Dataset Information

Chems4EU: chemsex use and its impacts across four European countries in HIV-positive men who have sex with men attending HIV services.

ABSTRACT:

Introduction

Chemsex in a European context is the use of any of the following drugs to facilitate sex: crystal methamphetamine, mephedrone and gamma-hydroxybutyrate (GHB)/gamma-butyrolactone (GBL) and, to a lesser extent, cocaine and ketamine. This study describes the prevalence of self-reported recreational drug use and chemsex in HIV-positive men who have sex with men (MSM) accessing HIV services in four countries. It also examines the problematic impacts and harms of chemsex and access to chemsex-related services.

Methods

This is a cross-sectional multi-centre questionnaire study of HIV-positive MSM accessing nine HIV services in the UK, Spain, Greece and Italy.

Results

In all, 1589 HIV-positive MSM attending HIV services in four countries completed the questionnaire. The median age of participants was 38 years (interquartile range: 32-46 years) and 1525 (96.0%) were taking antiretroviral therapy (ART). In the previous 12 months, 709 (44.6%) had used recreational drugs, 382 (24.0%) reported chemsex and 104 (6.5%) reported injection of chemsex-associated drugs ('slamsex'). Of the 382 engaging in chemsex, 155 (40.6%) reported unwanted side effects as a result of chemsex and 81 (21.2%) as a result of withdrawal from chemsex. The reported negative impacts from chemsex were on work (25.1%, 96), friends/family (24.3%, 93) and relationships (28.3%, 108). Fifty-seven (14.9%) accessed chemsex-related services in the past year, 38 of whom (67%) felt the service met their needs.

Discussion

A quarter of participants self-reported chemsex in the past 12 months. There were high rates of harms from chemsex across all countries, including negative impacts on work, friends/family and relationships. Although a minority of those engaging in chemsex accessed support, most found this useful.

SUBMITTER: Whitlock GG

PROVIDER: S-EPMC9290820 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Publications

Chems4EU: chemsex use and its impacts across four European countries in HIV-positive men who have sex with men attending HIV services.

Whitlock Gary G GG Protopapas Konstantinos K Bernardino Jose I JI Imaz Arkaitz A Curran Adrian A Stingone Christof C Shivasankar Sivapatham S Edwards Sarah S Herbert Sophie S Thomas Konstantinos K Mican Rafael R Prieto Paula P Nestor Garcia Jorge J Andreoni Massimo M Hill Samantha S Okhai Hajra H Stuart David D Bourne Adam A Conway Katie K

HIV medicine 20210825 10

<h4>Introduction</h4>Chemsex in a European context is the use of any of the following drugs to facilitate sex: crystal methamphetamine, mephedrone and gamma-hydroxybutyrate (GHB)/gamma-butyrolactone (GBL) and, to a lesser extent, cocaine and ketamine. This study describes the prevalence of self-reported recreational drug use and chemsex in HIV-positive men who have sex with men (MSM) accessing HIV services in four countries. It also examines the problematic impacts and harms of chemsex and acces ...[more]

PMID: 34432363

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Project description:BackgroundChemsex, characterized by the intentional use of specific drugs to enhance sexual experiences during group sessions, represents a challenge for the health of some sexually active communities, such as men who have sex with men (MSM). MSM may experience mental health issues associated with chemsex participation. This survey aims to investigate the characteristics, prevalence, and correlates of sexualized drug use (SDU) and chemsex with a focus on the emotional vulnerability associated with chemsex and SDU engagement among MSM at high risk of sexually transmitted infections (STI).MethodsA self-administered anonymous questionnaire to investigate demographical data, attitudes toward substance dependence, sexual behaviors and vulnerability for common mental disorders (CMD), was offered to consecutive MSM attending the STI/HIV Unit of San Gallicano Dermatological Institute of Rome, Italy, from 1 to 30 November 2023. The Mann-Whitney and Fisher's test were used to assess differences in terms of sexual behavior, SDU, STI risk and vulnerability for CMD between MSM who don't engage in SDU, who engage only in SDU (no chemsex) and chemsex.ResultsOne hundred and twenty-two MSM agreed to participate. Overall, 47.3% (57/119) were people living with HIV (PLWH) on antiretroviral therapy (ART); fifty (40.9%, 95% CI: 32.7-49.9) participants reported SDU, 24 (19.7%, 95% CI: 13.6-27.6) of which reported chemsex. Participants reporting SDU or chemsex were in unstable relationships (p = < 0.01), engaged in group sex (p = < 0.01) and had more than 10 sexual partners in the previous year (p = < 0.01) compared to those who denied SDU. Chemsex participants were more likely to use condoms inconsistently (p = 0.02), have a history of STIs (p = 0.02), and have had over 10 sexual partners in the past year (p = 0.04) than those who only engaged in SDU. Chemsex participants used specific and exclusive drugs when compared to other MSM engaged in SDU. Overall, 35 (28.7%; 95% CI: 21.4-37.2) and 52 (42.6%; 95% CI: 34.2-51.5) participants showed symptoms of depression and anxiety, respectively. Chemsex involvement showed a strong association with symptoms of depression compared with no-SDU andno- chemsex (COR = 3.8; 95% CI: 1.22-11.6; p < 0.01), particularly among PLWH (p = 0.04).ConclusionsDepression may be associated with chemsex behavior, particularly in MSM with HIV. SDU, in particular chemsex, are proxies in practitioners for increased STIs risk and severe psychological distress, both as determinants and outcomes. Healthcare professionals in STI centers need more awareness of SDU and ongoing evaluation with a larger population.

Project description:BackgroundMen who have sex with men (MSM) who practice chemsex have a higher likelihood of engaging in risky sexual behaviors and higher rates of HIV infection and other sexually transmitted infections (STIs) than those who do not.ObjectiveThis trial aimed to evaluate the effectiveness of a web-based intervention in reducing the sexual harms of chemsex among MSM.MethodsThe study was a 2-arm, assessor-blinded, randomized, parallel-group trial with a 3-month follow-up period. The study was conducted in the year 2021 in Hong Kong. Underpinned by the theory of planned behaviors and a harm reduction approach, the intervention consisted of interactive components and knowledge-based information about chemsex. Participants in the control group received brief information and content about sexual violence. The primary outcome was self-efficacy in refusing risky sexual behaviors and chemsex, as measured by the Condom Self-Efficacy Scale (CSES), Self-Efficacy for Sexual Safety (SESS) instrument, and Drug Avoidance Self-Efficacy Scale (DASES). The secondary outcomes included intentions to have chemsex, actual engagement in chemsex, HIV and other STI testing, and condom use in the last 3 months. All outcomes were self-reported. An online structured questionnaire was used to collect data.ResultsIn total, 316 MSM enrolled in the study. The intervention group demonstrated a significantly larger improvement in condom-use self-efficacy (as measured by CSES scores; time-by-group interaction: β=4.52, 95% CI 2.03-7.02; P<.001), self-efficacy for sexual safety (as measured by SESS scores; time-by-group interaction: β=2.11, 95% CI 0.66-3.56; P=.004), and drug avoidance self-efficacy (as measured by DASES scores; time-by-group interaction: β=6.98, 95% CI 1.75-12.22; P=.009). Regarding the secondary outcomes, participants in the intervention group demonstrated a significantly larger reduction in the likelihood of having engaged in chemsex in the last 3 months (time-by-group interaction: odds ratio [OR]=0.23, 95% CI 0.10-0.53; P=.001) and likelihood of having had the intention to engage in chemsex in the last 3 months (time-by-group interaction: OR=0.37, 95% CI 0.18-0.78; P=.009). Participants in the intervention group also showed a significantly larger increase in the likelihood of having undergone HIV testing in the last 3 months (time-by-group interaction: OR=3.08, 95% CI 1.72-5.54; P<.001).ConclusionsThis study suggests that a web-based intervention with a harm reduction approach can enhance the self-efficacy of MSM in refusing risky sexual behaviors and chemsex and improve the uptake of HIV testing. We also provide initial evidence that such interventions can reduce both the intention of MSM to engage in chemsex and their actual engagement in chemsex.Trial registrationISRCTN Registry ISRCTN20134522; https://www.isrctn.com/ISRCTN20134522.International registered report identifier (irrid)RR2-10.1186/s12889-021-10742-8.

Dataset Information

Chems4EU: chemsex use and its impacts across four European countries in HIV-positive men who have sex with men attending HIV services.

Introduction

Methods

Results

Discussion

Publications

Chems4EU: chemsex use and its impacts across four European countries in HIV-positive men who have sex with men attending HIV services.

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