title: High prevalence of quasi-legal psychoactive substance use among male patients in HIV care in Japan: a cross-sectional study.
abstract: Syndemics of illicit drug use and HIV remain as significant public health issues around the world. There has been increasing concern regarding the rapidly growing market of new psychoactive substances, particularly in Asia. In response, the Japanese government has increasingly banned such substances in recent years. We sought to identify the prevalence and correlates of use of quasi-legal psychoactive substances among people living with HIV/AIDS (PLHIV) in Japan.
  
  
  
  Data were derived from a nationwide survey of PLHIV conducted at nine leading HIV/AIDS care hospitals between July and December 2013. The prevalence and correlates of the use of quasi-legal psychoactive substances (e.g., synthetic cannabinoids, cathinone derivatives, etc. that had not been prohibited from using at the time of survey) among male participants were examined using multivariate survey logistic regression.
  
  
  
  Among 963 study participants, the majority (95.3%) were male. The most commonly used drug among men was quasi-legal psychoactive substances (55.3% ever and 12.8% in the previous year). In multivariate analysis, the lifetime use of tryptamine-type derivatives (i.e., 5-MeO-DIPT or N,N-diisopropyl-5-methoxytryptamine) (adjusted odds ratio [AOR]: 2.42; 95% confidence interval [CI]: 1.36-4.28) and methamphetamine/amphetamine (AOR: 3.59; 95% CI: 2.13-6.04) were independently associated with recent quasi-legal psychoactive substance use.
  
  
  
  In our sample of male PLHIV in Japan, quasi-legal psychoactive substances were the most commonly used drugs. Individuals who had ever used tryptamine-type derivatives or methamphetamine/amphetamine were more likely to report recent quasi-legal psychoactive substance use, suggesting a potential shift in drug use patterns from regulated to unregulated substances among this population. These findings indicate a need for further research to examine implications for HIV care.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. uhri-kh@cfenet.ubc.ca.|Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. uhri-kh@cfenet.ubc.ca.|BC Centre for Excellence in HIV/AIDS, 1026 Nelson Street, Vancouver, BC, V6E 4S7, Canada. uhri-kh@cfenet.ubc.ca.
authors.forename: Kanna
authors.identifier: 0000-0003-3843-2928
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Department of Health Sciences, Saitama Prefectural University, 820 Sannomiya, Koshigaya-shi, Saitama, 343-8540, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Wakabayashi
authors.affiliation: Positive Living and Community Empowerment Tokyo (Place Tokyo), 4-11-5-403 Takadanobaba, Shinjuku-ku, Tokyo, 169-0075, Japan.
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Ikushima
authors.affiliation: Faculty of Letters, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, 108-8345, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Tarui
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D007564:Japan; D007880:Legislation, Drug; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011619:Psychotropic Drugs / Q000008:administration & dosage*
chemical_list: D011619:Psychotropic Drugs
keywords: Drug and narcotic control; Epidemiology; HIV/AIDS; Japan; Men who have sex with men; New psychoactive substance