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In 2010, EMIS recruited 174,209 men from 38 countries to an anonymous online questionnaire in 25 languages.
As harm reduction services for drugs and sex are organised at a local level, we chose to compare cities rather than countries.
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Anecdotal evidence suggests that men who have sex with men (MSM) are increasingly combining sex and illicit drugs (an activity referred to as ‘chemsex’), in particular GHB/GBL, ketamine, crystal meth, or mephedrone (here called 4-chems).
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Data from 55,446 MSM living in 44 urban centres were included.
Use of 4-chems (past 4 weeks) was highest in Brighton (16.3%), Manchester (15.5%), London (13.2%), Amsterdam (11.2%), Barcelona (7.9%), Zurich (7.0%) and Berlin (5.3%). The rank order was largely consistent when controlling for age, HIV diagnosis, and number of sexual partners.
We defined 44 cities based on region/postal code and settlement size.
For multivariable regression analyses, three comparison groups of MSM not living in these cities were applied: MSM living in Germany, the UK, and elsewhere in Europe.