Recreational and sexualised drug use among gay, bisexual, and other men who have sex with men (gbMSM) in Ireland-Findings from the European MSM internet survey (EMIS) 2017.

BACKGROUND: Gay, bisexual, and other men who have sex with men (gbMSM) report a higher prevalence of drug use in comparison to the general male population. However, in Ireland, there is a paucity of literature regarding the prevalence of drug use and its determinants among gbMSM. AIMS/OBJECTIVES: To quantify the prevalence of (i) recreational drug use (RDU) and (ii) sexualised drug use (SDU) among gbMSM in Ireland, and to identify the factors associated with these drug use practices. METHODS: The European MSM Internet Survey (EMIS) 2017 was an online, anonymous, internationally-promoted questionnaire. Two binary outcomes were included in our analyses: (1) RDU and (2) SDU in the previous year. Multivariable-adjusted logistic regression explored factors associated with these outcomes, and all independent covariates were adjusted for one another. RESULTS: Among gbMSM without HIV (n = 1,898), 40.9% and 13.1% engaged in RDU and SDU in the previous year, respectively. Among diagnosed-positive gbMSM (n = 141), the past-year respective prevalence estimates were 51.8% and 26.2%. Increased odds of RDU were observed among gbMSM who were younger (vs. 40+ years) (18-24 years; AOR 2.96, 95% CI 2.05-4.28, 25-39 years; AOR 1.66, 95% CI 1.27-2.16), lived in Dublin (vs. elsewhere) (AOR 1.47, 95% CI 1.17-1.83), and engaged in condomless anal intercourse (CAI) in the previous year (vs. none) (1-2 partners; AOR 1.79, 95% CI 1.34-2.38, 6+ partners; AOR 1.79, 95% CI 1.18-2.71). Greater odds of SDU were identified among those who lived in Dublin (vs. elsewhere) (AOR 1.50, 95% CI 1.07-2.10), and engaged in CAI (vs. none) (1-2 partners; AOR 3.16, 95% CI 2.05-4.88, 3-5 partners; AOR 2.50, 95% CI 1.47-4.26, and 6+ partners; AOR 3.79, 95% CI 2.23-6.43). CONCLUSION: GbMSM report a high prevalence of drug use in Ireland. Targeted interventions, including harm reduction campaigns, may be needed to support healthier drug use choices among this community.

How to Be Irish in an Epidemic: A Dossier Article on HIV and AIDS in Ireland, Then and Now.

This dossier article contains four short and varied contributions from activists and other service and healthcare providers who have been agitating and working on the frontlines of HIV/AIDS in Ireland since the early 1980s. The dossier contains: (1) a history, by Bill Foley, of the early collective efforts of a group of gay men to provoke government action and healthcare under the umbrella of Gay Health Action (GHA) (2) a speech delivered by Dr. Erin Nugent to government officials on the re-branding of HIV Ireland in 2015; (3) a brief history, recounted by Noel Donnellan, of ACT UP Dublin since it was revitalized in 2016 by a small cohort of dedicated activists from a dormant group into a vibrant collective that has achieved great legislative change with regards to pre-exposure prophylaxis (PrEP); and (4) a polemic, written by Thomas Strong, on living with HIV as a queer man in Ireland that demonstrates the ways in which HIV stigma not only thrives in but molds and shapes twenty-first-century gay men's communities, both in real life and online.

Hepatitis A and B vaccination in gbMSM in Ireland: findings from the European MSM Internet Survey 2017 (EMIS-2017).

OBJECTIVES: Gay, bisexual and other men who have sex with men (gbMSM) have a higher risk of acquiring hepatitis A and B viruses (HAV and HBV) than the general population and are recommended for vaccination against both in Ireland. This study aims to determine the prevalence of self-reported HAV and HBV infection and vaccination among gbMSM in Ireland and explore factors associated with self-reported HAV and HBV vaccination among gbMSM. METHODS: This study analysed Irish data from the European MSM Internet Survey 2017 (EMIS-2017) to measure the prevalence of self-reported HAV and HBV infection and vaccination among gbMSM in Ireland. Multivariable logistic regression was used to explore the associations between sociodemographic, healthcare-related and behavioural factors and self-reported vaccination. RESULTS: There were 2083 EMIS-2017 respondents in Ireland. Among HIV-negative gbMSM, 4.6% and 4.4% reported previous HAV and HBV infection, respectively, and 51% and 57% reported the receipt of one or more vaccine dose for HAV and HBV, respectively. In the multivariable analysis, HIV-negative gbMSM had lower odds of self-reported HAV vaccination if they lived outside the capital, Dublin (aOR 0.61, 95% CI: 0.48 to 0.78), had no third-level education (aOR 0.65, 95% CI: 0.45 to 0.92), were not tested for HIV in the last year (aOR 0.39, 95% CI: 0.31 to 0.50), had never tried to obtain pre-exposure prophylaxis (PrEP, aOR 0.60, 95% CI: 0.38 to 0.96) and had not been diagnosed with a sexually transmitted infection (STI) in the previous year (aOR 0.42, 95% CI: 0.28 to 0.63). Similar associations were observed for self-reported HBV vaccination. CONCLUSIONS: Self-reported vaccination against HAV and HBV among gbMSM in Ireland is high, but the level of vaccination remains insufficient to protect against future HAV and HBV infections and outbreaks. Efforts to increase vaccination coverage among gbMSM should focus on men who live outside the capital, have lower educational attainment and do not engage with sexual health services.

Potential alcohol use disorder among MSM in Ireland - Findings from the European MSM internet survey (EMIS 2017).

BACKGROUND: Alcohol consumption is a major public health concern in Ireland. Alcohol use disorder (AUD) disproportionately affects men who have sex with men (MSM). However, little is known about the prevalence of AUD in this group in Ireland specifically, and the characteristics of MSM who may struggle with this. METHODS: The European MSM Internet Survey 2017 was an online, self-completed, anonymous questionnaire among MSM in Ireland. Standardised questions were used to explore a variety of topics. The validated CAGE-4 questionnaire was used to screen for potential AUD, defined as a CAGE-4 score of ≥2 out of 4. Multivariable-adjusted logistic regression analysis was used to identify factors associated with potential AUD. RESULTS: In total, 1793 MSM met inclusion criteria. 31 % screened positive for AUD. We observed higher odds of possible AUD among MSM who were bisexual (vs. gay/homosexual) (aOR 1.48 95 %CI 1.01-2.18), native to Ireland (vs. non-native) (aOR 1.49 95 %CI 1.12-1.96), unemployed (vs. employed) (aOR 1.80 95 %CI 1.02-3.16), had used illicit drugs in the previous year (vs. none) (cannabis only, aOR 1.74 95 %CI 1.14-2.63) (other illicit drugs, aOR 2.28 95 %CI 1.67-3.09), reported anxiety/depression (vs. none) (aOR 1.73 95 %CI 1.12-2.66), and MSM who experienced homophobic abuse (vs. never) (aOR 1.55 95 %CI 1.09-2.22). Student MSM were less likely to screen positive for AUD (vs. employed) (aOR 0.65 95 %CI 0.46-0.93). CONCLUSIONS: The prevalence of AUD appears to be higher in the MSM population compared to the general male population in Ireland. Targeted interventions may be warranted to reduce the burden of AUD among MSM.