Chemsex drugs on the rise: a longitudinal analysis of the Swiss HIV Cohort Study from 2007 to 2017

Hampel, Benjamin; Kusejko, Katharina; Kouyos, RD; Böni, Jürg; Flepp, Markus; Stöckle, Marcel; Conen, Anna; Béguelin, Charles; Künzler-Heule, Patrizia; Nicca, Dunja; Schmidt, AJ; Nguyen, Huyen; Delaloye, Julie; Rougemont, Mathieu; Bernasconi, Enos; Rauch, Andri; Günthard, Huldrych F.; Braun, Daniela; Fehr, Jan; Anagnostopoulos, Alexia; Battegay, Manuel; Bucher, Heiner C.; Calmy, Alexandra; Cavassini, Matthias; Ciuffi, Angela; Dollenmaier, Günter; Egger, Matthias; Elzi, Luigia; Fellay, Jacques; Furrer, Hansjakob; Fux, Christoph A; Haerry, David; Hasse, Barbara; Hirsch, HH; Hoffmann, Matthias; Hösli, Irène; Huber, Matthew; Kahlert, Christian; Kaiser, Laurent; Keiser, Olivia; Klimkait, Thomas; Kovari, Helen; Ledergerber, Bruno; Martinetti, Gladys; Tejada, Begoña Martínez de; Marzolini, Catia; Metzner, KJ; Müller, Nicolas; Paioni, Paolo; Pantaleo, G.; Perreau, Matthieu; Rudin, Christoph; Scherrer, Alexandra U.; Schmid, Patrick; Speck, Roberto F.; Tarr, Philip; Trkola, Alexandra; Vernazza, Pietro; Wandeler, Gilles; Weber, Rainer; Yerly, Sabine

doi:10.1111/hiv.12821

Cited by 59 publications

(41 citation statements)

References 24 publications

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“…What these studies have in common is the anonymous nature of reporting illicit/stigmatised behaviour. Surprisingly, Chemsex figures were not higher among HIV-positive MSM in the Swiss HIV Cohort Study [31], possibly indicating under-reporting of illicit/stigmatised behaviour in a clinical interview setting.…”

Section: Risk and Precautionary Behaviourmentioning

confidence: 80%

The Swiss STAR trial – an evaluation of target groups for sexually transmitted infection screening in the sub-sample of men

Schmidt

Rasi

Esson³

et al. 2020

Swiss Med Wkly

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OBJECTIVES: In Switzerland, universal health insurance does not cover any routine testing for sexually transmitted infections (STIs), not even in individuals at high risk, and extra-genital swabbing is not standard of care. We determined the prevalence and incidence of human immunodeficiency virus (HIV), viral hepatitis and non-viral STIs in a multicentre prospective observational cohort of multi-partner men who have sex with men (MSM) and other men.MATERIALS AND METHODS: Between January 2016 and June 2017, we offered free STI testing to all men with multiple sexual partners (three or more in the previous 12 months), with follow-up examinations every 6 months. We used multiplex polymerase chain-reaction testing (for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium) on pooled swabs (pharynx, urethra/vagina, anus), and antibody tests for HIV and Treponema pallidum at every visit, and for hepatitis B/C at baseline. RESULTS: We screened 779 multi-partner MSM and 92 other men. Previously undiagnosed HIV was found in 0.5% vs 0.0%, respectively and T. pallidum antibodies in 15.3% vs 1.1%. STIs requiring antibiotic treatment comprised: active syphilis 1.7% vs 0.0%; N. gonorrhoeae 10.3% vs 0.0%; C. trachomatis 8.7% vs 1.1%. One in four MSM versus 1 in 100 other multi-partner men had any of these three STIs at baseline. 10.4% vs 1.3% had a history of hepatitis B, 31.9% vs 47.3% had no immunity (HBs-AB <10 IU/l). Ten MSM had HCV antibodies (1.4%), with 8 out of the 10 being MSM with HIV; HCV seroprevalence was 0.3% among HIV-negative MSM. In MSM, incidence of the three bacterial STIs was 25.5 per year over 333 person years of follow-up, HIV incidence was 0.3%. Non-condom-use (in the last 3 months) for anal/vaginal sex was not associated with STIs. Independent risk factors were sex with men (adjusted odds ratio [aOR] 16.4) and the number of sexual partners (aOR 2.3 for >20). CONCLUSION: Among MSM, but not among other multipartner men, STIs, mostly asymptomatic, are common. Given the high risk of onward transmission, low-cost or free routine screening of multi-partner MSM is a public health priority.

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Section: Risk and Precautionary Behaviourmentioning

confidence: 80%

The Swiss STAR trial – an evaluation of target groups for sexually transmitted infection screening in the sub-sample of men

Schmidt

Rasi

Esson³

et al. 2020

Swiss Med Wkly

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“…Similar findings have been observed in other recent studies in Europe. There is also some evidence that the prevalence of drug use associated with chemsex is increasing among GBMSM ( Hampel et al., 2019 ; Sewell et al., 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Recreational drug use and use of drugs associated with chemsex among HIV-negative and HIV-positive heterosexual men and women attending sexual health and HIV clinics in England

Miltz

Rodger

Sewell

et al. 2021

International Journal of Drug Policy

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Background There is little information on the prevalence of recreational drug use among UK heterosexual men and women, in particular on use of drugs associated with ‘chemsex’ within gay communities. The aim of this study was to examine among HIV-negative and HIV-positive heterosexual men and women in England: (i) the prevalence of recreational drug use (including use of drugs associated with chemsex), (ii) socio-economic/lifestyle correlates of drug use, and (iii) the association of drug use with sexual behavior measures and mental health symptoms. Methods Data are from the AURAH study of HIV-negative individuals attending sexual health clinics across England (2013–2014) and the ASTRA study of HIV-positive individuals attending HIV outpatient clinics in England (2011–2012). Prevalence of recreational drug use (past three months) and associations are presented separately among the four sample groups: HIV-negative ( N = 470) and HIV-positive ( N = 373) heterosexual men and HIV-negative ( N = 676) and HIV-positive ( N = 637) women. Results The age standardized prevalence of any drug use was 22.9%, 17.1%, 15.3%, and 7.1% in the four sample groups respectively. In all groups, cannabis was the drug most commonly used (range from 4.7% to 17.9%) followed by cocaine (1.6% to 8.5%). The prevalence of use of drugs associated with chemsex was very low among HIV-negative participants (1.0% heterosexual men, 0.2% women) and zero among HIV-positive men and women. In age-adjusted analysis, factors linked to drug use overall and/or to cannabis and cocaine use specifically in the four sample groups included Black/mixed Caribbean and white (vs. Black/mixed African) ethnicity, lower level of education , cigarette smoking, and higher risk alcohol consumption. Associations of recreational drug use with measures of condomless sex, depression, and anxiety were observed in the four groups, but were particularly strong/apparent among women. Conclusion Providers need to be aware of cannabis and cocaine use and its potential link with sexual risk behavior and symptoms of depression and anxiety among heterosexual men and women attending sexual health and HIV clinics.

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“…This is the first study from a Nordic country to demonstrate that chemsex occurs among both MSM and non-MSM and is associated with reduced mental health. While several studies show that use of drugs is more common among MSM than non-MSM [6,28,29], we are only aware of one other study with both MSM and non-MSM that has examined the use of specific recreational drugs used shortly before the sexual session [1]. Similar to the study by Lawn and colleagues [1], we found that chemsex was somewhat more common among MSM (17% vs 12%), they were more likely to prefer GHB/GBL and used the drugs to enhance the sexual experience.…”

Section: Discussionmentioning

confidence: 99%

“…Also a review of chemsex shows that prevalence estimates of chemsex among MSM vary greatly across various samples and measurement and recruitment methods used, ranging from 3 to 29% [4]. Longitudinal research demonstrates mixed evidence on prevalence changes over time in the use of chemsex drugs among MSM [6,7].…”

Section: Introductionmentioning

confidence: 99%

Links between chemsex and reduced mental health among Norwegian MSM and other men: results from a cross-sectional clinic survey

2020

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Background The use of specific drugs to facilitate, enhance or prolong sexual sessions is referred to as ‘chemsex’. The popularity of the behavior seems to be growing, but there is a paucity of information on the mental health aspects associated with chemsex and no data on chemsex from Nordic countries. We investigated the link between chemsex and mental health among men who have sex with men (MSM) and other men in Norway. Methods We recruited participants from a walk-in sexually transmitted infections (STI) clinic. Participants completed a piloted, anonymous self-administered survey. It consisted of questions about men’s sociodemographic characteristics, mental health, sexual behaviors, substance use, and chemsex. The outcome we investigated was reduced mental health, measured with the validated Hopkins Symptom Check List. We obtained descriptive statistics and performed univariate and multivariate logistic regression analyses. Results 1013 (96%) of the surveys were complete and could be analysed. The mean age of the sample was 33, 51% were MSM, and 21.7% had reduced mental health. More MSM than other men engaged in chemsex in the past year (17% vs 12%). The most frequently reported chemsex drugs were cocaine and gamma hydroxybutyrate/gamma butyrolactone (GHB/GBL). Men engaged in chemsex primarily to enhance sexual pleasure and excitement, and about half reported almost never or never using condoms for chemsex. In univariate analyses, significant predictors of reduced mental health was chemsex (Odds Ratio [OR] = 1.82), being unemployed (OR = 3.54), and having sex with only women (OR = 0.58). In multivariate analyses, two variables remained significantly associated with reduced mental health: chemsex (adjusted OR = 2.18, 95%CI = 1.25–3.78) and being unemployed (adjusted OR = 4.10, 95%CI = 2.13–7.87). Conclusions In our sample of men from an STI clinic in Norway, about 14% self-reported engaging in chemsex in the past year and about a fifth of the men had reduced mental health. Men who engaged in chemsex, which more MSM engaged in than other men, had two times greater odds of reduced mental health. These findings suggest that mental health assistance should be among the interventions offered to men engaging in chemsex.

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Chemsex drugs on the rise: a longitudinal analysis of the Swiss HIV Cohort Study from 2007 to 2017

Cited by 59 publications

References 24 publications

The Swiss STAR trial – an evaluation of target groups for sexually transmitted infection screening in the sub-sample of men

The Swiss STAR trial – an evaluation of target groups for sexually transmitted infection screening in the sub-sample of men

Recreational drug use and use of drugs associated with chemsex among HIV-negative and HIV-positive heterosexual men and women attending sexual health and HIV clinics in England

Links between chemsex and reduced mental health among Norwegian MSM and other men: results from a cross-sectional clinic survey

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