The role of drugs during group sex among gay men in Australia.
BACKGROUND
Drug use has been associated with risk behaviour among gay men. We examined the use of drugs and sexual risk behaviour among homosexually-active men who engaged in group sex in Australia.


METHODS
We used an anonymous, self-complete survey about participants' most recent occasion of group sex with other men and in-depth interviews with a small number of these survey participants. The 746 men who reported having engaged in group sex within the previous 6 months were included in these analyses.


RESULTS
Among 746 men who engaged in group sex within the previous 6 months, 63.0% reported using illicit drugs at the group sex encounter. Men commonly reported using drugs specifically to enhance their sexual experience and to intensify the pleasure of that experience. After controlling for each drug type and other risk factors, only use of methamphetamine (odds ratio = 1.74, confidence interval = 1.06-2.88, P = 0.030) and having more than five drinks (odds ratio = 2.41, confidence interval = 1.34-4.33, P = 0.003) were independently associated with unprotected anal intercourse with non-HIV seroconcordant partners in multivariate analysis.


CONCLUSIONS
Methamphetamine and heavy alcohol use are associated with increased sexual risk behaviour among men who engage in group sex. Within more 'adventurous' gay community subcultures, drug use is often for the explicit purpose of enhancing the sexual experience and this complex relationship may be key to understanding HIV risk among these men.
Prestage
Garrett
G
National Centre in HIV Epidemiology and Clinical Research, 376 Victoria Street, Darlinghurst, NSW 2010, Australia. gprestage@nchecr.unsw.edu.au
Grierson
Jeffrey
J
Bradley
Jack
J
Hurley
Michael
M
Hudson
Jeff
J
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D001315:Australia / Q000453:epidemiology; D006127:Group Structure; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012650:Self Disclosure; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
D013287:Illicit Drugs