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Introduction: Investigating drug trends among Australian gay and bisexual men (GBM) is crucial for understanding levels of use and the potential for harm, including HIV transmission risk. Method: Using repeated, national, cross‐sectional survey data collected between 2012 and 2021 (69,567 surveys), trends of recent (previous 6 months) and frequent (weekly) drug use were analysed, using logistic regression models. The last round of data from each jurisdiction (6709 surveys) was used to compare GBM who reported no use, infrequent (less than weekly) use and frequent (at least weekly) use of party drugs to investigate the association between party drug use and HIV transmission risk, using multinomial logistic regression models. Results: There was a significant upward trend in any recent drug use (from 58.4% in 2012 to 64.1% in 2021; p < 0.001). Frequent party drug use remained a minority practice over the period (consistently less than 3%). In cross‐sectional analysis, frequent party drug users were more likely to report behaviours with HIV transmission risks, such as condomless anal intercourse without biomedical prevention strategies (30.0% vs. 13.1%; adjusted relative risk ratio [aRRR], 2.08; 95% CI, 1.24–3.47), weekly group sex (16.3% vs. 0.6%; aRRR, 12.36; 95% CI, 5.75–26.56) and more than 20 recent sexual partners (42.5% vs. 5.0%; aRRR, 21.44; 95% CI, 5.82–78.89), compared with GBM who did not use party drugs. Discussion and Conclusion: Our findings suggest that the frequent use of party drugs remains a marker of HIV transmission risk among Australian GBM, despite the increased adoption of biomedical HIV prevention strategies over the past few years. [ABSTRACT FROM AUTHOR]

Aim: Young people who are socially engaged with people who inject drugs are at higher risk of transitioning to injecting drug use. We aimed to examine rates of exposure to injecting among young people in an online survey, and whether exposure to injecting was related to hepatitis C(HCV) knowledge. Methods: A cross-sectional, online survey was completed by 827 young people (aged 16-26 years) in New South Wales, Australia. Exposure to injecting in the preceding 12 months was measured by asking participants whether close friends and romantic/sexual partners had injected, and whether somebody had offered them an injection. HCV knowledge was measured using items adapted from a survey of Australian secondary school students. Findings: Eleven percent of participants reported recent exposure to injecting.Participants exposed to injecting were significantly more likely than other participants to report use of injectable drugs. Some aspects of HCV transmission were poorly understood, and exposure to injecting was not significantly associated with higher HCV knowledge. Conclusions: While online methods were only moderately successful in recruiting people exposed to injecting, higher rates of use of injectable drugs and HCV knowledge deficits in this group suggests that they are an important target for HCV education and prevention.

Introduction: We determined the contribution of undiagnosed HIV to new infections among gay and bisexual men (GBM) over a 12-year period in Australia where there has been increasing focus on improving testing and HIV treatment coverage. Methods: We generated annual estimates for each step of the HIV cascade and the number of new HIV infections for GBM in Australia over 2004 to 2015 using relevant national data. Using Bayesian melding we then fitted a quantitative model to the cascade and incidence estimates to infer relative transmission coefficients associated with being undiagnosed, diagnosed and not on ART, on ART with unsuppressed virus, or on ART with suppressed virus. Results: Between 2004 and 2015, we estimated the percentage of GBM with HIV in Australia who were unaware of their status to have decreased from 14.5% to 7.5%. During the same period, there was a substantial increase in the number and proportion of GBM living with HIV on treatment and with suppressed virus, with the number of virally suppressed GBM increasing from around 3900 (30.2% of all GBM living with HIV) in 2004 to around 14,000 (73.7% of all GBM living with HIV) in 2015. Despite the increase in viral suppression, the annual number of new infections rose from around 660 to around 760 over this period. Our results have a wide range due to the uncertainty in the cascade estimates and transmission coefficients. Nevertheless, undiagnosed GBM increasingly appear to contribute to new infections. The proportion of new infections attributable to undiagnosed GBM almost doubled from 33% in 2004 to 59% in 2015. Only a small proportion ( Discussion: Our study suggests that an increase in HIV treatment coverage in Australia has reduced the overall risk of HIV transmission from people living with HIV. However, the proportion of infections and the rate of transmission from undiagnosed GBM has increased substantially. These findings highlight the importance of HIV testing and intensified prevention for Australian GBM at high risk of HIV. Keywords: Australia; gay and bisexual men; mathematical model; transmission dynamics; undiagnosed HIV; HIV cascade, 1 | INTRODUCTION People with undiagnosed HIV contribute disproportionately to HIV transmission because the early stages of infection are the most infectious, and without treatment an individual remains infectious [1-7]. [...]

'Slamsex' has emerged in gay vernacular in recent years to denote a particular way of taking drugs and a particular kind of sex. Slamming refers in this context to the practice of injecting drugs – typically crystal methamphetamine – intravenously. To pair 'slamming' with 'sex' is to propose that a particular mode of drug administration is constitutive of a particular kind of sex – a relatively novel idea that deserves some unpacking. What does it mean to make a route of drug administration definitional in the delineation of a sexual practice? What does this move reveal about contemporary practices of sex and drug consumption? In this article, we explore these questions with reference to theories of drug effects and practitioners' accounts of slamsex. We conclude by considering the implications of our analysis for slamsex relations and associated harm reduction measures. [ABSTRACT FROM AUTHOR]

It is well documented that lower socio-economic status is associated with poorer health outcomes, while health literacy is considered important for improving health. What is less clear, is the extent to which greater health literacy can improve health outcomes among people for whom poverty or financial insecurity are important barriers to health. The paper presents findings from an Australian survey of people living with HIV (PLHIV) (N = 835) in which we explored the relationship between financial insecurity and health outcomes, looking at the extent to which health literacy mediates this relationship. The study drew on a comprehensive definition of health literacy, measuring participant's confidence to communicate with healthcare providers, navigate the health system and take an active stance in relation to their health. Findings showed that financial insecurity was associated with lower health literacy and poorer self-reported physical and mental health. Health literacy mediated 16.2% of the effect of financial insecurity on physical health scores and 16.6% of the effect of financial insecurity on mental health scores. This suggests that programmes which seek to build health literacy among PLHIV may improve health outcomes among PLHIV who are struggling financially. Health literacy programmes are likely to be effective if they build confidence and resourcefulness among people to engage with health information, decision-making and care. [ABSTRACT FROM AUTHOR]