ORCID Profile
0000-0001-6832-2418
Current Organisations
University of Queensland
,
London South Bank University
,
London School of Hygiene and Tropical Medicine
,
University College London
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Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.DRUGPO.2016.10.007
Abstract: 'Chemsex' refers to the combining of sex and illicit drugs, typically mephedrone, GHB/GBL, and crystal meth hetamine. While numerous studies have examined the role of illicit drugs in sexual risk taking, less attention has been paid to the broader social context and structures of their use among gay men. Given their established role in influencing health related behaviour, this study sought to examine the nature and operation of social norms relating to chemsex among gay men residing in South London. In-depth interviews were conducted with thirty self-identifying gay men (age range 21-53) who lived in three South London boroughs, and who had used either crystal meth hetamine, mephedrone or GHB/GBL either immediately before or during sex with another man during the previous 12 months. Data were subjected to a thematic analysis. In addition, two focus groups (n=12) were conducted with gay men from the community to explore group-level perceptions of drug use and chemsex. Chemsex was perceived as ubiquitous amongst gay men by a majority of participants, who additionally described a variety of ways it is arranged (including mobile apps) and a variety of settings in which it occurs (including commercial and private settings). Chemsex was associated with unique sexual permissions and expectations, although participants also described having personal boundaries with respect to certain drug and sex practices, suggesting within-group stigmatisation. This study clearly documents exaggerated beliefs about the ubiquity of chemsex, shifts in the perceived normativity of certain settings and means to facilitate chemsex, and attitudes revealing stigma against certain types of chemsex and men who engage in it. There is a need for health promotion interventions to challenge social norms relating to drug use generally, and chemsex specifically, and for such interventions to make use of the online settings in which chemsex is often facilitated.
Publisher: Springer Science and Business Media LLC
Date: 18-12-2020
DOI: 10.1007/S13178-019-00413-0
Abstract: Men-who-have-sex-with-men (MSM) carry a disproportionate burden of sexually transmitted infections across Europe. Health planners require sexual health needs assessment data to respond appropriately. In addition, surveillance of risk and precaution behaviours in this population enables evaluative judgements of policy responses. The European MSM Internet Survey (EMIS-2017) aimed to repeat the pan-European online survey on male homosexual behaviour conducted in 2010, both to update information required to plan and monitor health promotion interventions and consolidate harmonisation of existing behavioural surveillance approaches. Our study team collaborated with more than 200 partners from academia, public health and civil society across 50 countries. Starting from our previous EMIS-2010 questionnaire, partners engaged in three rounds of iterative survey development and piloting until the final content was agreed. Transfer to an online survey application was followed by further pre-testing before translation into 32 additional languages, final testing and sign-off. The survey was available to complete online in 33 languages simultaneously from 18 October 2017 to 31 January 2018. Ten international MSM dating mobile apps were paid to send short promotional messages, and national partners promoted the survey via at least another 272 websites and social media accounts. Real-time monitoring of responses facilitated targeted advertising by country and recruitment source. Ultimately 144,305 cases were submitted of which 137,358 (95.2%) were eligible for inclusion. EMIS-2017 demonstrated the feasibility of multi-country online MSM surveying with public funding. Meaningful involvement of a large number of collaborators in the survey design and its execution ensured successful recruitment. Careful design, piloting and presentation ensured the survey was acceptable and had authority and perceived community benefit. Partners in 38 countries have already been supplied with a national database of 100 or more respondents for national analysis, while the study team has focussed on international comparisons among 137,358 respondents in 50 countries.
Publisher: Cold Spring Harbor Laboratory
Date: 26-10-2021
DOI: 10.1101/2021.10.22.21264941
Abstract: Access to quality sexual and reproductive health (SRH) services remains imperative, even during a pandemic. Our objective was to understand experiences of delayed or unsuccessful access to SRH services in Britain during the early stages of COVID-19 pandemic. Semi-structured qualitative follow-up interviews were conducted in October-November 2020 (six months after the first UK lockdown) with participants of Natsal-COVID, a quasi-representative web-panel survey of sexual health and behaviour during COVID-19 (n=6654). Inductive thematic analysis was used to identify lessons for future SRH service access and quality. Telephone interviews with participants from the general population. 14 women and 6 men (24-47-years-old) reporting unmet need for SRH services and agreeing to recontact (n=311) were selected for interview using socio-demographic quotas. Participant experiences spanned ten different SRH services, including contraception and antenatal/maternity services. At interview, ten participants still experienced unmet need. Participants reported hesitancy and self-censorship of need. Accessing services required tenacity. Challenges included navigating inconsistent information and changing procedures perceptions of gatekeepers as obstructing access and inflexible appointment systems. Concerns about reconfigured services included reduced privacy decreased quality of interactions with professionals reduced informal support due to lone attendance and fewer routine physical checks. However, participants also described ex les of more streamlined services and staff efforts to compensate for disruptions. Many viewed the blending of telemedicine with in-person care as a positive development. COVID-19 impacted access and quality of SRH services. The accounts of those who struggled to access services revealed self-censorship of need, difficulty navigating shifting service configurations, and perceived reduction in quality due to a socially-distanced service model. Telemedicine offers potential for greater efficiency if blended intelligently with in-person care. We offer some initial data-based recommendations for promoting equitable access and quality in restoration and future adaption of SRH services. Access to quality sexual and reproductive health (SRH) services remains imperative, even during a pandemic. In response to the threat of COVID-19, SRH services limited in-person provision, introduced social distancing and mask wearing, and expanded remote consultations and postal services. There are no published qualitative community studies in Britain exploring service-user experiences of the rapid adaption and scaling-down of SRH services in response to COVID-19. This study provides important insights into how rapid contraction and adaptation of sexual and reproductive health services was experienced by service users. It adds the patient perspective to formal and informal learning and sharing of knowledge been practitioners and policy makers. The study highlights that difficulty accessing services, decreased quality of SRH interactions, reduced opportunity to receive informal support, and fewer routine physical checks were difficult for patients. Our data-driven recommendations – including cautious adoption of telemedicine and improving collaboration across services – have relevance across SRH services and may be useful to other primary and secondary care providers.
Publisher: BMJ
Date: 05-03-2020
DOI: 10.1136/SEXTRANS-2019-054345
Abstract: Chemsex, the use of select psychoactive drugs to enhance sexual experience, typically among men who have sex with men (MSM), is associated with sexual behaviours with higher STI risk. Understanding patterns of chemsex among MSM as well as the characteristics and sexual health service engagement of chemsex participants is important for developing interventions. Between 5/2016 to 5/2017, 3933 MSM completed an online survey, recruited in sexual health clinics (SHCs) in England (n=421) and via four social networking/dating apps (n=3512). We described patterns of chemsex in the past year and used multivariable logistic regression to investigate differences in demographics and sexual behaviours by chemsex history. We described history of SHC attendance and STI test in the past year among app-recruited chemsex participants. Chemsex in the past year was reported by 10% of respondents 19% of SHC-recruited and 9% of app-recruited. Among chemsex participants, 74% had used ≥2 chemsex drugs. In the multivariable model, MSM engaging in chemsex had a raised odds of being HIV-positive (adjusted OR (aOR): 3.6 95% CI 2.1 to 6.1), aged 30–44 (aOR 1.5 vs years 95% CI 1.0 to 2.1), being born outside the UK and having engaged in higher risk sexual behaviours in the past 3 months. Chemsex participants also had higher odds of condomless anal sex with partners of different or unknown HIV status, but only among HIV-negative/untested. In the past year, 66% of app-recruited chemsex participants had attended a SHC and 81% had had an STI test. One in 10 MSM recruited through community and clinical settings across England had engaged in chemsex in the past year. Those that did appear to be at greater STI risk but engaged more actively with sexual health services. This highlights the need and opportunity for chemsex-related services in SHCs and robust referral pathways to drug treatment services.
Publisher: BMJ
Date: 21-07-2022
DOI: 10.1136/SEXTRANS-2022-055429
Abstract: We examined the impact of COVID-19-related restrictions on sexual behaviours, STI and HIV testing and testing need among men who have sex with men (MSM) in the UK. We used social media and dating applications to recruit to three cross-sectional surveys (S1-S3) during the UK's pandemic response (S1: 23 June-14 July 2020 S2: 23 November-12 December 2020 S3: 23 March-14 April 2021). Surveys included lookback periods of around 3-4 months (P1-P3, respectively). Eligible participants were UK resident men (cisgender/transgender) and gender- erse people assigned male at birth (low numbers of trans and gender- erse participants meant restricting these analyses to cisgender men), aged ≥16 years who reported sex with men (cisgender/transgender) in the last year (S1: N=1950 S2: N=1463 S3: N=1487). Outcomes were: recent STI/HIV testing and unmet testing need (new male and/or multiple condomless anal sex partners without a recent STI/HIV test). Crude and adjusted associations with each outcome were assessed using logistic regression. Participants' sociodemographic characteristics were similar across surveys. The proportion reporting a recent STI and/or HIV test increased between P1 and P2 (25.0% to 37.2% (p<0.001) and 29.7% to 39.4% (p<0.001), respectively), then stabilised in P3 (40.5% reporting HIV testing). Unmet STI testing need increased across P1 and P2 (26.0% to 32.4% p<0.001), but trends differed between groups, for ex le, unmet STI testing need was higher in bisexually-identifying (vs gay-identifying) MSM across periods (adjusted OR (aOR): P1=1.64 P2=1.42), but declined in HIV-positive (vs HIV-negative/unknown) MSM (aOR: P1=2.06 P2=0.68). Unmet HIV testing need increased across P1 and P2 (22.9% to 31.0% p<0.001) and declined in P3 (25.1% p=0.001). During P3, MSM reporting a low life-satisfaction level (vs medium-very high) had greater unmet need (aOR: 1.44), while from P2 onwards HIV pre-exposure prophylaxis users (vs non-users) had lower unmet need (aOR: P2=0.32 P3=0.50). Considerable unmet STI/HIV testing need occurred among MSM during COVID-19-related restrictions, especially in bisexually-identifying men and those reporting low life satisfaction. Improving access to STI/HIV testing in MSM is essential to prevent inequalities being exacerbated.
Publisher: JMIR Publications Inc.
Date: 21-09-2017
Abstract: exually transmitted infection (STI) surveillance is vital for tracking the scale and pattern of epidemics however, it often lacks data on the underlying drivers of STIs. his study aimed to assess the acceptability and feasibility of implementing a bio-behavioral enhanced surveillance tool, comprising a self-administered Web-based survey among sexual health clinic attendees, as well as linking this to their electronic health records (EHR) held in England’s national STI surveillance system. taff from 19 purposively selected sexual health clinics across England and men who have sex with men and black Caribbeans, because of high STI burden among these groups, were interviewed to assess the acceptability of the proposed bio-behavioral enhanced surveillance tool. Subsequently, sexual health clinic staff invited all attendees to complete a Web-based survey on drivers of STI risk using a study tablet or participants’ own digital device. They recorded the number of attendees invited and participants’ clinic numbers, which were used to link survey data to the EHR. Participants’ online consent was obtained, separately for survey participation and linkage. In postimplementation phase, sexual health clinic staff were reinterviewed to assess the feasibility of implementing the bio-behavioral enhanced surveillance tool. Acceptability and feasibility of implementing the bio-behavioral enhanced surveillance tool were assessed by analyzing these qualitative and quantitative data. rior to implementation of the bio-behavioral enhanced surveillance tool, sexual health clinic staff and attendees emphasized the importance of free internet/Wi-Fi access, confidentiality, and anonymity for increasing the acceptability of the bio-behavioral enhanced surveillance tool among attendees. Implementation of the bio-behavioral enhanced surveillance tool across sexual health clinics varied considerably and was influenced by sexual health clinics’ culture of prioritization of research and innovation and availability of resources for implementing the surveys. Of the 7367 attendees invited, 85.28% (6283) agreed to participate. Of these, 72.97% (4585/6283) consented to participate in the survey, and 70.62% (4437/6283) were eligible and completed it. Of these, 91.19% (4046/4437) consented to EHR linkage, which did not differ by age or gender but was higher among gay/bisexual men than heterosexual men (95.50%, 722/756 vs 88.31%, 1073/1215 P .003) and lower among black Caribbeans than white participants (87.25%, 568/651 vs 93.89%, 2181/2323 P .002). Linkage was achieved for 88.88% (3596/4046) of consenting participants. mplementing a bio-behavioral enhanced surveillance tool in sexual health clinics was feasible and acceptable to staff and groups at STI risk however, ensuring participants’ confidentiality and anonymity and availability of resources is vital. Bio-behavioral enhanced surveillance tools could enable timely collection of detailed behavioral data for effective commissioning of sexual health services.
Publisher: Informa UK Limited
Date: 08-06-2022
DOI: 10.1080/13691058.2022.2080866
Abstract: Sexting has generated considerable public and professional interest with concerns centring on young people, and potential harms to mental and sexual health. Little research thus far has explored the practice among adults and none has focused on the cultural norms relating to the emotional experience of sexting across different ages and genders. We conducted 40 semi-structured interviews with a erse s le of adults aged 18-59 years in Britain on the role of digital technologies in participants' sexual lives. In this paper, we draw on the accounts of 34 people with experience of sexting. We identified three main themes in participants' accounts related to the emotional aspects of sexting: (1) trust, (2) desire/intimacy and (3) shame. Under each theme, we identified motivations, 'feeling rules', and ex les of 'emotion work' relating to the self, the other and the dyad. We conclude that there are shared cultural norms that constitute what appropriate sexting should feel like. Interventions aiming to minimise harms arising from sexting need to build on commonly held cultural conventions regarding the 'rules of the game' concerning feelings as well as behaviours.
Publisher: Informa UK Limited
Date: 08-06-2022
DOI: 10.1080/13691058.2022.2078507
Abstract: Government controls over intimate relationships, imposed to limit the spread of Sars-CoV-2, were unprecedented in modern times. This study draws on data from qualitative interviews with 18 participants in Natsal-COVID, a quasi-representative web-panel survey of the British population (
Publisher: BMJ
Date: 02-2022
DOI: 10.1136/BMJOPEN-2021-055284
Abstract: Physical distancing as a non-pharmaceutical intervention aims to reduce interactions between people to prevent SARS-CoV-2 transmission. Intimate physical contact outside the household (IPCOH) may expand transmission networks by connecting households. We aimed to explore whether intimacy needs impacted adherence to physical distancing following lockdown in Britain in March 2020. The Natsal-COVID web-panel survey (July–August 2020) used quota-s ling and weighting to achieve a quasi-representative population s le. We estimate reporting of IPCOH with a romantic/sexual partner in the 4 weeks prior to interview, describe the type of contact, identify demographic and behavioural factors associated with IPCOH and present age-adjusted ORs (aORs). Qualitative interviews (n=18) were conducted to understand the context, reasons and decision making around IPCOH. Of 6654 participants aged 18–59 years, 9.9% (95% CI 9.1% to 10.6%) reported IPCOH. IPCOH was highest in those aged 18–24 (17.7%), identifying as gay or lesbian (19.5%), and in steady non-cohabiting relationships (56.3%). IPCOH was associated with reporting risk behaviours (eg, condomless sex, higher alcohol consumption). IPCOH was less likely among those reporting bad/very bad health (aOR 0.54 95% CI 0.32 to 0.93) but more likely among those with COVID-19 symptoms and/or diagnosis (aOR 1.34 95% CI 1.10 to 1.65). Two-thirds (64.4%) of IPCOH was reported as being within a support bubble. Qualitative interviews found that people reporting IPCOH deliberated over, and made efforts to mitigate, the risks. Given 90% of people did not report IPCOH, this contact may not be a large additional contributor to SARS-CoV-2 transmission, although heterogeneity exists within the population. Public health messages need to recognise how single people and partners living apart balance sexual intimacy and relationship needs with adherence to control measures.
Publisher: Cold Spring Harbor Laboratory
Date: 11-05-2023
DOI: 10.1101/2023.05.11.23289797
Abstract: Mpox cases, first identified as part of the multi-country outbreak in May 2022, rapidly fell in the UK from September 2022. Public health responses included community-coordinated messaging and a targeted mpox vaccination in eligible gay, bisexual, and other men who have sex with men (GBMSM). Using data from an online, community survey of GBMSM (November/December 2022), we examined self-reported mpox diagnoses, behavioural risk modification, and mpox vaccination offer and uptake (≥1 dose). Thirty-five participants (2.6%, 35/1,333) were ever mpox test positive half (53%, 707/1,333) reported behaviour modification to avoid mpox. In GBMSM considered vaccine eligible, uptake was 69% (95% CI: 65%-72%, 601/875) or 92% (95% CI: 89%-94%, 601/655) in those eligible and offered. GBMSM self-identifying as bisexual, those with lower educational qualifications, and those unemployed were less likely to be vaccinated. Equitable mpox vaccine offer and provision is needed to minimise the risk of future outbreaks and mpox-related health inequalities.
Publisher: BMJ
Date: 03-2023
DOI: 10.1136/SEXTRANS-2022-055689
Abstract: We examined sexual behaviour, sexually transmitted infection (STI) and HIV testing and testing need, and identified associated factors, among gay, bisexual and other men who have sex with men (GBMSM) in the UK after COVID-19 restrictions ended, and compared these with ‘pre-pandemic’ estimates. We analysed survey data from GBMSM (N=1039) recruited via social media and Grindr in November–December 2021. We then compared Grindr-recruited 2021 participants (N=437) with those from an equivalent survey fielded in March–May 2017 (N=1902). Questions on sexual behaviour and service use had lookback periods of 3–4 months in both surveys. Unmet testing need was defined as reporting any new male and/or multiple condomless anal sex (CAS) partners without recent STI/HIV testing. Participants were UK residents, GBMSM, aged ≥16 years who reported sex with men in the last year. Multivariable logistic regression identified associated sociodemographic and health-related factors with unmet STI/HIV testing need in 2021, and then for 2017/2021 comparative analyses, adjusting for demographic differences. In 2021, unmet STI and HIV testing need were greater among older GBMSM (aged ≥45 years vs 16–29 years adjusted OR (aOR): 1.45 and aOR: 1.77, respectively), and lower for pre-exposure prophylaxis (PrEP) users (vs non-PrEP users aOR: 0.32 and aOR: 0.23, respectively). Less unmet STI testing need was observed among HIV-positive participants (vs HIV-negative/unknown aOR: 0.63), and trans and non-binary participants (vs cisgender male aOR: 0.34). Between 2017 (reference) and 2021, reported sexual risk behaviours increased: ≥1 recent new male sex partner (72.1%–81.1%, aOR: 1.71) and ≥2 recent CAS partners (30.2%–48.5%, aOR: 2.22). Reporting recent STI testing was greater in 2021 (37.5%–42.6%, aOR: 1.34) but not recent HIV testing, and there was no significant change over time in unmet STI (39.2% vs 43.7%) and HIV (32.9% vs 39.0%) testing need. Comparable community surveys suggest that UK resident GBMSM may have engaged in more sexual risk behaviours in late 2021 than pre-pandemic. While there was no evidence of reduced STI/HIV service access during this time, there remained considerable unmet STI/HIV testing need.
Publisher: JMIR Publications Inc.
Date: 04-05-2018
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for David Reid.