Lysa Silveira Remy

Correlates of unprotected sex in a sample of young club drug users

OBJECTIVES: To assess the demographic characteristics, psychiatric symptoms, substance use patterns, and sexual risk behaviors in a sample of club drug users to identify factors associated with unprotected sex during the 12 months prior to the interview. METHODS: This cross-sectional study employed the targeted sampling and ethnographic mapping approaches via face-to-face interviews conducted at bars and electronic music festivals using an adapted, semi-structured version of the Global Appraisal of Individual Needs questionnaire. The sample comprised 240 male and female young adults who had used ecstasy and/or LSD in the 90 days prior to the interview and who were not receiving treatment for alcohol or drug abuse. RESULTS: Of the 240 subjects selected (mean age: 22.9±4.5 years), 57.9% were men; of the male subjects, 52.5% reported having had unprotected sex in the previous 12 months. Of the total sample, 63.33% reported having had unprotected sex. Multivariate regression analysis showed that anal sex (PR = 1.26; 95% confidence interval (CI): 1.044–1.543; p = 0.017) and the use of alcohol/drugs to make sex last longer (PR = 1.430; 95% CI: 1.181–1.732; p<0.001) are associated with unprotected sex. CONCLUSIONS: The implementation of intervention strategies aimed at reducing sexually risky behaviors should take into consideration the specific characteristics of drug users and should include the development of safer sex negotiation skills.

Age of Sexual Initiation, Psychiatric Symptoms, and Sexual Risk Behavior among Ecstasy and LSD Users in Porto Alegre, Brazil: A Preliminary Analysis

Ecstasy and LSD use is widespread in large Brazilian cities, but there is limited information on their use among young, middle-class, club goers in Brazil. We conducted standardized face-to-face interviews with 200 male and female ecstasy and/or LSD users, focusing on drug use and sexual history, current risk behaviors, and psychiatric symptomatology. Participants with early sexual debut (before 14) were more likely to report lifetime use of marijuana and powder and crack cocaine than those with later sexual initiation. Early sexual debut was associated with past year sexual risk behaviors, including having sex while high (Prevalence Ratio (PR)=1.3), having two or more sex partners (PR=1.3), as well as history of sexual abuse (PR=13.6). Depression and anxiety scores were similar by age of sexual initiation. The implications of these findings are discussed.

Anxiety and depression symptoms in Brazilian sexual minority ecstasy and LSD users

BACKGROUND This study examined drug use patterns and psychiatric symptoms of anxiety and depression among young Brazilian sexual minority ecstasy and LSD users and compared findings with those reported for their heterosexual peers. METHOD This cross-sectional study employed targeted sampling and ethnographic mapping approaches via face-to-face interviews conducted at bars and electronic music festivals using an adapted, semi-structured version of the Global Appraisal of Individual Needs questionnaire. The sample comprised 240 male and female young adults who had used ecstasy and/or LSD in the 90 days prior to the interview and who were not on treatment for alcohol and drug abuse. RESULTS Of the 240 subjects enrolled (mean age: 22.9±4.5 years), 28.7% were gay or bisexuals. Multivariate regression analysis showed that the prevalence of depression symptoms in the past 12 months in the sexual minority group was 37% higher than among heterosexuals (prevalence ratio [PR]=1.79; 95% confidence interval [95%CI] 1.03-3.11; p=0.037). CONCLUSION Strategies should be developed to assess and address individual needs and treatment approaches should be tailored to address depressive symptoms in young, sexual minority club drug users.

Motivations for Selling Ecstasy among Young Adults in the Electronic Dance Music Club Culture in Brazil

ABSTRACT This article describes data on the motivations for selling ecstasy among young adults in the electronic dance music (EDM) club culture in Brazil. Individual interviews were conducted with 20 individuals recruited for their involvement in the EDM club scene. Eligible participants were aged 18–39 and reported ecstasy and/or LSD use one or more times in the past 90 days. Exclusion criteria included current treatment for drug/alcohol problems and cognitive impairment or clinically evident psychiatric disorder. Mean age was 22.92 (SD 2.77), 60% were male, 45% reported 12 or more years of education, 50% did not have a primary partner, 50% were living alone, and all had friends who also used ecstasy. Three main themes emerged: (1) “easy” transition from ecstasy user to seller; (2) desire to achieve popularity and fame; and (3) need to sell ecstasy to maintain the high cost of EDM club scene participation. This is one of the first studies of ecstasy sellers in Brazil. The results demonstrate the ease with which the participants transition from ecstasy user to seller. Given the potential health and social dangers associated with ecstasy use, public health campaigns to prevent ecstasy use and policy initiatives to limit the ecstasy supply are warranted.

Changes in method for obtaining better outcomes in the recruitment of synthetic drug users

Objective: To describe the problems encountered and resolved in the course of using respondent-driven sampling (RDS), targeted canvassing (TARC), and ethnographic fieldwork (EFW) to recruit ecstasy and/or lysergic acid diethylamide (LSD) users. Method: This study is nested within a larger project designed to investigate the course of drug use, sexual risk behaviors, and psychiatric comorbidities in 240 ecstasy/LSD users. Eligible participants were males and females with ages ranging from 18 to 39 years, who reported ecstasy and/or LSD use at least once during the 90 days prior to interview and were not under treatment for drug and alcohol problems. Strategies were implemented sequentially, over four-month time frames for each method, aiming at fulfilling study objectives. Results: The final sample included 174 participants (64.36% males). Eight (4.6%) were selected using RDS, 26 (14.94%) with TARC, and 140 (80.45%) using EFW. RDS recruited participants with a higher education level, employed, and with a higher monthly income. Conversely, a higher frequency of drug usage and a higher number of drugs ever used were evident among participants selected via EFW. Conclusions: Different recruitment techniques reached different types of participants. EFW showed the best performance, granting access to the largest number of participants and with a higher number of drugs ever used. Both RDS and TARC required more time to recruit participants and yielded a lower number of eligible subjects. Participants recruited via RDS had a higher socioeconomic level but also a shorter lifetime history of drug use.

Multianalytical Method Validation for Qualitative and Quantitative Analysis of Solvents of Abuse in Oral Fluid by HS-GC/MS.

The use of oral fluid as a biological matrix to monitor the use of drugs of abuse is a global trend because it presents several advantages and good correlation to the blood level. Thus, the present work aimed to develop and validate an analytical method for quantification and detection of solvents used as inhalants of abuse in oral fluid (OF), using Quantisal™ as collector device by headspace and gas chromatography coupled with a mass detector (HS-GC/MS). Chromatographic separation was performed with a ZB-BAC1 column and the total time of analysis was 11.8 min. The method showed good linearity (correlation coefficient higher than 0.99 for all solvents). The limits of detection ranged from 0.05 to 5 mg/L, while the lower limits of quantification ranged from 2.5 to 12.5 mg/L. Accuracy, precision, matrix effect, and residual effect presented satisfactory results, meeting the criteria accepted for the validation of bioanalytical methods. The method showed good selectivity considering that, for solvents coeluting at the same retention time, resolution was performed by the mass detector. The method developed proved to be adequate when applied in OF samples from users of drugs and may be used to monitor the abuse of inhalants in routine forensic analyses.