SETTING THE SCENE

1. SETTING THE SCENE Increased sexualised and intra-venous drug use (Methamphetamine, Mephedrone {& GBL-oral only) (Data from The Lancet, HIV Nursing Journal, Antidote, Club Drug Clinic and NDTMS Discussed at HPE NIN last week 3 day drug-fuelled “benders”, multiple partners, poor condom use/extreme sex, increased injecting use MSM drug users now Most-At-Risk group for HIV MSM intra-venous drug users now Most-At-Risk group for co-infection HIV/HCV

5. Setting up a Chem Sex Clinic Create a safe, non-judgmental space

6. Develop appropriate tools/models Assessment tools that encourage disclosure Motivational Interviewing to address ambivalence Using language/slang terms familiar to this patient group Addressing on-line behaviour

7. BRING CLINIC AS A WHOLE IN LINE WITH THESE TRENDS • Training for all front line staff in; • General party-drugs awareness/context of use • Symptoms/identifying signs of chem-sex behaviour • Urgent medical concerns • Communication skills with this patient group • Referral pathways Develop a proforma for all clinic staff to identify and manage chem-sex presentations Begin monitoring these trends more effectively than has traditionally been done (ie; I/V opiate use)

8. FILLING THE CLINIC (FROM WITHIN) Welcome sheets across all clinics to routinely offer drug use advice “Business cards” left in waiting rooms/reception for discreet contact

9. FILLING THE CLINIC (FROM WITHOUT/REFERRALS IN)

10. THE MDT MODEL

11. THE EXPRESS MODEL • Drugs worker • Is a mobile • chem-sex clinic • Brief interventions/follow-ups HA CLINIC HIV CLINIC Psycho- sexual/ psychology dept’s PEP CLINIC STI CLINIC