Vulnerability Conditions in a Cohort of Men Who Have Sex with Men Who Engage in Chemsex in Barcelona City: a Cross-Sectional Study

Abstract

Introduction Chemsex is a dynamic phenomenon with cultural variation. There is limited information about its prevalence and specific characteristics in our geographical area. Methods In this cross-sectional study of a series of gay, bisexual, and other men who have sex with men (gbMSM) who engaged in chemsex and were attending the Hospital Clinic of Barcelona, Spain, between March 2018 and May 2019, we aimed to identify potential vulnerabilities and describe the profiles of individuals who engaged in chemsex in our site. Baseline clinical and epidemiological characteristics related to HIV, HCV, STIs, sexual practices, and drug consumption were evaluated. A sub-analysis considering vulnerability conditions was completed. Results We included 161 participants: 67% were migrants and 48% were Latin American. A total of 150 participants were people living with HIV (PLWH), and 13% had a detectable HIV viral load (VL). The prevalence of HCV infection was 37%. Slamming practice was reported by 20% of the participants. Migrants from Latin America were younger, had a lower percentage of university education, and more frequently had detectable HIV-VLs and syphilis. HCV-positive participants reported more injecting drug use, versatile fisting practices, and syphilis. Slam users consumed more methamphetamine and mephedrone, had significantly higher HIV-VLs when detectable, and reported less sober sex. Conclusion and Policy Implications We identified certain baseline characteristics of our chemsex cohort that may confer a profile of greater vulnerability, which must be addressed in a personalized way when attempting damage reduction and a global approach to the practice of chemsex at our site. Access to specialized and interdisciplinary services with cultural competence in the complexity of the phenomenon should be guaranteed to these individuals for better management.

Do ART and Chemsex Drugs Get Along? Potential Drug–Drug Interactions in a Cohort of People Living with HIV Who Engaged in Chemsex: A Retrospective Observational Study

“…Chemsex has an impact on sexual health and increases the risk of transmission of HIV, hepatitis C virus (HCV), and other sexually transmitted diseases (STDs) [12]. Data from our hospital corroborate the aforementioned concerns and describe a heterogeneous cohort of chemsex users with health, social, and psychological implications [13].…”

Evolution of Risk Behaviors, Sexually Transmitted Infections and PrEP Care Continuum in a Hospital-Based PrEP Program in Barcelona, Spain: A Descriptive Study of the First 2 Years’ Experience

“…The recent increase in people who engage in chemsex in several cities in Europe [ 24 – 26 , 42 ], including in Barcelona [ 27 – 30 ], may have influenced our users’ elevated substance consumption data. The chemsex rate in our cohort was higher than that described in other international studies, as we found that 87% of people who used drugs engaged in chemsex ( n / N = 160/292, 55% of the whole cohort), compared to 38.5% detected in a multicenter English study [ 31 ] or 42.6% in a Paris cohort [ 15 ].…”

“…These practices also confer a higher risk for bacterial STIs [ 23 ]. The chemsex phenomenon is rapidly spreading in European countries [ 24 – 26 ], and Barcelona is the Spanish city with the highest prevalence [ 27 – 30 ]. PrEP could be offered as an additional HIV and STI prevention strategy to people who engage in chemsex as part of a comprehensive risk reduction program [ 31 – 33 ].…”

Increasing of New CA-MRSA Infections Detected in people living with HIV Who Engage in Chemsex in Barcelona: An Ambispective Study

“…An uncontrolled HIV VL has been identified as another risk factor for CA-MRSA infections and recurrence [ 14 , 15 ]. We have previously reported that people who engage in chemsex have significantly higher HIV viral load than general PLWH from our cohort [ 8 ], as one of the potential consequences of problematic chemsex practice.…”

“…This is an ambispective longitudinal study carried out between February 2018 and January 2022 in the Hospital Clinic of Barcelona (HCB), Spain. HCB follows a prospective cohort of 299 PLWH who engage in chemsex, as a result of a pilot study [ 8 ] within the global cohort of nearly 6000 PLWH. The present study was developed within this prospective cohort.…”