were associated with drug-related hospitalisation in both cohorts, as was being a consistently high meth/amphetamine user throughout follow-up [IRR 3.24 (1.07–9.83)] and being an inconsistent or consistent injecting drug user throughout follow-up [IRR 3.94 (1.61–9.66), IRR 4.43(1.04–18.76), respectively]. Other risk factors for drug-related hospitalisation indicated the likelihood of comorbid drug and mental health issues in GBM hospitalised for drug use.


Illicit drug use Homosexual Gay Bisexual Male Hospital admission 


  1. 1.
    Chakraborty A, McManus S, Brugha TS, Bebbington P, King M. Mental health of the non-heterosexual population of England. British J Psychiatry. 2011;198(2):143–8.CrossRefGoogle Scholar
  2. 2.
    Cochran SD, Ackerman D, Mays VM, Ross MW. Prevalence of non-medical drug use and dependence among homosexually active men and women in the US population. Addiction. 2004;99(8):989–98.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Fredriksen-Goldsen KI, Kim HJ, Barkan SE, Muraco A, Hoy-Ellis CP. Health disparities among lesbian, gay, and bisexual older adults: results from a population-based study. Am J Public Health. 2013;103(10):1802–9.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Stall R, Wiley J. A comparison of alcohol and drug use patterns of homosexual and heterosexual men: the San Francisco Men’s Health Study. Drug Alcohol Depend. 1988;22(1–2):63–73.CrossRefPubMedGoogle Scholar
  5. 5.
    Welfare AIoHa. National Drugs Strategy Household Surveys (NDSHS) (AIHW): Highlights from the 2013 Survey Canberra: AIHW; 2013 [cited 2014 19/09/2014]. Available from:
  6. 6.
    Holt M, Lee E, Prestage GP, Zablotska I, de Wit J, Mao L. The converging and diverging characteristics of HIV-positive and HIV-negative gay men in the Australian Gay Community Periodic Surveys, 2000-2009. AIDS Care. 2013;25(1):28–37.CrossRefPubMedGoogle Scholar
  7. 7.
    Hull P, Mao L, Kao SC, Edwards B, Prestage G, Zablotska I, et al. Gay community periodic survey: Sydney 2013. Sydney: National Centre in HIV Social Research, University of New South Wales; 2013.Google Scholar
  8. 8.
    Lee E, Mao L, McKenzie T, Batrouney C, West M, Prestage G, et al. Gay community periodic survey: Melbourne 2013. Sydney: National Centre in HIV Social Research, Universtiy of New South Wales; 2013.Google Scholar
  9. 9.
    Lee E, Mao L, Skene H, Cannon R, Narciso L, Prestage G, et al. Gay Community periodic survey: Adelaide 2012. Sydney: National Centre in HIV Social Research, University of New South Wales; 2013.Google Scholar
  10. 10.
    Lee E, Mao L, Watts P, Mackie A, Prestage G, Zablotska I, et al. Gay community periodic survey: Queensland 2013. Sydney: Centre for Social Research in Health, University of New South Wales; 2014.Google Scholar
  11. 11.
    Lee E, Hull P, Mao L, Comfort J, Chanmugam M, Laing S, et al. Gay community periodic survey: Perth 2014. Sydney: Centre for Social REsearch in Health, UNSW Australia; 2014.Google Scholar
  12. 12.
    Centers for Disease Control and Prevention (CDC). Methamphetamine use and risk for HIV/AIDS. Atlanta: CDC; 2007.Google Scholar
  13. 13.
    Bourne A. Drug use among men who have sex with men. Implications for harm reduction. London: Harm Reduction International; 2012.Google Scholar
  14. 14.
    Lea T, Prestage G, Mao L, Zablotska I, de Wit J, Holt M. Trends in drug use among gay and bisexual men in Sydney, Melbourne and Queensland, Australia. Drug Alcohol Rev. 2013;32(1):39–46.CrossRefPubMedGoogle Scholar
  15. 15.
    Lea T, Mao L, Bath N, Prestage G, Zablotska I, de Wit J, et al. Injecting drug use among gay and bisexual men in Sydney: prevalence and associations with sexual risk practices and HIV and hepatitis C infection. AIDS Behav. 2013;17(4):1344–51.CrossRefPubMedGoogle Scholar
  16. 16.
    Colfax G, Vittinghoff E, Husnik MJ, McKirnan D, Buchbinder S, Koblin B, et al. Substance use and sexual risk: a participant- and episode-level analysis among a cohort of men who have sex with men. Am J Epidemiol. 2004;159(10):1002–12.CrossRefPubMedGoogle Scholar
  17. 17.
    Operario D, Choi K-H, Chu P, McFarland W, Secura G, Behel S, et al. Prevalence and correlates of substance use among young asian pacific islander men who have sex with men. Prev Sci. 2006;7(1):19–29.CrossRefPubMedGoogle Scholar
  18. 18.
    Daskalopoulou M, Rodger A, Phillips AN, Sherr L, Speakman A, Collins S, et al. Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study. Lancet HIV. 2014;1(1):e22–31.CrossRefPubMedGoogle Scholar
  19. 19.
    Lee SJ, Galanter M, Dermatis H, McDowell D. Circuit parties and patterns of drug use in a subset of gay men. J Addict Dis. 2003;22(4):47–60.CrossRefPubMedGoogle Scholar
  20. 20.
    Jones JD, Mogali S, Comer SD. Polydrug abuse: a review of opioid and benzodiazepine combination use. Drug Alcohol Depend. 2012;125(1–2):8–18.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Chen C-Y, Lin K-M. Health consequences of illegal drug use. Curr Opin Psychiatry. 2009;22(3):287–92.CrossRefPubMedGoogle Scholar
  22. 22.
    Arendt M, Munk-Jorgensen P, Sher L, Jensen SO. Mortality among individuals with cannabis, cocaine, amphetamine, MDMA, and opioid use disorders: a nationwide follow-up study of Danish substance users in treatment. Drug Alcohol Depend. 2011;114(2–3):134–9.PubMedGoogle Scholar
  23. 23.
    Moore TH, Zammit S, Lingford-Hughes A, Barnes TR, Jones PB, Burke M, et al. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet. 2007;370(9584):319–28.CrossRefPubMedGoogle Scholar
  24. 24.
    Bakir AA, Dunea G. Drugs of abuse and renal disease. Curr Opin Nephrol Hypertens. 1996;5(2):122–6.CrossRefPubMedGoogle Scholar
  25. 25.
    Burgess C, O’Donohoe A, Gill M. Agony and ecstasy: a review of MDMA effects and toxicity. European Psychiatry. 2000;15(5):287–94.CrossRefPubMedGoogle Scholar
  26. 26.
    Hill SL, Thomas SH. Clinical toxicology of newer recreational drugs. Clinical Toxicol. 2011;49(8):705–19.CrossRefGoogle Scholar
  27. 27.
    Bukoski WJ. NIDA Research Monograph 107. In: Leukefeld CG, Bukoski WJ, editors. Drug Abuse Prevention Intervention Research: Methodoloigcal Issues. Rockville: U.S. Department of Health and Human Services; 1991.Google Scholar
  28. 28.
    Prestage G, Degenhardt L, Jin F, Grulich A, Imrie J, Kaldor J, et al. Predictors of frequent use of amphetamine type stimulants among HIV-negative gay men in Sydney. Australia. Drug Alcohol Depend. 2007;91(2–3):260–8.CrossRefPubMedGoogle Scholar
  29. 29.
    Prestage G, Fogarty AS, Rawstorne P, Grierson J, Zablotska I, Grulich A, et al. Use of illicit drugs among gay men living with HIV in Sydney. AIDS. 2007;21(Suppl 1):S49–55.CrossRefPubMedGoogle Scholar
  30. 30.
    Jin F, Prestage GP, Mao L, Kippax SC, Pell CM, Donovan B, et al. Transmission of herpes simplex virus types 1 and 2 in a prospective cohort of HIV-negative gay men: the health in men study. J Infect Dis. 2006;194(5):561–70.CrossRefPubMedGoogle Scholar
  31. 31.
    Prestage G, Mao L, Kippax S, Jin F, Hurley M, Grulich A, et al. Use of viral load to negotiate condom use among gay men in Sydney, Australia. AIDS Behav. 2009;13(4):645–51.CrossRefPubMedGoogle Scholar
  32. 32.
    Mao L, Van De Ven PG, Prestage G, Jin F, Grulich AE, Crawford J, et al. Health in men. Baseline data UNSW. Sydney: National centre in HIV Social Research; 2002.Google Scholar
  33. 33.
    Prestage G, Song A, Grierson J, Race K, Grulich A, Kippax S. Positive health: method and sample 1998–1999. Sydney: National Centre in HIV Social Research; 2000.Google Scholar
  34. 34.
    Prestage G, Kippax SC, Grulich AE, Race K, Grierson JW, Song A. Positive health: method and sample. Sydney: University of NSW; 2001.Google Scholar
  35. 35.
    Jaro MA. Probabilistic linkage of large public health data files. Stat Med. 1995;14(5–7):491–8.CrossRefPubMedGoogle Scholar
  36. 36.
    Australian Institute of Health and Welfare. National Hospital Morbidity Database 2011/12, Principal Dianosis. In: AIHW, editor. Canberaa2013.Google Scholar
  37. 37.
    Stukel TA, Glynn RJ, Fisher ES, Sharp SM, Lu-Yao G, Wennberg JE. Standardized rates of recurrent outcomes. Stat Med. 1994;13(17):1781–91.CrossRefPubMedGoogle Scholar
  38. 38.
    Colfax G, Coates TJ, Husnik MJ, Huang Y, Buchbinder S, Koblin B, et al. Longitudinal patterns of methamphetamine, popper (amyl nitrite), and cocaine use and high-risk sexual behavior among a cohort of san francisco men who have sex with men. J Urban Health. 2005;82(1 Suppl 1):i62–70.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Hunter LJ, Dargan PI, Benzie A, White JA, Wood DM. Recreational drug use in men who have sex with men (MSM) attending UK sexual health services is significantly higher than in non-MSM. Postgrad Med J. 1061;2014(90):133–8.Google Scholar
  40. 40.
    Wei C, Guadamuz TE, Lim SH, Huang Y, Koe S. Patterns and levels of illicit drug use among men who have sex with men in Asia. Drug Alcohol Depend. 2012;120(1–3):246–9.CrossRefPubMedGoogle Scholar
  41. 41.
    Daskalopoulou M, Rodger A, Thornton A, Phillips A, Sherr L, Gilson R, et al. Sexual behaviour, recreational drug use and hepatitis C co-infection in HIV-diagnosed men who have sex with men in the United Kingdom: results from the ASTRA study. J Int AIDS Soc. 2014;17(4 Suppl 3):19630.PubMedPubMedCentralGoogle Scholar
  42. 42.
    Patterson T, Semple S, Zians J, Strathdee S. Methamphetamine-using HIV-positive men who have sex with men: correlates of polydrug use. J Urban Health. 2005;82(1):i120–6.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Rosenberg ES, Sullivan PS, Dinenno EA, Salazar LF, Sanchez TH. Number of casual male sexual partners and associated factors among men who have sex with men: results from the National HIV Behavioral Surveillance system. BMC Public Health. 2011;11:189.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Zablotska I, Frankland A, Prestage G, Down I, Ryan D. Gay community periodic survey: Sydney, February 2008. Sydney: The University of New South Wales; 2008.Google Scholar
  45. 45.
    Smith AM, Rissel CE, Richters J, Grulich AE, de Visser RO. Sex in Australia: sexual identity, sexual attraction and sexual experience among a representative sample of adults. Aust N Z J Public Health. 2003;27(2):138–45.CrossRefPubMedGoogle Scholar
  46. 46.
    Fendrich M, Mackesy-Amiti ME, Johnson TP. Validity of self-reported substance use in men who have sex with men: comparisons with a general population sample. Ann Epidemiol. 2008;18(10):752–9.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Cecilia L. Moore
    • 1
  • Heather F. Gidding
    • 2
  • Fengyi Jin
    • 1
  • Limin Mao
    • 3
  • Kathy Petoumenos
    • 1
  • Iryna B. Zablotska
    • 1
  • I. Mary Poynten
    • 1
  • Garrett Prestage
    • 1
    • 4
  • Matthew G. Law
    • 1
  • Andrew E. Grulich
    • 1
  • Janaki Amin
    • 1
  1. 1.The Kirby InstituteUniversity of New South WalesSydneyAustralia
  2. 2.School of Public Health and Community MedicineUniversity of New South WalesSydneyAustralia
  3. 3.Centre for Social Research in HealthUniversity of New South WalesSydneyAustralia
  4. 4.Australian Research Centre in Sex, Health and SocietyLa Trobe UniversityMelbourneAustralia

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