Men who have sex with men (MSM) are a risk group for new HIV infections. Drug use among men who have sex with men is often accompanied by risky sexual behaviours. Local AIDS help centres and gay advice centres are recording an increase in drug use among MSM clients in Germany. This study examines reasons for drug use and drug use contexts for MSM, including syndemic factors and experiences of social support. The study is based on a qualitative research approach. We conducted 14 structured, in-depth interviews with substance-using MSM in three German cities. An interview guidance document was used that was developed on the basis of the syndemic approach. Data analysis was based on structured analysis of content. The MSM interviewed had extensive experience of drug use, in particular amyl nitrate, amphetamines, methamphetamine, ketamine, cocaine and cannabis. The drugs were used both at parties and in connection with sexual experiences (chemsex). Twelve men said that they had an existing HIV infection at the time of the interview. The men also reported experiences of violence and discrimination because of their sexual orientation. The social networks of the MSM and dating apps are highly relevant for experiencing chemsex. Certain places in the MSM community also have an impact on drug purchase, drug consumption and chemsex sessions. MSM are a group that is vulnerable to psychological problems, in particular problematic drug use. This group requires specific help from drug services and AIDS support services that are orientated towards the life situation and substance use contexts of the clients. Both support systems should work together more closely and network. Furthermore, specific prevention strategies, aimed at both mental and physical well-being, should be developed for substance-using MSM.

Background: The above-average proportion of people with opioid use disorder living in prisons is a worldwide reality, and the need to treat these people was recognized internationally more than 20 years ago. Studies have shown that substitution therapies are best suited to treat opioid use disorder and reduce the risk of HIV and hepatitis C transmission and overdose. However, huge health inequalities exist in and outside of prison due to the different implementation of opioid substitution therapy (OST). People living in prisons are entitled to the best possible health care. This is established by the Universal Declaration of Human Rights and by the International Convention on Economic, Social and Cultural Rights. Solely the imprisonment, and not the loss of fundamental human rights, constitutes the punishment. Methods: A qualitative literature search using PubMed and Google Scholar was performed in order to identify relevant publications. Results: This review shows the inequality in availability of opioid substitution therapy for people living in prison compared with people outside of prison in Germany. It also gives possible reasons and evidence for this inequality, showing that continuing or initiating OST in prison is more beneficial for the health of people living in prison than abstinence-oriented treatment only. Conclusion: It is important that drug use disorder is treated as a serious illness also in prison. Joint efforts are needed to provide people living in prison with the best possible treatment and to minimize the adverse effects of drug use. Therefore, with laws, policies, and programs that conform to international human rights standards, each state must ensure that people living in prison receive the same health care as people outside of prison.

Background: The measures taken to contain the COVID-19 pandemic have led to significant changes in people’s daily lives. This paper examines changes in substance use during the first lockdown (March–July 2020) and investigates mental health burdens in substance users with increased consumption of alcohol, nicotine or tetrahydrocannabinol (THC) in Germany compared to users with unchanged or reduced consumption. Method: In a cross-sectional online survey, 2369 people were asked about their mental health and their substance use during the first lockdown in Germany. Results: Of the participants, 28.5% increased their alcohol use, 28.8% their use of tobacco products, and 20.6% their use of THC-containing products during the pandemic. The groups with increased alcohol, nicotine, and THC use during the first lockdown reported more depressive symptoms and anxiety. Individuals who reported increased consumption of alcohol or nicotine were also more likely to experience loneliness and have suicidal thoughts and were more often stressed due to social distancing. Conclusion: Alcohol, nicotine and THC increased in a subgroup of consumers who reported to have more mental health problems compared to individuals who did not increase their consumption. This increased substance use could, therefore, be understood as a dysfunctional strategy to cope with negative emotions during the lockdown.

In this quantitative study, data on 746 students of social work were collected regarding their current sense of stress, experience of psychosocial drain as well as their use of specific coping strategies. The Perceived Stress Scale (PSS) and the Trier Inventory of Chronic Stress (TICS) were used. The results show that one out of 3 students suffer from a lot of to extreme stress. One-fourth of the students report feeling overworked and socially overburdened. More than half of the students are exposed to psychosocial drain as a consequence of past events in their biography (e.g. death or mental illness of a close relative). Despite these obvious burdens, only one-fourth made use of professional aid or counseling. Students who are primarily using functional coping strategies have a lower sensibility to stress and feel less overworked than students primarily using dysfunctional coping strategies. In the university setting, the theoretically and empirically sound knowledge based on this report can be used profitably: The increasing implementation of seminars on coping with stress at universities itself suggests that learning and utilizing functional coping strategies can contribute to a reduction of stress and strain among students.

Zusammenfassung: Hintergrund: Sexarbeiter*innen erleben aufgrund ihrer Tätigkeit in der Gesellschaft häufig mangelnde Akzeptanz und Stigmatisierungen. Daraus resultieren für sie zahlreiche Ausschlussmechanismen und Belastungsfaktoren, die mit einer erhöhten Vulnerabilität für psychische Erkrankungen einhergehen können. Zielsetzung: Identifikation von Studien zur psychischen Situation von Sexarbeiter*innen in Europa. Methodik: Im Rahmen eines Scoping-Reviews konnten in den wissenschaftlichen Datenbanken LIVIVO, BASE, PubMed und PSYNDEX n=12 relevante Studien identifiziert werden, die ab 1990 publiziert wurden. Ergebnisse: Bei 56–75% der befragten Sexarbeiter*innen wurde mindestens eine psychische Störung berichtet. Besonders häufig treten bei den Befragten Depressionen, Substanzkonsum, Suizidalität und posttraumatischer Stress auf. Die Ergebnisse zeigen, dass Sexarbeiter*innen vulnerabel für psychische Belastungsfaktoren und Erkrankungen sind. Eine umfassende psychosoziale Unterstützung und Beratung ist unter Berücksichtigung der verschiedenen Arbeitskontexte und Lebenswelten indiziert.

The ongoing Covid-19 pandemic not only threatens physical health, but also affects the mental health of people. Yet, health consequences of the pandemic do not affect all members of society equally. We therefore assessed the mental health burden of individuals who are at increased risk of severe illness from Covid-19 compared to individuals who are at low risk of severe illness during the first lockdown (March, 2020) in Germany. Furthermore, we investigated variables mediating the effect of being an individual at increased risk of serve illness on depression. Adult German residents (n = 2.369) provided responses to a cross-sectional online survey about risk factors for of severe illness from Covid-19 and various aspects of mental health during the first lockdown in Germany. For data collection, standardized and validated self-report measures were used and for data analysis Mann-Whitney U-tests as well as regression and mediation analyses were performed. The results clearly show that the mental health burden is higher among individuals at increased risk of severe illness from Covid-19 compared to individuals at low risk of severe illness from Covid-19. Moreover, our findings indicate that the association between Covid-19 risk status and depressive symptoms is mediated by concerns about mental health, anxiety and loneliness in a causal effect chain. Individuals at increased risk of severe illness from Covid-19 have an increased need for psychosocial support during times of lockdown. Future public health policies should pay special attention to these individuals and support them by targeted offers. More research, however, is needed on possible long-term consequences of social distancing on mental health.