@article{ref1,
title="Illicit drug use among gay and bisexual men in 44 cities: findings from the European MSM Internet Survey (EMIS)",
journal="International journal on drug policy",
year="2016",
author="Schmidt, Axel J. and Bourne, Adam and Weatherburn, Peter and Reid, David and Marcus, Ulrich and Hickson, Ford",
volume="38",
number="",
pages="4-12",
abstract="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. <br><br>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. <br><br>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. <br><br>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.<br><br>Copyright © 2016 Elsevier B.V. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0955-3959",
doi="10.1016/j.drugpo.2016.09.007",
url="http://dx.doi.org/10.1016/j.drugpo.2016.09.007"
}