“Slam Sex” - Sexualized Injecting Drug Use (“SIDU”) Amongst Men Who Have Sex with Men (MSM)—A Scoping Review

Scheibein, Florian; Wells, John; Henriques, Susana; Hout, Marie Claire Van

doi:10.1080/00918369.2020.1804258

Cited by 15 publications

(13 citation statements)

References 47 publications

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“…have poor knowledge of and insufficient experience with their practices. As suggested before by Scheibein et al, 14 these issues need to be addressed by and integrated in professional healthcare programmes. Current results may contribute to the development and updated provision of low-threshold, non-judgmental and well informed prevention and harm reduction activities and support for MSM involved in slamsex.…”

Section: Conclusion and Recommendationsmentioning

confidence: 86%

Slamsex in The Netherlands among men who have sex with men (MSM): use patterns, motives, and adverse effects

Knoops¹,

Amsterdam

Albers

et al. 2022

Sex. Health

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Background This paper describes an online survey of men who have sex with men (MSM) and use drugs before or during sex (‘chemsex’) via injection (‘slamming’ or ‘practising slamsex’). Approximately 15–30% of the MSM population in The Netherlands have practiced chemsex at some point, and 0.5–3.1% of them ever had ‘slamsex’. This study investigates which substances are used in The Netherlands during slamsex, the motives for slamming and the health risks involved. Method In total, 175 MSM from The Netherlands, who had used substances before or during sex via injection completed an ad hoc online questionnaire designed for this study. Results Mean age of respondents was 47.8 years. During chemsex, almost every substance was used; the most common substances that were injected (slammed) were 3-methylmethcathinone (3-MMC), methamphetamine, ketamine, 4-methylethcathinone (4-MEC) and mephedrone (4-MMC). Reasons for slamming were mainly to experience a more intense rush and longer sex. Virtually none of the respondents used a condom during slamsex, but needles were almost never shared or used only once. Slammers reported health problems associated with injecting drugs (skin problems, collapsed veins and infections). Of most concern were the psychological symptoms reported by about three-quarters of respondents (e.g. insomnia, sadness, depressed mood, anxiety, suicidal tendencies). About half of respondents reported some degree of loss of control or concerns about their slamming behaviour. Conclusion Results show that slamsex is associated with consciously chosen sexual risk behaviours and risk-avoidance slam behaviours. This study may contribute to the reinforcement of accessible, non-judgmental and well informed prevention and harm reduction activities to support MSM practising slamsex.

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Section: Conclusion and Recommendationsmentioning

confidence: 86%

Slamsex in The Netherlands among men who have sex with men (MSM): use patterns, motives, and adverse effects

Knoops¹,

Amsterdam

Albers

et al. 2022

Sex. Health

View full text Add to dashboard Cite

show abstract

“…Moreover, we have limited data on whether chemsex includes injecting drug use due to substantial missing data. However, because it poses an increased risk for HIV acquisition, it is worth mentioning as another behavioral characteristic to consider for PrEP uptake [ 25 ]. Lastly, sex work was also an important feature for class 3; however, it was uncommon.…”

Section: Discussionmentioning

confidence: 99%

Characterizing subgroups of sexual behaviors among men who have sex with men eligible for, but not using, PrEP in the Netherlands

et al. 2023

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This study identified subgroups of sexual behaviors associated with increased STI/HIV risk among those eligible for but not using pre-exposure prophylaxis (PrEP) in order to improve PrEP uptake and prioritization in the context of restricted capacity. We used data from sexual health centers (SHCs) in the Netherlands, including all visits of eligible but non-PrEP using men who have sex with men (MSM), men who have sex with men and women (MSMW) and transgender persons between July 2019 (start of the Dutch national PrEP pilot (NPP)) and June 2021. Using latent class analysis (LCA), we identified classes of sexual behaviors (number of partners, chemsex, group sex and sex work) and explored whether these classes were associated with STI diagnosis and sociodemographics. Across 45,582 visits of 14,588 eligible non-PrEP using individuals, the best fitting LCA model contained three classes of sexual behaviors. Classes were distinguished by seldomly reported sexual behaviors (class 1; 53.5%, n = 24,383), the highest proportions of ≥6 partners and group sex (class 2; 29.8%, n = 13,596), and the highest proportions of chemsex and sex work (class 3; 16.7% of visits, n = 7,603). Visits in classes 2 and 3 (vs. class 1) were significantly more often with individuals who were diagnosed with an STI, older (≥36 vs. ≤35 years), MSMW (vs. MSM), and visiting an urban (vs. non-urban) SHC; while these visits were significantly less often with individuals from an STI/HIV endemic area. The percentage of visits at which an STI was diagnosed was 17.07% (n = 4,163) in class 1, 19.53% (n = 2,655) in class 2 and 25.25% (n = 1,920) in class 3. The highest risk of STI, and thereby HIV, was in those engaging in specific subgroups of sexual behavior characterized by frequently reporting multiple partners, group sex, sex work or chemsex. PrEP uptake should be encouraged and prioritized for these individuals.

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“…As far as we know, this is the first study to provide clear empirical evidence that injecting drugs to have sex is being the most common first episode of injection for MSM. Previous studies [ 17 ] have documented the use of injection as an administration route for various different drugs consumed for having sex. However, none of these studies asked whether the first injection was for sex or for any other purpose.…”

Section: Discussionmentioning

confidence: 99%

Sexualized drug injection among men who have sex with men in Madrid and Barcelona as the first episode of drug injecting

et al. 2021

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Background We estimate the prevalence of drug injection, the variables associated with having ever injected and the proportion of ever injectors whose first drug injection was for having sex; we describe the first drug injection episode, analyze the drugs most frequently injected and estimate the prevalence of risky injecting behaviors. Methods The participants were 3387 MSM without a previous HIV diagnosis attending four HIV/STI diagnosis services in Madrid and Barcelona. Lifetime prevalence and prevalence ratios (PRs) by different factors were calculated using Poisson regression models with robust variance. We compared the characteristics of first drug injection episode, lifetime injection and risky injecting behaviors of those whose first injection was for sex (FIS) with those whose was not (non-FIS). Results Lifetime prevalence of injection was 2.1% (CI 1.7–2.7). In the multivariate analysis, it was strongly associated with having been penetrated by more than five men in the last 12 months (aPR = 10.4; CI 2.5–43.4) and having met most of their partners at private parties (aPR = 7.5; CI 4.5–12.3), and less strongly with other factors. Of those who had ever injected drugs, 81.9% injected for sex the first time they injected drugs (FIS). At first injection, FIS participants had a mean age of 31 years, 62.7% used mephedrone and 32.2% methamphetamine on that occasion. Of this FIS group 39.0% had ever shared drugs or equipment and 82.6% had always shared for sex. Some 30.8% of non-FIS reported having also injected drugs for sex later on. Conclusions Only two out of a hundred had ever injected, most to have sex and with frequent drug or injecting equipment sharing. Injecting for sex is the most common first episode of drug injection and is the most efficient risky behavior for the transmission of HIV, hepatitis B or C and other blood-borne infections. MSM participating in private parties should be considered a priority group for prevention policies.

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“Slam Sex” - Sexualized Injecting Drug Use (“SIDU”) Amongst Men Who Have Sex with Men (MSM)—A Scoping Review

Cited by 15 publications

References 47 publications

Slamsex in The Netherlands among men who have sex with men (MSM): use patterns, motives, and adverse effects

Slamsex in The Netherlands among men who have sex with men (MSM): use patterns, motives, and adverse effects

Characterizing subgroups of sexual behaviors among men who have sex with men eligible for, but not using, PrEP in the Netherlands

Sexualized drug injection among men who have sex with men in Madrid and Barcelona as the first episode of drug injecting

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