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Background: The United States is currently experiencing the worst epidemic of drug overdose in the country's history. We sought to understand whether changes in drug use behavior and access to prevention services during the COVID-19 pandemic may have contributed to increased drug overdose., Methods: We recruited adults with a history of injection drug use to complete an online survey during March through June 2021 to assess whether overdose experiences, drug use behaviors, and access to prevention services changed due to the pandemic., Results: Diminished social support during the pandemic was correlated with reporting disrupted access to harm reduction services ( P  = 0.006) and experiencing an overdose ( P  = 0.005). Disrupted access to harm reduction services also was correlated with being female ( P  = 0.03) and reporting feeling pressure to share drugs or equipment ( P  = 0.01), worrying about withdrawal ( P  = 0.03), and changes to how and where individuals got their drugs, drug price and availability, with whom and where drugs were used, and the quantity or properties of drugs purchased (all P  < 0.01)., Discussion: The cumulative impact of COVID-19-related disruptions may have resulted in heightened risk for overdose, as these findings suggest that, in many cases, experiencing one risk factor was suggestive of experiencing several risk factors., (Copyright© Board of Regents of the University of Wisconsin System and The Medical College of Wisconsin, Inc.)

Young men who have sex with men (YMSM), and particularly ethnic minority YMSM, experience high incidence HIV infection due to continued patterns of high-risk sexual behaviour. The intent of this research was to systematically solicit input and recommendations from YMSM themselves concerning the kinds of HIV prevention programmes that would best meet their needs and would address risk issues they believed are critical. In-depth qualitative interviews were conducted with a sample of 72 purposively selected YMSM to identify necessary components of HIV prevention targeting YMSM. Respondents noted a need for comprehensive HIV prevention programmes that addressed issues related to dating and intimacy, sexuality and arousal, drugs and alcohol, self-esteem and self-worth, abuse and coercion, and sexual identity. Respondents emphasized the importance of keeping programmes confidential, fun, comfortable, accepting and open to all YMSM regardless of sexual identity. Identified community resource needs included safe havens for youth, more peer educators and older MSM mentors, increased school-based sexuality education, and greater support from the society at large as well as from churches, the gay community and communities of Color. Implications of these findings for HIV prevention are discussed.