Davis Stuart & Joe Phillips' (56 Dean St) presentation 20/10/15 Meeting: Checkpoints: Beyond VCT Centres Next steps for community testing in Europe

1. CHEMSEX
@davidastuart david.stuart@chelwest.nhs.uk

2. @davidastuart
Simplifying access to treatment

3. • Estimated 3,000 ChemSex presentations per month
• 100 per month willing to access behaviour change support
• Multiple partners per ChemSex episode
• Multiple PEP presentations
• Poor condom use common
• Good ARV adherence amongst HIV+ve cohort
• Little experience of sober sex
• Potential clusters of new HIV infections within ChemSex “scenes”
• Very high PrEP interest
• Increasing injecting use, poor safer injecting awareness – HCV risks
• Multiple HCV re-infections, including amongst HIV-ve non-injecters
@davidastuart
Results
Ref; Stuart, David, and Johannes Weymann. "ChemSex and Care-panning: One Year in Practice."
HIV Nursing Journal 15, no. 2 (2015): 24, 25, 26, 27, 28

4. Identifying high risk
• Drugs Used; Crystal methamphetamine, Mephedrone, GHB/GBL being highest risk drugs
• Frequency of drug-using episodes and frequency of sober sex encounters
• Number of partners per drug-using episode
• Prevalence of condomless sex per drug-using episode (sorted by HIV-ve, HIV+ve, those
on treatment, those undetectable)
• Route of drug administration (snorted, injected, swallowed, booty-bumped/intra-anal)
• Likelihood of traumatic sex during drug-using episode
• Alerts for:
o Seroconversion symptoms
o HIV+ve not on treatment
o Poor antiretroviral adherence (where likely to impact viral suppression)
o High number of PEP presentations/courses prescribed
o Infrequent HIV screening/GUM attendance
o Frequent GUM infections
o Frequent overdoses linked to possible drug interactions
o HCV infection
o Sharing of drug use equipment
o Fisting

5. •“Do you use Party Drugs for sex?”
•(and if so…) “Tina, Mephedrone or G”
•“How long do you stay awake for?”
•“Have you had any bad experiences?” (eg; paranoia)
•“Do you sometimes regret the choices you make when high?”
•When did you last have sober sex?
•“What’s your non-sexual/non-clubbing social life like?”
•“Are you slamming (injecting) ?”
•“Do you want to talk to someone about being safer with
drugs?”
Questions to ask
@davidastuart
@davidastuart

6. ChemSex CARE PLAN

7. ChemSex CARE PLAN

8. People
struggling
with
unprecedented
on-line
behaviour
norms
@davidastuart

9. WWW.CHEMSEXSUPPORT.COM
(FROM 56 DEAN STREET)
@davidastuart
For chem users
How to access support
Tips for safer use/drug info/sexual health info
Behaviour change video library (craving
management, reduction tips, sober sex advice,
safer play information)
List of London recreational/social alternatives to
bars, clubs, saunas, chems
DS16

10. WWW.CHEMSEXSUPPORT.COM
(FROM 56 DEAN STREET)
@davidastuart
For professionals
• A working definition, ChemSex
• Referral information
• Video tutorials/conducting
ChemSex interventions
• Resources/tools for working with
ChemSexers
• Papers on adapting services
to be ChemSex efficient
• ChemSex research
• Drug–drug interactions
DS17

11. @davidastuart

12. DEAN STREET WELLBEING PROGRAMME
Sponsored by Monument Trust
Events, 2014