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

Abstract

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.

Does sexuality matter? A cross-sectional study of drug use, social injecting, and access to injection-specific care among men who inject drugs in Melbourne, Australia

“…We investigated whether factors previously highlighted as important for understanding injecting drug use among GBMSM (e.g., methamphetamine use, social injecting, peer-to-peer injecting) translate into quanti able differences between men strati ed by sexuality in a cohort of people who inject drugs in Melbourne. In line with previous research ndings, a larger proportion of GBMSM reported preferring methamphetamine (9,17,19,20,25). Otherwise, we found little difference in demographics, drug use, or service access between the groups.…”

“…The intersection of injection and sexual minority practices is associated with distinct risks and potential harms (25)(26)(27)(28). Studies comparing the characteristics of GBMSM who inject drugs and other people who inject drugs have found GBMSM have a higher risk of intentional overdose (29), a lower likelihood of accessing addiction treatment (18) and heightened 'sexual risk' (typically implying condomless anal intercourse and greater number of sexual partners) (30).…”

“…Evidence suggests that GBMSM who inject drugs are more likely to occupy distinct socio-cultural spaces than other people who inject drugs (17), with qualitative analyses highlighting GBMSM-speci c socio-cultural meanings of injecting drug use (33,34). These includes gaining access to particular socio-sexual networks and establishing relationships with other men (26,27), where peer-to-peer injecting (i.e., injecting each other) can foster greater intimacy and social capital (25,35).…”

Does sexuality matter? A cross-sectional study of drug use, social injecting, and access to injection-specific care among men who inject drugs in Melbourne, Australia

“…The intersection of injection and sexual minority practices is associated with distinct risks and potential harms [ 25 – 28 ]. Studies comparing the characteristics of GBMSM who inject drugs and other people who inject drugs have found GBMSM have a higher risk of intentional overdose [ 29 ], a lower likelihood of accessing addiction treatment [ 18 ] and heightened ‘sexual risk’ (typically implying condomless anal intercourse and greater number of sexual partners) [ 30 ].…”

“…These include gaining access to particular socio-sexual networks and establishing relationships with other men [ 26 , 27 ], where peer-to-peer injecting (i.e. injecting each other) can foster greater intimacy and social capital [ 25 , 35 ].…”