Patterns and levels of illicit drug use among men who have sex with men in Asia

BackgroundThe emergence of gay communities in Asia may predispose men who have sex with men (MSM) to drug use. We describe patterns and levels of illicit drug use, and characteristics of stimulant drug users among MSM in Asia.MethodsA cross-sectional Internet-based survey was conducted among 10,861 participants recruited through online methods. Pearson's chi-square tests were used to compare patterns of drug use by participants’ HIV status. Multivariable logistic regression analysis was conducted to identify significant correlates of stimulant drug use.ResultsOverall, 16.7% of participants reported recreational drug use in the past 6 months. Ecstasy (8.1%) and Viagra (7.9%) were the most prevalent drugs being used. HIV-positive MSM reported significantly higher levels of individual drug use and polydrug use compared to HIV-negative/unknown MSM. Being gay (AOR = 1.62, 95% CI: 1.28, 2.05), having casual male partners only or having both casual and regular partners (AOR = 2.05, 95% CI: 1.66, 2.53; AOR = 2.97, 95% CI: 2.39, 3.69), HIV-positive status (AOR = 4.54, 95% CI: 3.63, 5.69), sex work (AOR = 1.52, 95% CI: 1.19, 1.93), and having more gay friends (“Some” vs. “A few/None” AOR = 1.98, 95% CI: 1.62, 2.43; “Most/All” vs. “A few/None” AOR = 4.59, 95% CI: 3.77, 5.59) were independently associated with stimulant drug use.ConclusionsOur findings point to the urgency of incorporating substance use prevention and treatment into current HIV prevention activities in Asia, which must use a harm reduction approach and galvanize dignity.