Chemsex-related drug use and its association with health outcomes in men who have sex with men: a cross-sectional analysis of Antidote clinic service data

Abstract

PurposeChemsex-related drug use (CDU) is an escalating public health issue among men who have sex with men (MSM), associated with significant physical, biomedical and psychosocial harm. Few interventions exist to help MSM engaging in chemsex and little data exist on which to build. This cross-sectional analysis, using data from Antidote, the UK’s only lesbian, gay, bisexual, and transgender specialist drug service, aims to remedy this paucity of data.MethodsModified Poisson regression was used to assess associations between CDU and a range of health outcomes; CDU+ subanalysis disaggregated MSM by primary chemsex drug of concern; and HIV+ subanalysis investigated whether CDU was associated with self-reported treatment adherence, HIV seroconversion and other HIV-specific issues.FindingsCompared with CDU− MSM, MSM presenting for CDU were more likely to be HIV+, current or previous injectors, to have used postexposure prophylaxis in the last year, and have had ≥6 sexual partners in the last 90 days, though less likely to be hazardous alcohol consumers or to have experienced previous suicidal ideation (all p<0.0005). CDU+ subanalysis revealed health outcome differences—those selecting mephedrone were less likely to be hepatitis C+, HIV+, current or previous injectors, or to have experienced previous suicidal ideation (all p<0.0005), whereas those selecting methamphetamine were more likely (all p<0.0005, except suicidal ideation p=0.009).ImplicationsThis analysis shows MSM presenting for CDU are a heterogeneous high-risk population with unmet health needs. There is a need for standardised chemsex surveillance and for improved intersectorial working between sexual health and drug treatment services. Future research should investigate typological differences between MSM presenting for CDU.Originality/valueTo date, this is the world’s largest analysis of MSM seeking treatment for CDU. Further, the publication of ‘real-world’ service data is a valuable addition to the literature alongside surveys and recruited studies.

Influence of Social Media on Sexualized Drug Use and Chemsex Among Chinese Men Who Have Sex With Men: Observational Prospective Cohort Study

“…Psychoactive substances such as those used for SDU/chemsex adversely affect users’ capacity to perceive and respond to risks during sexual encounters, and may prompt them to engage in high-risk sexual practices [ 11 ]. Studies have consistently shown that SDU and chemsex were associated with a higher risk of condomless anal intercourse (CAI), group sex, and fisting, resulting in a higher risk of HIV and other STIs [ 3 , 8 , 12 ]. SDU/chemsex among MSM in Hong Kong may aggravate the worsening HIV epidemic in this group (6.54% of MSM were HIV-positive in 2017) [ 13 ].…”

“…Factors associated with SDU/chemsex among MSM included those related to sociodemographics (eg, age, ethnicity, income, education level, and employment status), sexual orientation, and utilization of HIV testing and other HIV/STI prevention services [ 3 , 5 , 9 ]. Studies also showed that MSM with SDU/chemsex experience were more likely to access pre-exposure prophylaxis (PrEP) [ 10 , 12 ]. These factors were considered in this study.…”

The Role of Mental Health Conditions in the Diagnosis of Neurocognitive Impairment in People Living with HIV

“…In this research, we observed a minor proportion of patients who are dependent on addictive substances, something that was unknown to HIV clinicians and was not self-reported previously by patients. Chemsex-related drug use is an escalating public health issue among men who have sex with men, associated with significant physical, biomedical and psychosocial harm [ 48 ]. Generally, Chemsex is not self-reported by the patients to HIV clinicians and it is not identified as drug abuse by patients themselves.…”

Sex, Drugs, and Impulse Regulation: A Perspective on Reducing Transmission Risk Behavior and Improving Mental Health Among MSM Living With HIV

“…However, current evidence is also limited, mainly due to methodological limitations, including small sample sizes and observational designs (Johnson et al, 2008). Furthermore, there is a lack of scientifically tested treatment behavioral intervention protocols for chemsex and sexual compulsivity for MSM living with HIV (Evers et al, 2020;Stevens et al, 2020).…”