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Background: Compared to the general population, among gay and bisexual men (GBM) prevalence rates of anxiety and depression, and of drug use, are high.Objective: This paper explores the relationship between mental health, sexual risk behavior, and drug use among Australian GBM. We identify factors associated with indicators of poor mental health.Methods: Between September 2014 and July 2017, 3017 GBM responded to measures of anxiety and depression in an online cohort study of drug use.Results: Mean age was 35.3 years (SD 12.8). 17.9% screened positive for current moderate-severe anxiety and 28.3% for moderate-severe depression. The majority (52.2%) reported use of illicit drugs in the previous six months, including 11.2% who had used methamphetamine. One third had high (20.4%) or severe (10.6%) risk levels of alcohol consumption, and 18.3% who were current daily smokers. Most illicit drug use in general was not associated with either anxiety or depression, but men who used cannabis were more likely to show evidence of depression (p = 0.005). Among recent methamphetamine users, 28.0% were assessed as dependent: dependent users were more likely to show evidence of both depression and anxiety than were non-dependent users. High or severe risk drinking was associated with depression and daily tobacco use was associated with both anxiety and depression. Depression and anxiety was associated with: less personal support, viewing oneself as 'feminine', and being less socially engaged with gay men. Sexual risk behavior was not associated with either depression or anxiety.Conclusion: Prevalence of anxiety and depression was high, as was prevalence of licit and illicit drug use. Substance use was associated with anxiety and depression only when the use was considered problematic or dependent. Social isolation and marginalization are strong drivers of poor mental health, even within this population for whom anxiety and depression are common. [ABSTRACT FROM AUTHOR]

Background: International drug law enforcement agencies have identified an apparent rise in high level drug traffickers choosing to deal in multiple different drugs. It is hypothesised that this may be a "deliberate modus operandi" and that the formation of "portfolios of trades" may make such traffickers more profitable, harmful and resilient to changes in drug supply and policing. In this paper we provide the first exploration of the extent, nature and harms of poly-drug trafficking at Australian borders.Methods: Two different methods were used. First, we used Australian Federal Police (AFP) data on all commercial level seizures at the Australian border from 1999 to 2012 to identify the proportion of seizures that were poly-drug and trends over time. Second, we used unit-record data on a sub-set of 20 drug trafficking cases and linked-cases (defined as the original drug trafficking case and all other criminal cases that were connected via common offenders and/or suspects) to compare the profiles of poly-drug and mono-drug traffickers, including: the total weight and type of drug seized, the value of assets seized, and the level of involvement in other crime (such as money laundering and corruption).Results: Between 5% and 35% of commercial importations at the Australian border involved poly-drug trafficking. Poly-drug trafficking occurred in almost every year of analysis (1999-2012), but it increased only slightly over time. Compared to mono-drug traffickers poly-drug traffickers were characterised by: larger quantities of drugs seized, larger networks, longer criminal histories and more involvement in other types of serious crime.Conclusion: Some fears about poly-drug traffickers may have been overstated particularly about the inherent escalation of this form of trafficking. Nevertheless, this suggests poly-drug traffickers are likely to pose added risks to governments and law enforcement than mono-drug traffickers. They may necessitate different types of policy responses. [ABSTRACT FROM AUTHOR]