Is There a Reduction in Chemsex Practice in Men Who Have Sex With Men During COVID-19 Lockdown? Results of the CheRRLock Study

Abstract

a,c on behalf of the "190" working group Background and aims: Chemsex is a growing concern among men who have sex with men (MSM). COVID-19 lockdowns have had consequences on social and sexual interactions. We aimed to assess changes in chemsex practices during COVID-19 lockdown in France among MSM and factors associated with maintaining or increasing chemsex practice.Methods: Repeated face-to-face questionnaires were conducted at "Le 190" Sexual Health Center, Paris, France, exploring lifestyle, sexual, and chemsex practices, COVID-19 concerns and mental health before and during second lockdown in France (30/10/ 2020-15/12/2020). Inclusion criteria were chemsex practices at least 3 times throughout lifetime and at least once in the 3 months before second lockdown. The primary end point was the proportion of participants who declared having stopped, decreased, maintained, or increased their chemsex practice during lockdown. Univariable and multivariable logistic regressions were used to analyze factors associated with evolutions of chemsex practice.Results: Ninety-three MSM were included: 66% HIV-positive and 30% taking PrEP. Drugs most used were cathinones (91%) and GHB/GBL (52%). Participants reported stopping, decreasing, maintaining, and increasing chemsex drugs use in 14%, 22%, 22%, and 42% of cases, respectively. Despite this overall increase in chemsex practice, MSM decreased their number of sexual partners. Factors significantly associated with maintaining or increasing chemsex drugs use were feeling lonely (OR = 3.24), craving (OR = 4.51), and working during lockdown (OR = 3.27), contrasting with fear of COVID-19 (OR = 0.31). Conclusion:Restriction measures lead to changes in sexual behavior and seem to increase chemsex practice. Maintaining care for most isolated patients should be a priority in COVID-19 context.

Harm reduction and multidisciplinary consultations for gay, bisexual, and other men who have sex with men practising chemsex based in a French infectious disease unit: patients’ characteristics and perceptions

“…loneliness, loss of sense of meaning), and reduced access to health care. 7 This may partially explain that a majority expressed a need for the intervention. Data was collected retrospectively and was self-reported.…”

“…5 While synthetic substances such as crystal methamphetamine (or crystal meth), g-hydroxybutyrate/gammabutyrolactone (GHB/GBL), and cathinones (including 3-methylmethcathinone/3-chloromethcathinone (3MMC/ 3CMC), mephedrone, etc. ), and also cocaine and ketamine 6,7 are mainly used in chemsex, the term includes several practices that vary in terms of consumed substances, intensity, frequency, and nature. For instance, 'Slam' is a type of chemsex practice involving the injection of drugs reported among about 5% of people practising chemsex in literature reviews.…”

Coronavirus (COVID-19) and sexualised drug use among men who have sex with men: a systematic review

“…47 A French study of chemsex behaviour during lockdown found that 64% of participants maintained (22%) or increased (42%) while 36% stopped (14%) or decreased (22%) their chemsex drug consumption during lockdown. 48 They also found that the median number of chemsex days during 6 weeks of lockdown (n = 8) increased significantly from the 6 weeks preceding lockdown (n = 3). 48 The prevalence of GHB/GBL use (52% vs 58%, P = 0.038) and slamming (19% vs 24%) both increased though the latter was not statistically significant.…”

“…48 They also found that the median number of chemsex days during 6 weeks of lockdown (n = 8) increased significantly from the 6 weeks preceding lockdown (n = 3). 48 The prevalence of GHB/GBL use (52% vs 58%, P = 0.038) and slamming (19% vs 24%) both increased though the latter was not statistically significant. 48 Across three waves of follow-up, corresponding to three episodes of pandemic-related restrictions, between 40.4% and 46.9% of a PrEP-using cohort reported chemsex participation.…”

Intention to use PrEP among men who have sex with men and engage in chemsex: an international descriptive study

“…8,9 There has been an exponential increase in the association between the practice of chemsex and the population of men who have sex with men (MSM) in both developed and developing countries. [10][11][12][13] There are a series of health risks associated with this practice, particularly vulnerability to sexually transmitted infections, including HIV. Two literature reviews confirm evidence of the association between chemsex and increased risk of HIV infection among MSM 14,15 due to susceptibility to engage in sexual practice that increase HIV risk that include barebacking, having multiple casual/occasional partners, group sex, challenging/complex sexual engagement (i.e.…”