Background and methods
The overall prevalence of recreational drug use (RDU) has risen in Ireland from 5.6% in 2002/2003 to 7.4% in 2019/2020; and males report a higher prevalence of RDU in comparison to females (12.3% and 5.7%, respectively).1 International evidence suggests that gay, bisexual, and other men who have sex with men (gbMSM) have a higher prevalence of drug use versus age-comparable non-gbMSM.2 Previously cited reasons for this drug use disparity may include ‘minority stress’, as well as the perceived ‘normalisation’ of drug use within the gbMSM community, including sexualised drug use (SDU).3,4,5 However, in Ireland, there is a paucity of literature regarding the prevalence of drug use and its determinants among gbMSM.

A 2023 study2 quantified the prevalence of RDU and SDU among gbMSM in Ireland using data from the European Men-Who-Have-Sex-With-Men Internet Survey (EMIS-2017), an online, anonymous, internationally promoted questionnaire. In this research, published in the journal PLOS One, multivariable-adjusted logistic regression explored factors associated with RDU and SDU. The main findings from this study are discussed below.

Results
Among gbMSM without HIV (n=1898), some 40.9% and 13.1% engaged in RDU and SDU in the previous year, respectively. Among HIV diagnosed-positive gbMSM (n=141), the past-year respective prevalence estimates were 51.8% and 26.2%. Increased odds of RDU were observed among gbMSM who were younger (OR=2.96; 95% CI: 2.05–4.28), lived in Dublin (OR=1.47; 95% CI: 1.17–1.83), and engaged in condomless anal intercourse (CAI) in the previous year (1–2 partners: OR=1.79; 95% CI: 1.34–2.38, 6+ partners: OR=1.79; 95% CI: 1.18–2.71). Greater odds of SDU were identified among those who lived in Dublin (OR=1.50; 95% CI: 1.07–2.10) and engaged in CAI (1–2 partners: OR=3.16, 95% CI: 2.05–4.88, 3–5 partners: OR=2.50; 95% CI: 1.47–4.26, and 6+ partners: OR=3.79; 95% CI: 2.23–6.43).

Conclusions
The authors noted that gbMSM in Ireland reported a high prevalence of RDU and SDU, and that this was particularly true for men who were living in Dublin, presented for HIV testing, engaged in more CAI encounters, and among those who reported a recent diagnosis of a bacterial sexually transmitted infection. They suggest that messaging should be tailored to subgroups of gbMSM who are likely to be at increased odds of drug-related harms, and that findings from the study may serve as a guideline to relevant partner organisations who work to promote the overall health and well-being of gbMSM nationally.

1    Mongan D, Millar SR and Galvin B (2021) The 2019–20 Irish National Drug and Alcohol Survey: main findings. Dublin: Health Research Board. Available from: https://www.drugsandalcohol.ie/34287/

2    Daly FP, O’Donnell K, Davoren MP, Noone C, Weatherburn P, Quinlan M, et al. (2023) Recreational and sexualised drug use among gay, bisexual, and other men who have sex with men (gbMSM) in Ireland – findings from the European MSM internet survey (EMIS) 2017. PLOS ONE, 18(7): e0288171. Available from:
https://www.drugsandalcohol.ie/39293/

3    Meyer IH (2003) Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull, 129(5): 674–697.

4    Hughes TL and Eliason M (2002) Substance use and abuse in lesbian, gay, bisexual and transgender populations. J Prim Prev, 22(3): 263–298.

5    Amundsen E, Haugstvedt Å, Skogen V and Berg RC (2022) Health characteristics associated with chemsex among men who have sex with men: results from a cross-sectional clinic survey in Norway. PLOS One, 17(10): e0275618.