Recreational drug use during sex and sexually transmitted infections among clients of a city sexually transmitted infections clinic in Amsterdam, the Netherlands.
BACKGROUND
Recreational drug use is associated with high-risk sexual behavior and sexually transmitted infections (STIs). We assessed the prevalence of drug use during sex and the associations between such use and STI (chlamydia, gonorrhea, or syphilis).


METHODS
During 3 periods in 2008 and 2009, attendees of an STI clinic in Amsterdam were interviewed about sexual behavior and drug use during sex and tested for STI. Associations between sex-related drug use and STI were assessed separately for heterosexual men, men who have sex with men (MSM), and women. We examined whether drug use was associated with STI after adjusting for high-risk sexual behavior.


RESULTS
Nine hundred sixty-one heterosexual men, 673 MSM, and 1188 women participated in this study. Of these, 11.9% had chlamydia, 3.4% gonorrhea, and 1.2% syphilis. Sex-related drug use in the previous 6 months was reported by 22.6% of heterosexual men, 51.6% of MSM, and 16.0% of women. In multivariable analyses, adjusting for demographics (and high-risk sexual behavior in MSM), sex-related drug use was associated with STI in MSM (any drugs and poppers) and women (GHB and XTC) but not in heterosexual men. Stratified analysis in MSM showed that sex-related use of poppers was associated with STI in HIV-negative MSM but not in HIV-infected MSM.


CONCLUSIONS
Clients reported frequent sex-related drug use, which was associated with STI in MSM and women. In MSM, sex-related drug use was associated with STI after adjusting for high-risk sexual behavior but only in HIV-negative MSM. Prevention measures targeted at decreasing sex-related drug use could reduce the incidence of STI.
Cluster of Infectious Diseases, Health Service of Amsterdam, Amsterdam, The Netherlands. mheiligenberg@ggd.amsterdam.nl
Marlies
M
Heiligenberg
Paulien R
PR
Wermeling
Martijn S
MS
van Rooijen
Anouk T
AT
Urbanus
Arjen G C L
AG
Speksnijder
Titia
T
Heijman
Maria
M
Prins
Roel A
RA
Coutinho
Maarten F Schim
MF
van der Loeff
D000293:Adolescent; D000328:Adult; D003075:Coitus / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D012747:Sexual Partners / Q000523:psychology; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D047568:Unsafe Sex; D014505:Urban Population; D055815:Young Adult
D013287:Illicit Drugs