Increases in condomless chemsex associated with HIV acquisition in MSM but not heterosexuals attending a HIV testing center in Antwerp, Belgium

Abstract

BackgroundIt has been speculated that the prevalence of chemsex is increasing in men who have sex with men and that this may be playing a role in the spread of HIV.MethodsWe assessed if the prevalence of reported chemsex was increasing and if chemsex was associated with HIV infection in clients attending the ‘Helpcenter’, Antwerp, between 2011 and 2017. This is a HIV/STI testing center that offers HIV/STI testing to HIV-uninfected individuals from key populations including MSM.ResultsWe found an increase in the reporting of condomless sex associated with the use of a number of drugs, including ecstasy, amphetamines, GHB and cocaine in MSM (from 8 to 17%) but not in heterosexuals. Reporting condomless chemsex was associated with HIV infection (adjusted odds ratio 5.7 [95% confidence interval 3.2–10.4]).ConclusionsOur findings provide further evidence of the importance of asking MSM clients about the use of psychoactive substances during consultations and tailoring interventions such as pre exposure prophylaxis, more frequent STI screening and substance abuse counseling accordingly.

Attitude and beliefs about the social environment associated with chemsex among MSM visiting STI clinics in the Netherlands: An observational study

“…Chemsex has been associated with several adverse sexual and mental health outcomes. For example, chemsex has been associated with an increased risk of condomless anal intercourse [ 9 – 12 ], acquisition of sexually transmitted infections (STIs) [ 10 , 13 , 14 ] and anxiety and depression when the use was considered dependent [ 15 ].…”

Chemsex is not a barrier to self-reported daily PrEP adherence among PROUD study participants

“…Chemsex drug use has been associated with a number of harms including; sexual and other behaviours carrying HIV and hepatitis C risk (such as CAI, group sex and multiple partners, fisting and injecting) (Bourne et al., 2015; Daskalopoulou et al., 2017; Glynn et al., 2018; Hegazi et al., 2017; Maxwell, Shahmanesh & Gafos, 2019; Ristuccia, LoSchiavo, Halkitis & Kapadia, 2018; Tomkins et al., 2019), HIV diagnosis (Halkitis, Levy, Moreira & Ferrusi, 2014; Kenyon, Wouters, Platteau, Buyze & Florence, 2018; Pakianathan et al, 2018; White et al, 2019) and suboptimal adherence to ART among people living with HIV (Daskalopoulou et al., 2014; Perera, Bourne & Thomas, 2017; Stuart, 2013). The evidence on chemsex impacting ART adherence includes a systematic review published in 2017, reporting chemsex drug users as having 23% higher odds of ART non-adherence than non-chemsex drug users (OR 1.23, 95%CI 1.10–1.38, I2 0%, p = 0.372) (Perera et al., 2017).…”

Pre-exposure prophylaxis makes it possible to better live one’s sexuality and guide men who have sex with men towards a responsible approach to their health: a phenomenological qualitative study about primary motivations for PrEP

“…This feeling of ‘ invulnerability’ temporarily diminished their vigilance with regard to other preventive measures in our study, but interviewees were quickly caught by a negative self-esteem and feeling of guilt driving them to resume their original behaviours, as evidenced in other studies [ 31 , 32 ]. Kenyon’s study findings about chemsex provide further evidence of the importance of asking MSM clients about the use of psychoactive substances during consultations and tailoring interventions such as pre exposure prophylaxis, more frequent STI screening and substance abuse counseling accordingly [ 33 ].…”