Chemsex: a treatment response

Monty MoncrieffChief Executive, London Friend

HIV Prevention England Conference19th February 2015

Who are we?

• London Friend – since 1972• LGBT health & wellbeing• Antidote – since 2002• Antidote @ Friend – since 2011• HIV Prevention England local delivery partner

Contents

• Emerging new trends• Meeting emerging needs• Partnership responses• Ongoing Challenges

Recent trends – presentations to Antidote

Issue 2005/6 – 179 clients 2013/14 – 758 clients

Alcohol 130 – 73% 79 – 11%

Cocaine 46 – 26% 86 – 11%

Ecstasy/MDMA 37 – 21% 9 – 1%

Ketamine 23 – 13% 44 – 6%

GHB/GBL 3 – 2% 334 – 46%

Crystal meth 0 – 0% 373 – 51%

Mephedrone 0 – 0% 461 – 64%

Heroin 5 – 3% 2 – >1%

Crack 14 – 8% 6 – 1%

What we’re seeing

• Sexualised using, multiple partners• Meeting & trading drugs through apps• Private sex parties, sex on premises venues• High level of current sexual risk• Injecting crystal meth & mephedrone• Around half are HIV +• Poor adherence to HIV meds whilst using• Widespread poor self-esteem issues

Meeting emerging treatment needs

• Initial response due to demand• Identified G as dependence-forming• Integrated sexual health & HIV prevention into

substance misuse keyworking• Identified opportunities for earlier intervention

– GUM outreach• Identified trends in support needs: identity, self-

esteem, seeking different relationships• SWAP – structured weekend programme

Meeting emerging needs strategically

• Training: GUM, treatment agencies• Informing: Government, conferences• Developing clinical guidelines – Project

NEPTUNE• Out Of Your Mind report – improving

treatment for LGBT people• PHE MSM Action Plan – drugs & sexual health• GUMCAD – drug use intelligence

Partnership Responses

• GUM outreach: Code Clinic, Mortimer Market, cliniQ

• Screening, earlier identification, brief interventions, MI, prevention

• CNWL Club Drug Clinic• Centre of excellence around drugs more

commonly used in chemsex• Not LGBT specific but 75% MSM

Ongoing Challenges

• Localism – commissioning drug treatment• Commissioning – growing need for higher

intensity & therapeutic HIV prevention interventions

• Cultural competence - drug treatment services• Surveillance data: prevalence, treatment, causal

link to HIV infections• Integration with mental health support• Alcohol

Resources

• London Friend: http://londonfriend.org.uk/ • Antidote: http://londonfriend.org.uk/antidote • Antidote’s Out Of Your Mind report: http://londonfriend.org.uk/outofyourmind/ • Antidote/Orange Nation G-Aware campaign: http://londonfriend.org.uk/get-support/g-aware/ • NTA Club Drug Report: http://www.nta.nhs.uk/uploads/clubdrugsreport2012[0].pdf • Chemsex Study http://sigmaresearch.org.uk/projects/gay/project59?/chemsex • UK Drug Policy Commission Report:

http://www.ukdpc.org.uk/publication/the-impact-drugs-different-minority-groups-lgbt-groups/ • UK Drug Policy Commission Policy Briefing: http://www.ukdpc.org.uk/publication/drugs-diversity-lgbt-groups-policy-briefing

/ • Lesbian & Gay Foundation Part of the Picture: http://www.lgf.org.uk/policy-research/part-of-the-picture/ • Lancet article of crystal meth rise in London (Jan 2013): http://

www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60032-X/fulltext • Club Drug Clinic: http://clubdrugclinic.cnwl.nhs.uk/ • LDAN News Nov/Dec 2012 (Club Drugs & Antidote articles): http://www.ldan.org.uk/PDFs/LDANNewsDec12.pdf • LDAN News Dec 2014 (Improving treatment for LGBT people):

https://ldannews.wordpress.com/2014/12/09/out-of-your-mind-improving-drug-and-alcohol-services-for-lgbt-people/ • Engendered Penalties: http://www.pfc.org.uk/pdf/EngenderedPenalties.pdf • Sexual Orientation Monitoring Guide: http://www.lgf.org.uk/Our-services/Campaigns/sexual-orientation-monitoring-guide/ • Stonewall Healthy Lives mini-site: http://www.healthylives.stonewall.org.uk/ • Public Health Outcomes Framework LGBT Companion: http://www.lgf.org.uk/phof

Contact details

• www.londonfriend.org.uk • www.londonfriend.org.uk/antidote • antidote@londonfriend.org.uk (monty@ )• www.facebook.com/londonfriend• Twitter: @lgbtfriend • 020 7833 1674