High Rates of Sexualized Drug Use or Chemsex among Brazilian Transgender Women and Young Sexual and Gender Minorities

Abstract

(1) Background: We aimed to estimate sexualized drug use (SDU) prevalence and its predictors among sexual and gender minorities. (2) Methods: We used an online and on-site survey to enroll sexual/gender minorities people between October–December/2020, and multivariate logistic regression to obtain SDU correlates. (3) Results: We enrolled 3924 individuals (280 transgender women [TGW], 3553 men who have sex with men [MSM], and 91 non-binary), 29.0% currently on pre-exposure prophylaxis (PrEP). SDU prevalence was 28.8% (95% confidence interval [CI] 27.4–30.2). TGW had 2.44-times increased odds (95%CI 1.75–3.39) of engaging in SDU compared to MSM, regardless of PrEP use. PrEP use (aOR 1.19, 95%CI 1.00–1.41), South/Southeast region (aOR 1.26, 95%CI 1.04–1.53), younger age (18–24 years: aOR 1.41, 95%CI 1.10–1.81; 25–35 years: aOR 1.24, 95%CI 1.04–1.53), white race/color (aOR 1.21, 95%CI 1.02–1.42), high income (aOR 1.32, 95%CI 1.05–1.67), binge drinking (aOR 2.66, 95%CI 2.25–3.14), >5 sexual partners (aOR 1.88, 95%CI 1.61–2.21), condomless anal sex (aOR 1.49, 95%CI 1.25–1.79), self-reported sexually transmitted infection (aOR 1.40, 95%CI 1.14–1.71), and higher perceived HIV-risk (aOR 1.37, 95%CI 1.14–1.64) were associated with SDU. (4) Conclusions: TGW had the highest SDU odds. SDU may impact HIV vulnerability among key populations and should be addressed in HIV prevention approaches.

Chemsex and Psychosis: A Systematic Review

“…An added limitation was the heterogeneity in collecting and reflecting the findings in the studies, as well as the presence of four articles that sampled more specific subpopulations than the one in this review, which made it difficult to unify and synthesize the information. As previously mentioned, only one study included a trans population [ 36 ]; furthermore, the fact that it did so by self-identification with male sex left out trans women, a part of the group in which a large amount of sexualized drug use is being found [ 54 ]. However, as we explained, the role of this minority group has yet to be studied, with MSM being the clear demographic that defines chemsex.…”

Preferences for pre-exposure prophylaxis (PrEP) among sexual and gender minorities: a discrete choice experiment in Brazil

“…They are also more likely to engage in HIV risk behavior and face more barriers to accessing healthcare. 53 , 54 A study suggested that transwomen bore the highest HIV burden among any population at risk in Brazil, and the high proportion of diagnoses among young participants pointed to the need for tailored long-term healthcare and prevention services to curb the epidemic and improve their quality of life. 55 …”

Patterns of Polysubstance use in young Black and Latinx sexual minority men and transgender women in its association with sexual partnership factors: The PUSH study

“…With prior work suggesting that younger SMM and TW may be at more risk for cocaine and amphetamine use prior to or during sex than older peers, [15, 46] interventions will need to be multi-factorial and address not only individual substance use, but also incorporate aspects victimization, violence and pressure that may occur within the sexual partnerships of young SMM and TW. [47] Continued research is needed to disaggregate components of HIV risk for young Black and Latinx youth – for example, how aspects of condomless sex, older partners and sexual violence may be inter-related to substance use.…”