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Objectives: To investigate the association between chemsex drug use and HIV clinic attendance among gay and bisexual men in London. Methods: A cross‐sectional survey of adults (> 18 years) diagnosed with HIV for > 4 months, attending seven London HIV clinics (May 2014 to August 2015). Participants self‐completed an anonymous questionnaire linked to clinical data. Sub‐optimal clinic attenders had missed one or more HIV clinic appointments in the past year, or had a history of non‐attendance for > 1 year. Results: Over half (56%) of the 570 men who identified as gay or bisexual reported taking recreational drugs in the past 5 years and 71.5% of these men had used chemsex drugs in the past year. Among men reporting chemsex drug use (past year), 32.1% had injected any drugs in the past year. Sub‐optimal clinic attenders were more likely than regular attenders to report chemsex drug use (past year; 46.9% vs. 33.2%, P = 0.001), injecting any drugs (past year; 17.1% vs. 8.9%, P = 0.011) and recreational drug use (past 5 years; 65.5% vs. 48.8%, P < 0.001). One in five sub‐optimal attenders had missed an HIV clinic appointment because of taking recreational drugs (17.4% vs. 1.8%, P < 0.001). In multivariable logistic regression, chemsex drug use was significantly associated with sub‐optimal clinic attendance (adjusted odds ratio = 1.71, 95% confidence interval: 1.10–2.65, P = 0.02). Conclusions: Our findings highlight the importance of systematic assessment of drug use and development of tools to aid routine assessment. We suggest that chemsex drug use should be addressed when developing interventions to improve engagement in HIV care among gay and bisexual men. [ABSTRACT FROM AUTHOR]

Objectives The aim of the study was to explore HIV testing frequency among UK men who have sex with men ( MSM) in order to direct intervention development. Methods Cross-sectional surveys were completed by 2409 MSM in Edinburgh, Glasgow and London in 2011 and a Scotland-wide online survey was carried out in 2012/13. The frequency of HIV testing in the last 2 years was measured. Results Overall, 21.2% of respondents reported at least four HIV tests and 33.7% reported two or three tests in the last 2 years, so we estimate that 54.9% test annually. Men reporting at least four HIV tests were younger and less likely to be surveyed in London. They were more likely to report higher numbers of sexual and anal intercourse partners, but not 'higher risk' unprotected anal intercourse ( UAI) with at least two partners, casual partners and/or unknown/discordant status partners in the previous 12 months. Only 26.7% (238 of 893) of men reporting higher risk UAI reported at least four tests. Among all testers ( n = 2009), 56.7% tested as part of a regular sexual health check and 35.5% tested following a risk event. Differences were observed between surveys, and those testing in response to a risk event were more likely to report higher risk UAI. Conclusions Guidelines recommend that all MSM test annually and those at 'higher risk' test more frequently, but our findings suggest neither recommendation is being met. Additional efforts are required to increase testing frequency and harness the opportunities provided by biomedical HIV prevention. Regional, demographic and behavioural differences and variations in the risk profiles of testers suggest that it is unlikely that a 'one size fits all' approach to increasing the frequency of testing will be successful. [ABSTRACT FROM AUTHOR]

Objectives There is evidence that HIV-positive patients are suffering from a greater burden of morbidity as they age due to non AIDS-related complications. To date it has been difficult to determine what part of this excess risk is due to the health effects of HIV, its treatment or to lifestyle factors common to gay and bisexual men ( GBM). We calculated overall and cause-specific hospitalisation rates and risk factors for hospitalisations in HIV-negative and HIV-positive cohorts of GBM and compare these with rates in the general male population. Methods We conducted a record linkage study, linking two cohorts of HIV-negative ( n = 1325) and HIV-positive ( n = 557) GBM recruited in Sydney, New South Wales ( NSW), Australia with the NSW hospital discharge data register. We compared rates of hospitalisation in the two cohorts and risk factors for hospitalisation using random-effects Poisson regression methods. Hospitalisation rates for each cohort were further compared with those in the general male population using indirect standardisation. Results We observed 2032 hospitalisations in the HIV-negative cohort during 13 016 person-years ( PYs) [crude rate: 15.6/100 PYs (95% CI: 14.9-16.3)] and 2130 hospitalisations in the HIV-positive cohort during 5571 PYs [crude rate: 38.2/100 PYs (95% CI: 36.6-39.9)]. HIV-positive individuals had an increased risk of hospitalisation compared with the HIV-negative individuals [adjusted- IRR: 2.34 (95% CI: 1.91-2.86)] and the general population [ SHR: 1.45 (95% CI: 1.33-1.59)]. Hospitalisation rates were lower in the HIV-negative cohort compared with the general population [ SHR: 0.72 (95% CI: 0.67-0.78)]. The primary causes of hospitalisation differed between groups. Conclusions HIV-positive GBM continue to experience excess morbidity compared with HIV-negative GBM men and the general population. HIV-negative GBM had lower morbidity compared with the general male population suggesting that GBM identity does not confer excess risk. [ABSTRACT FROM AUTHOR]