Characteristics and sexual health service use of MSM engaging in chemsex: results from a large online survey in England

Abstract

BackgroundChemsex, the use of select psychoactive drugs to enhance sexual experience, typically among men who have sex with men (MSM), is associated with sexual behaviours with higher STI risk. Understanding patterns of chemsex among MSM as well as the characteristics and sexual health service engagement of chemsex participants is important for developing interventions.MethodsBetween 5/2016 to 5/2017, 3933 MSM completed an online survey, recruited in sexual health clinics (SHCs) in England (n=421) and via four social networking/dating apps (n=3512). We described patterns of chemsex in the past year and used multivariable logistic regression to investigate differences in demographics and sexual behaviours by chemsex history. We described history of SHC attendance and STI test in the past year among app-recruited chemsex participants.ResultsChemsex in the past year was reported by 10% of respondents; 19% of SHC-recruited and 9% of app-recruited. Among chemsex participants, 74% had used ≥2 chemsex drugs. In the multivariable model, MSM engaging in chemsex had a raised odds of being HIV-positive (adjusted OR (aOR): 3.6; 95% CI 2.1 to 6.1), aged 30–44 (aOR 1.5 vs <30 years; 95% CI 1.0 to 2.1), being born outside the UK and having engaged in higher risk sexual behaviours in the past 3 months. Chemsex participants also had higher odds of condomless anal sex with partners of different or unknown HIV status, but only among HIV-negative/untested. In the past year, 66% of app-recruited chemsex participants had attended a SHC and 81% had had an STI test.ConclusionOne in 10 MSM recruited through community and clinical settings across England had engaged in chemsex in the past year. Those that did appear to be at greater STI risk but engaged more actively with sexual health services. This highlights the need and opportunity for chemsex-related services in SHCs and robust referral pathways to drug treatment services.

Impact of Sexualized Substance Use and Other Risk Practices on HCV Microelimination in gbMSM Living with HIV: Urgent Need for Targeted Strategies. Results of a Retrospective Cohort Study

“…Unlike other studies, we asked specifically about the use of individual chemsex drugs and found a very common use of poppers, cocaine, methamphetamine and GHB/ GBL. These results differ slightly from those observed in other countries and other Spanish regions, where mephedrone was one of the main sexualized drugs among MSM [29,30], and demonstrate the dynamic nature and cultural variation of chemsex phenomenon, a fact that has to be taken into account when designing specific prevention strategies [31]. The social and personal factors involved in chemsex are as diverse as the barriers to reduce HCV-related sexual risk behaviour in this population, including social pressure, and HCV-HIV and drug consumption stigma [32].…”

Oral sex practices among men who have sex with men and transgender women at risk for and living with HIV in Nigeria

“…Women-identifying participants also reported a higher odds of oral sex, consistent with a quantitative study in Thailand that suggested TGW were more likely than MSM to prefer receptive anal sex and engage in only oral sex [44]. Moreover, our study identified an association between mobile phone ownership and oral sex, a sexual practice that has not been differentiated from anal sexual practices in prior studies [45][46][47].…”

Crime or culture? Representations of chemsex in the British press and magazines aimed at GBTQ+ men

“…There are a number of concerns around chemsex, though most notable are concerns about high rates of addiction, increased HIV transmission rates, and sexual assault which occurs when people are under the influence of these drugs (see Blomquist et al, 2020;Bourne et al, 2014;Bourne et al, 2015;Public Health England, 2015;Stevens et al, 2020). After an official review in Novemeber 2020, GHB and GBL werereclassified as class B drugs in March 2021.…”