Non-fatal GHB overdose among sexual and gender minorities: A syndemic perspective

This study examined prevalence and correlates of non-fatal gamma-hydroxybutyrate (GHB) overdose in sexual and gender minority (SGM) people.

Cross sectional analyses leveraged baseline data from a subset of 1815 participants from US cohort of SGM people that reported recent GHB use. The outcome was any self-reported nonfatal GHB overdose in the past year. The exposure was a syndemic burden score (0-4), based on the presence of depressive symptoms and hypersexual disorder, childhood sexual assault, and intimate partner violence. Multivariable logistic regression was used to examine correlates of overdose. Sensitivity analyses assessed interactions between syndemic conditions using the relative excess risk due to interaction to assess associations beyond an additive model.

Among the 1815 participants who used GHB, 244 (13%) reported a past year overdose. Compared to those with 0-1 syndemic conditions, those with two (aOR = 3.02; 95% CI: 1.89, 5.05; p < 0.001), three (aOR = 3.19; 95% CI: 1.96, 5.41; p < 0.001) and four conditions (aOR = 5.63; 95% CI: 3.02,10.70; p < 0.001) had higher odds of reporting a GHB overdose. Hazardous alcohol use and residing in an Ending the HIV Epidemic (EHE) jurisdiction had higher odds of syndemic factors. No significant interaction effects between syndemic factors were found in sensitivity analyses.

More than one-in-ten SGM people who use GHB report at least one overdose in the past year. Interventions are needed especially for those reporting hazardous alcohol use and residing in EHE regions.