Psychosocial and sexual factors associated with drug use and sexualised drug use among women who have sex with women: a need for targeted harm reduction responses

Matthew Hibbert, Caroline Brett, Lorna Porcellato, Vivian Hope

Introduction: Studies indicate that women who have sex with women (WSW) report greater levels of drug use than heterosexual women, but globally few studies have looked a sexualised drug use among WSW. This study investigated the factors associated with drug use and sexualised drug use among WSW.

Methodology: Potential participants from across the UK were invited to complete an anonymous online questionnaire between April-June 2018. The LGBT Sex and Lifestyles survey recruited through Facebook advertising and social media post by a range of community organisations. Multivariate logistic regression was used to compare WSW who had engaged in any illicit drug use in the past 12 months with those who had not, and those who engaged in sexualised drug use (e.g. cannabis, poppers) with those who engaged in other drug use.

Results: Of the 3,580 participants, 1,513 were WSW (42%) and 1,502 (99%) of these were included in the analyses (mean age was 29 years). Any drug use was reported by 40% of WSW, 45% of which (18% of total, n=263) reported sexualised drug use. Factors associated with drug use were identifying as queer (aOR=1.86, 95%CI 1.08-3.23), younger age (aOR=0.96, 95%CI 0.95-0.98), being born outside the UK (aOR=1.77, 95%CI 1.16-2.68), recent sexual assault (aOR=2.35, 95%CI 1.43-3.86), >=5 female sexual partners (aOR=3.82, 95%CI 1.81-8.03), and psychological distress (aOR=1.74, 95%CI 1.14-2.65). Sexualised drug use was associated with identifying as bisexual (aOR=2.19, 95%CI 1.48-3.22), >=5 female sexual partners (aOR=2.81, 95%CI 1.27-6.20), and highest education achieved at 16 (aOR=2.28, 95%CI 1.15-4.51).

Conclusions: WSW experience numerous health inequalities in relation to drug use and sexualised drug use. Harm reduction and health services that provide services for WSW should be aware of potentially compounding factors related to drug use, such as sexual assault and psychological distress, providing a safe and LGBT-friendly environment to discuss these issues.