1. Chemsex: a treatment response Monty Moncrieff Chief Executive, London Friend HIV Prevention England Conference 19 th February 2015

2. Who are we? London Friend – since 1972 LGBT health & wellbeing Antidote – since 2002 Antidote @ Friend – since 2011 HIV Prevention England local delivery partner

3. Contents Emerging new trends Meeting emerging needs Partnership responses Ongoing Challenges

4. Recent trends – presentations to Antidote Issue2005/6 – 179 clients2013/14 – 758 clients Alcohol130 – 73%79 – 11% Cocaine46 – 26%86 – 11% Ecstasy/MDMA37 – 21%9 – 1% Ketamine23 – 13%44 – 6% GHB/GBL3 – 2% 334 – 46% Crystal meth0 – 0%373 – 51% Mephedrone0 – 0%461 – 64% Heroin5 – 3%2 – >1% Crack14 – 8%6 – 1%

5. What we’re seeing Sexualised using, multiple partners Meeting & trading drugs through apps Private sex parties, sex on premises venues High level of current sexual risk Injecting crystal meth & mephedrone Around half are HIV + Poor adherence to HIV meds whilst using Widespread poor self-esteem issues

6. Meeting emerging treatment needs Initial response due to demand Identified G as dependence-forming Integrated sexual health & HIV prevention into substance misuse keyworking Identified opportunities for earlier intervention – GUM outreach Identified trends in support needs: identity, self- esteem, seeking different relationships SWAP – structured weekend programme

7. Meeting emerging needs strategically Training: GUM, treatment agencies Informing: Government, conferences Developing clinical guidelines – Project NEPTUNE Out Of Your Mind report – improving treatment for LGBT people PHE MSM Action Plan – drugs & sexual health GUMCAD – drug use intelligence

8. Partnership Responses GUM outreach: Code Clinic, Mortimer Market, cliniQ Screening, earlier identification, brief interventions, MI, prevention CNWL Club Drug Clinic Centre of excellence around drugs more commonly used in chemsex Not LGBT specific but 75% MSM

9. Ongoing Challenges Localism – commissioning drug treatment Commissioning – growing need for higher intensity & therapeutic HIV prevention interventions Cultural competence - drug treatment services Surveillance data: prevalence, treatment, causal link to HIV infections Integration with mental health support Alcohol

10. Resources London Friend: http://londonfriend.org.uk/http://londonfriend.org.uk/ Antidote: http://londonfriend.org.uk/antidotehttp://londonfriend.org.uk/antidote Antidote’s Out Of Your Mind report: http://londonfriend.org.uk/outofyourmind/http://londonfriend.org.uk/outofyourmind/ Antidote/Orange Nation G-Aware campaign: http://londonfriend.org.uk/get-support/g-aware/http://londonfriend.org.uk/get-support/g-aware/ NTA Club Drug Report: http://www.nta.nhs.uk/uploads/clubdrugsreport2012[0].pdfhttp://www.nta.nhs.uk/uploads/clubdrugsreport2012[0].pdf Chemsex Study http://sigmaresearch.org.uk/projects/gay/project59?/chemsexhttp://sigmaresearch.org.uk/projects/gay/project59?/chemsex UK Drug Policy Commission Report: http://www.ukdpc.org.uk/publication/the-impact-drugs-different-minority-groups-lgbt- groups/http://www.ukdpc.org.uk/publication/the-impact-drugs-different-minority-groups-lgbt- groups/ UK Drug Policy Commission Policy Briefing: http://www.ukdpc.org.uk/publication/drugs-diversity-lgbt-groups-policy- briefing/http://www.ukdpc.org.uk/publication/drugs-diversity-lgbt-groups-policy- briefing/ Lesbian & Gay Foundation Part of the Picture: http://www.lgf.org.uk/policy-research/part-of-the-picture/http://www.lgf.org.uk/policy-research/part-of-the-picture/ Lancet article of crystal meth rise in London (Jan 2013): http://www.thelancet.com/journals/lancet/article/PIIS0140- 6736(13)60032-X/fulltexthttp://www.thelancet.com/journals/lancet/article/PIIS0140- 6736(13)60032-X/fulltext Club Drug Clinic: http://clubdrugclinic.cnwl.nhs.uk/http://clubdrugclinic.cnwl.nhs.uk/ LDAN News Nov/Dec 2012 (Club Drugs & Antidote articles): http://www.ldan.org.uk/PDFs/LDANNewsDec12.pdfhttp://www.ldan.org.uk/PDFs/LDANNewsDec12.pdf LDAN News Dec 2014 (Improving treatment for LGBT people): https://ldannews.wordpress.com/2014/12/09/out-of-your- mind-improving-drug-and-alcohol-services-for-lgbt-people/https://ldannews.wordpress.com/2014/12/09/out-of-your- mind-improving-drug-and-alcohol-services-for-lgbt-people/ Engendered Penalties: http://www.pfc.org.uk/pdf/EngenderedPenalties.pdfhttp://www.pfc.org.uk/pdf/EngenderedPenalties.pdf Sexual Orientation Monitoring Guide: http://www.lgf.org.uk/Our-services/Campaigns/sexual-orientation-monitoring-guide/http://www.lgf.org.uk/Our-services/Campaigns/sexual-orientation-monitoring-guide/ Stonewall Healthy Lives mini-site: http://www.healthylives.stonewall.org.uk/http://www.healthylives.stonewall.org.uk/ Public Health Outcomes Framework LGBT Companion: http://www.lgf.org.uk/phofhttp://www.lgf.org.uk/phof

11. Contact details www.londonfriend.org.uk www.londonfriend.org.uk/antidote antidote@londonfriend.org.uk (monty@ ) antidote@londonfriend.org.uk www.facebook.com/londonfriend Twitter: @lgbtfriend 020 7833 1674