HIGH RISK SEX IN MSM THE INFLUENCE OF DRUGS AND ALCOHOL. Harold Tan and Bryan Choong

Transcription

1 HIGH RISK SEX IN MSM THE INFLUENCE OF DRUGS AND ALCOHOL Harold Tan and Bryan Choong

2 Be part of the conversation Option 1 - Speak in person Option 2 Use the online feedback form at

3 I have a flight out for my residential treatment in Thailand in 3 hours time. During that duration, I got someone over my place to have chill fun. It was uncontrollable. Tay, 25 years old male, student

4 Understanding drug addiction Drug addiction is a complex disease. Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her. Drug addiction affects the brain in ways that foster compulsive drug abuses and makes quitting difficult. Quitting takes more than good intention or strong will. Source: National Institute on Drug Abuses,

5 Most common drugs used by MSM in Singapore Methamphetamine (Ice) Ecstasy Ketamine (K) Gamma-Hydroxybutyrate (GHB) Amyl nitrite (Poppers) Viagra Source: MSM Survey for Singapore AIDS Conference 2014

6 Drug use in Singapore Source: Central Narcotics Bureau Press Release, 14 August 2014

7 Drug use in Singapore Methamphetamine or Ice is the most commonly abused drug amongst new abusers - 67% new abusers. Source: Central Narcotics Bureau Press Release, 14 August 2014

8 Drug use in Singapore 69% are repeated abusers Source: Central Narcotics Bureau Press Release, 7 February 2014

9 Dave called me during my work and said that the police was deployed on the ground floor, coming to catch him. He wanted me to go over immediately. When I reached the place, Dave was hiding in his room and there was no police. It happened so often that I could not take it anymore Edwin, 40 years old male, working professional

10 Drug use and its effect Drug use changes the brain - they change its structure and how it works. These brain changes can be long-lasting, and can lead to the harmful behaviors seen in people who abuse drugs. Source: National Institute on Drug Abuses,

11 Drug use and its effect Source: National Institute on Drug Abuses,

12 Drug use and its effect Source: National Institute on Drug Abuses,

13 Drug use and HIV The 2010 Asian MSM Internet Sex Survey (Respondents: 10,861 all over Asia) found that drug use was significantly higher among MSM with diagnosed HIV, particularly with respect to methamphetamine, ketamine and ecstasy. A 2009 study in Thailand identified an association between HIV prevalence and a history of drug use Drug use (especially Ice ) impairs judgment and inhibition. Ice and Ecstasy are known to increase libido. Source: 2012, The Global State of Harm Reduction Towards Integrated Response, Harm Reduction International.

14 Drug use and HIV A UK based study on drug use and sexual behaviour of 2248 MSM with HIV during Polydrug use and condomless sex are closely linked in HIVpositive MSM in the UK, and that polydrug users are likely to be a group at increased risk of transmission of HIV and other sexually transmitted infections (STIs) Recent users of five or more drugs were far more likely than those with no recent drug use to have sex without a condom (78% vs 24%) to have condom- less sex with a partner of HIV-negative or HIVunknown status (25% vs 10%); Source: Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study, Vol 1 October 2014

15 Treatments Different treatments 12 steps Narcotics Anonymous Program Addiction counselling Programs in wellness clinics and hospitals (such as National Addictions Management Services) Residential Treatment Key components in these treatments Learn about the disease (education) Gain motivation to maintain commitment to be sober Learn skills necessary to stay sober Create a support system for recovery and addressing underlying issues (eg loneliness, anger, self-esteem issues etc)

16 I thought I have recovered. When I used drugs again, on the date of my urinal test, I know I have relapsed William, 50 years old male, working professional

17 Conclusion Addiction is a complex but preventable disease There is no known guaranteed cure but it is manageable. Do not be discouraged by relapse (it is part of the process of recovery). That s why after care and support groups are important. The trust and relationship between therapist & the client is a critical component of treatment effectiveness.

18 Resources Drug Addiction specific National Addictions Management Service (IMH) We Care Community Services Promises The Cabin (Chiang Mai) Singapore Anti-Narcotics Association Narcotics Anonymous Singapore Other related services Sex and Love Addiction Anonymous (SLAA) Alcohol Anonymous (LGBT meeting) Oogachaga

19 Be part of the conversation Option 1 - Speak in person Option 2 Use the online feedback form at