Sexualised drug use and chemsex in Italy: A questionnaire study based on a cohort of clients attending a STI outpatient service in Milan

Abstract

Background Chemsex is a heterogeneous phenomenon with differences in distribution, setting, motivations and type of substances consumed between countries. The lack of data at national level of the Italian situation creates a perception of reduced need for intervention. Methods Anonymous paper questionnaires were distributed to patients who had registered themselves at the STI Department IRCCS Ca’ Granda Policlinico in Milan. Results A significant association was demonstrated between use of sexualised drugs, chemsex and the following variables: (1). Number of partners: in the group of clients with more than five partners, sexualised drug users were more than twice compared with those in the group with less than five partners (35.2% vs 16.2%) p<0.0001. (2). Use of dating apps: more than one out of two persons who used drugs during sex affirmed looking for partners on internet, p = 0.0059. (3). Low condom uses with occasional partners: percentage of individuals who declared not to use condoms or devices during their sexual encounters with occasional partners is more than twice as high in the sexualised drug users group with respect to controls (44.6% vs 21.4%); p = 0.0006). (4). Use of post exposure prophylaxis (PEP): among the PEP users, more than half participants belonged to the sexualised drug users’ group; p = 0.0021. Conclusions Sexualised drug use and chemsex are frequently practiced in Milan. This survey identified a specific population with higher-risk sexual behaviours and increased incidence of acute bacterial STIs.

Prevalence, characteristics, and associated risk factors of drug consumption and chemsex use among individuals attending an STI clinic (EpITs STUDY)

“…The most significant associated factors were the use of dating applications, chemsex use with a partner, pornography use, and bisexual orientation (18). Another questionnaire-based study conducted in an STI clinic in Italy found a prevalence of sex-related use of 24.7% during the last year, with a significant association between chemsex consumption and number of previous partners (>5), use of dating apps, reduced condom use and use of PEP between 96 MSM participants (19). The higher prevalence observed in our sample could be explained by the previous association between chemsex use and STIs, as all of our participants were evaluated for an STI diagnosis.…”

Incidence and risk factors associated with acquired syphilis in HIV pre-exposure prophylaxis users

“…Regarding behaviors associated with syphilis infection during PrEP, our study found a significant association between recreational drug use and syphilis acquired during PrEP, particularly for poppers, marijuana, cocaine, and erection stimulants. One study identified that sexual drugs and chemsex have a significant association with the number of partners, search for partners on the internet, and low condom use with casual partners [21]. These findings may corroborate an increased vulnerability with the use of these substances.…”