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1.
Addiction ; 117(1): 182-194, 2022 01.
Article in English | MEDLINE | ID: covidwho-1556743

ABSTRACT

AIMS: To describe (i) self-reported changes in drug use and (ii) trends in price, perceived availability, and perceived purity of illicit drugs, among people who regularly use ecstasy/ 3,4-methylenedioxymethamphetamine (MDMA) and other illicit stimulants in Australia following COVID-19 and associated restrictions. DESIGN: Annual interviews with cross-sectional sentinel samples conducted face-to-face in 2016-19 and via video conferencing or telephone in 2020. Data were collected via an interviewer-administered structured questionnaire. SETTING: Australian capital cities. PARTICIPANTS: Australians aged 16 years or older who used ecstasy/MDMA and other illicit stimulants on a monthly or more frequent basis and resided in a capital city, recruited via social media and word-of-mouth (n ~ 800 each year). MEASUREMENTS: Key outcome measures were self-reported illicit drug market indicators (price, purity and availability) and, in 2020 only, perceived change in drug use (including alcohol and tobacco) since March 2020 and reasons for this change. FINDINGS: For most drugs, participants reported either no change or a reduction in their use since COVID-19 restrictions were introduced. Ecstasy/MDMA was the drug most frequently cited as reduced in use (n = 552, 70% of those reporting recent use), mainly due to reduced opportunities for socialization. While market indicators were largely stable across most drugs, the odds of perceiving MDMA capsules as 'high' in purity decreased compared with 2016-19 [adjusted odds ratio (aOR) = 0.72, 95% confidence interval (CI) = 0.53-0.99], as did perceiving them as 'easy' to obtain (aOR = 0.42, CI = 0.26-0.67). The odds of perceiving cocaine and methamphetamine crystal as 'easy' to obtain also decreased (aOR = 0.67, CI = 0.46-0.96 and aOR = 0.12, CI = 0.04-0.41, respectively). CONCLUSIONS: After COVID-19-related restrictions were introduced in Australia, use of ecstasy/MDMA, related stimulants and other licit and illicit drugs mainly appeared to remain stable or decrease, primarily due to impediments to socialization.


Subject(s)
COVID-19 , Illicit Drugs , N-Methyl-3,4-methylenedioxyamphetamine , Australia/epidemiology , Cross-Sectional Studies , Humans , Pandemics , SARS-CoV-2
2.
Addiction ; 116(12): 3398-3407, 2021 12.
Article in English | MEDLINE | ID: covidwho-1503763

ABSTRACT

AIMS: To estimate change in young people's alcohol consumption during COVID-19 restrictions in Australia in early-mid 2020, and test whether those changes were consistent by gender and level of consumption prior to the pandemic. DESIGN: Prospective longitudinal cohort. SETTING: Secondary schools in New South Wales, Tasmania and Western Australia. PARTICIPANTS: Subsample of a cohort (n = 443) recruited in the first year of secondary school in 2010-11. Analysis data included three waves collected in September 2017-July 2018, September 2018-May 2019 and August 2019-January 2020), and in May-June 2020. MEASUREMENTS: The primary predictors were time, gender and level of consumption prior to the pandemic. Outcome variables, analysed by mixed-effects models, included frequency and typical quantity of alcohol consumption, binge drinking, peak consumption, alcohol-related harm and drinking contexts. FINDINGS: Overall consumption (frequency × quantity) during the restrictions declined by 17% [incidence rate ratio (IRR) = 0.83; 95% confidence interval (CI) = 0.73, 0.95] compared to February 2020, and there was a 35% decline in the rate of alcohol-related harms in the same period (IRR = 0.66; 95% CI = 0.54, 0.79). Changes in alcohol consumption were largely consistent by gender. CONCLUSIONS: From a survey of secondary school students in Australia, there is evidence for a reduction in overall consumption and related harms during the COVID-19 restrictions.


Subject(s)
COVID-19 , Pandemics , Adolescent , Adult , Alcohol Drinking/epidemiology , Australia/epidemiology , Cohort Studies , Humans , Prospective Studies , SARS-CoV-2
3.
Addiction ; 116(12): 3398-3407, 2021 12.
Article in English | MEDLINE | ID: covidwho-1262304

ABSTRACT

AIMS: To estimate change in young people's alcohol consumption during COVID-19 restrictions in Australia in early-mid 2020, and test whether those changes were consistent by gender and level of consumption prior to the pandemic. DESIGN: Prospective longitudinal cohort. SETTING: Secondary schools in New South Wales, Tasmania and Western Australia. PARTICIPANTS: Subsample of a cohort (n = 443) recruited in the first year of secondary school in 2010-11. Analysis data included three waves collected in September 2017-July 2018, September 2018-May 2019 and August 2019-January 2020), and in May-June 2020. MEASUREMENTS: The primary predictors were time, gender and level of consumption prior to the pandemic. Outcome variables, analysed by mixed-effects models, included frequency and typical quantity of alcohol consumption, binge drinking, peak consumption, alcohol-related harm and drinking contexts. FINDINGS: Overall consumption (frequency × quantity) during the restrictions declined by 17% [incidence rate ratio (IRR) = 0.83; 95% confidence interval (CI) = 0.73, 0.95] compared to February 2020, and there was a 35% decline in the rate of alcohol-related harms in the same period (IRR = 0.66; 95% CI = 0.54, 0.79). Changes in alcohol consumption were largely consistent by gender. CONCLUSIONS: From a survey of secondary school students in Australia, there is evidence for a reduction in overall consumption and related harms during the COVID-19 restrictions.


Subject(s)
COVID-19 , Pandemics , Adolescent , Adult , Alcohol Drinking/epidemiology , Australia/epidemiology , Cohort Studies , Humans , Prospective Studies , SARS-CoV-2
4.
Lancet Public Health ; 6(1): e2-e3, 2021 01.
Article in English | MEDLINE | ID: covidwho-1044663
5.
J Acquir Immune Defic Syndr ; 86(1): 22-30, 2021 01 01.
Article in English | MEDLINE | ID: covidwho-975391

ABSTRACT

BACKGROUND: In response to the novel coronavirus disease (COVID-19) pandemic, Australia introduced public health and physical distancing restrictions in late March 2020. We investigated the impact of these restrictions on HIV preexposure prophylaxis (PrEP) use among Australian gay and bisexual men (GBM). METHODS: Participants in an ongoing online cohort study previously reported PrEP use from 2014 to 2019. In April 2020, 847 HIV-negative and untested participants completed questionnaires assessing changes in PrEP use as a result of COVID-19 public health measures. Binary logistic multiple regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) to compare changes in PrEP use behaviors. RESULTS: Among 847 men, mean age was 44.1 years (SD: 12.7). PrEP use rose from 4.9% in 2015 to 47.2% in 2020. Among those, 41.8% (n = 167) discontinued PrEP use during COVID-19 restrictions. Discontinuing PrEP during COVID-19 restrictions was independently associated with being less likely to have recently tested for HIV (aOR: 0.17; 95% CI: 0.09 to 0.34; P < 0.001) and less likely to report sex with casual partners (aOR: 0.28; 95% CI: 0.14 to 0.54; P < 0.001). CONCLUSIONS: By April 2020, following the introduction of COVID-19 restrictions, GBM dramatically reduced PrEP use, coinciding with a reduction in sexual activity. Longer-term impacts of COVID-19 restrictions on sexual behaviors among GBM need to be monitored because they may foreshadow fluctuations in prevention coverage and risk of HIV infection. Our findings indicate a potential need for clear, targeted information about resumption of PrEP and on-demand optimal dosing regimens in response to ongoing changes in restrictions.


Subject(s)
COVID-19/prevention & control , HIV Infections/prevention & control , Physical Distancing , Pre-Exposure Prophylaxis/statistics & numerical data , Adolescent , Adult , Australia , Bisexuality , Homosexuality, Male , Humans , Male , Middle Aged , Prospective Studies , Sexual Behavior , Sexual and Gender Minorities , Young Adult
6.
J Subst Abuse Treat ; 121: 108189, 2021 02.
Article in English | MEDLINE | ID: covidwho-907188

ABSTRACT

The rapid spread of the coronavirus disease (COVID-19) has impacted the lives of millions around the globe. The COVID-19 pandemic has caused increasing concern among treatment professionals about mental health and risky substance use, especially among those who are struggling with a substance use disorder (SUD). The pandemic's impact on those with an SUD may be heightened in vulnerable communities, such as those living in under-resourced and rural areas. Despite policies loosening restrictions on treatment requirements, unintended mental health consequences may arise among this population. We discuss challenges that under-resourced areas face and propose strategies that may improve outcomes for those seeking treatment for SUDs in these areas.


Subject(s)
Comorbidity , Health Services Accessibility , Mental Disorders/therapy , Resource Allocation , Rural Population , Substance-Related Disorders/therapy , COVID-19 , Humans , Mental Health Services , Telemedicine
7.
J Acquir Immune Defic Syndr ; 85(3): 309-315, 2020 Nov 01.
Article in English | MEDLINE | ID: covidwho-878230

ABSTRACT

INTRODUCTION: In March 2020, Australian state and federal governments introduced physical distancing measures alongside widespread testing to combat COVID-19. These measures may decrease people's sexual contacts and thus reduce the transmission of HIV and other sexually transmissible infections (STIs). We investigated the impact of physical distancing measures due to COVID-19 on the sexual behavior of gay and bisexual men in Australia. METHODS: Between April 4, 2020, and April 29, 2020, 940 participants in an ongoing cohort study responded to questions to measure changes in sexual behaviors during the COVID-19 pandemic. Men reported the date they become concerned about COVID-19 and whether they engaged in sexual behavior with regular or casual partners or "fuckbuddies" in the 6 months before becoming concerned about COVID-19 (hereafter referred to as "before COVID-19"), and following the date, they become concerned about COVID-19 (hereafter referred to as "since COVID-19"). Before and since COVID-19 was based on individual participants' own perceived date of becoming concerned about COVID-19. RESULTS: The mean age of was 39.9 years (SD: 13.4). Most participants (88.3%) reported sex with other men during the 6 months before COVID-19. Of the 587 men (62.4%) who reported sex with casual partners before COVID-19, 93 (15.8%) continued to do so in the period since COVID-19, representing a relative reduction of 84.2%. CONCLUSION: Gay and bisexual men in Australia have dramatically reduced their sexual contacts with other men since COVID-19. These behavioral changes will likely result in short-term reductions in new HIV and STI diagnoses. If sexual health screenings are undertaken before resuming sexual activity, this could present a novel opportunity to interrupt chains of HIV and STI transmission.


Subject(s)
Betacoronavirus , Bisexuality , Coronavirus Infections/prevention & control , HIV Infections/epidemiology , Homosexuality, Male , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Sexually Transmitted Diseases/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Australia/epidemiology , Bisexuality/psychology , COVID-19 , Cohort Studies , Coronavirus Infections/complications , Coronavirus Infections/psychology , HIV Infections/prevention & control , Homosexuality, Male/psychology , Humans , Male , Middle Aged , Pneumonia, Viral/complications , Pneumonia, Viral/psychology , SARS-CoV-2 , Sexual Behavior , Sexual Partners/classification , Sexually Transmitted Diseases/prevention & control , Surveys and Questionnaires , Young Adult
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