Research paperFollowing Lives Undergoing Change (Flux) study: Implementation and baseline prevalence of drug use in an online cohort study of gay and bisexual men in Australia
Section snippets
Background
The prevalence of licit and illicit drug use among gay and bisexual men (GBM) is higher than in other population groups (Bolding, Hart, Sherr, & Elford, 2006; Cochran, Ackerman, Mays, & Ross, 2004; Hickson, Bonell, Weatherburn, & Reid, 2010; Lea et al., 2013b; Newcomb, Ryan, Greene, Garofalo, & Mustanski, 2014; Roxburgh, Lea, De Wit, & Degenhardt, 2015). In Australia, more than half of GBM reported recent (previous six months) illicit drug use (Lea et al., 2013b). One in twenty (5.6%) reported
Methods
The Flux study is being conducted nationally in Australia using online survey techniques. We systematically enrol and follow-up individual GBM to collect information about drug use, risk behaviour and associated harms, and gay community engagement. We obtained additional optional consent at enrolment for linkage to hospitalisation datasets to identify drug-related presentations and to the national HIV registry to confirm prevalent and incident HIV infections. The Flux protocol and all
Procedures for streamlined digital processing and data protection—FAME
The FAME process was designed to enable maximum digital management of the study and to ensure a simple, straightforward experience for participants. Each participant was digitally assigned a unique study identifier (USID) through the survey platform upon entry to the consent form. The USID was used to link to their unique records on all study data sources. It will remain the participants’ unique identifier throughout the study and is central to the implementation of FAME. All communications
Results
In total, 21,014 clicks were received on the studys website, and 6810 clicked through to the consent form. Of these, 4306 clicks were received past the first page of the consent form where they indicated their level of consent (six-monthly follow-up or baseline only). A total of 2943 people completed the consent form (six-monthly follow-up or baseline only), and 2705 men commenced survey responses, of whom 2250 (83.2%) provided sufficiently complete baseline data for tracking trends in drug use
Discussion
We have established an entirely online cohort study of incidence and risk factors for initiation, cessation, and changes in drug use over time among Australian GBM. The characteristics of both the enrolled and the anonymous participants in the Flux sample, while somewhat younger, are otherwise comparable to those of other samples of Australian GBM (Lea et al., 2013b, Prestage et al., 2009a; Zablotska, Holt, & Prestage, 2012). We have demonstrated the ability to collect sensitive information
Conclusions
Having successfully implemented FAME to establish the first entirely online cohort study of drug use among Australian GBM, the Flux study will be able to provide data on incidence and factors associated with initiation and cessation, and changes in patterns of drug use and related harms over time. The high rates of illicit drug use in this sample indicate the need for longitudinal enquiry and follow up to assess continuing and changing patterns of drug use over time within this population.
Funding source declaration
This study was funded by the Australian Research Council (ARC). ARC grant number: RG132750. The Kirby Institute and Centre for Social Research in Health receive funding from the Australian Government Department of Health. The National Drug and Alcohol Research Centre, UNSW is supported by funding from the Australian Government under the Substance Misuse Prevention and Service Improvements Grants Fund. Lisa Maher is supported by a National Health and Medical Research Council Senior Research
Author agreement/declaration
All authors certify that they have seen and approved the final version of the manuscript being submitted. All authors warrant that the article is the authors’ original work, has not received prior publication and is not under consideration for publication elsewhere.
References (44)
- et al.
Patterns of illicit drug use in NSW, Australia following a reduction in heroin supply
International Journal of Drug Policy
(2005) - et al.
Poly-club-drug use among gay and bisexual men: A longitudinal analysis
Drug and Alcohol Dependence
(2007) - et al.
Prevalence and patterns of smoking, alcohol use, and illicit drug use in young men who have sex with men
Drug and Alcohol Dependence
(2014) - et al.
A qualitative analysis of GHB use among gay men: Reasons for use despite potential adverse outcomes
International Journal of Drug Policy
(2006) - et al.
Use of illicit drugs and erectile dysfunction medications and subsequent HIV infection among gay men in Sydney, Australia
The Journal of Sexual Medicine
(2009) - et al.
Personality traits and mental health states of methamphetamine-dependent and methamphetamine non-using MSM
Addictive Behaviors
(2010) Latino gay men’s drug functionality: The role of social networks and social support
Journal of Ethnicity in Substance Abuse
(2008)- et al.
Use of crystal methamphetamine among gay men in London
Addiction
(2006) - et al.
Amphetamine use is associated with increased HIV incidence among men who have sex with men in San Francisco
Aids
(2005) - et al.
Prevalence of non-medical drug use and dependence among homosexually active men and women in the US population
Addiction
(2004)