Use of poppers and HIV risk behaviours among men who have sex with men in Paris, France: an observational study

Abstract

The use of inhaled nitrites, or poppers, among men who have sex with men (MSM) is prevalent, yet has been associated with HIV seroconversion. We surveyed 580 MSM from a geosocial networking smartphone application in Paris, France, in 2016. Of the respondents, 46.7% reported popper use within the previous 3 months. Regression models adjusted for sociodemographic characteristics found that the use of poppers was significantly (P<0.05) associated with the following during the prior 3 months: condomless anal intercourse (adjusted relative risk (aRR) 1.27, 95% confidence interval (CI) 1.07-1.50), use of alcohol and/or drugs during sex once or twice (adjusted relative risk ratio (aRRR) 2.33, 95% CI 1.44-2.03), three to five times (aRRR 5.41, 95% CI 2.98-9.84) or six or more times (aRRR 4.09, 95% CI 2.22-7.56), participation in group sex (aRRR 3.70, 95% CI 2.33-5.90) and self-reported diagnosis with any sexually transmissible infection over the previous year (aRR 1.63, 95% CI 1.18-2.27), specifically chlamydia (aRR 2.75, 95% CI 1.29-4.29) and syphilis (aRR 2.27, 95% CI 1.29-4.29).

Poppers and PrEP: Use of Pre-exposure Prophylaxis Among Men Who Have Sex with Men Who Use Inhaled Nitrites

“…Consistent with these data, in a prior analysis of survey data from 580 geosocial network app-using MSM in Paris, France (33), we found that poppers use was quite prevalent, with nearly half of survey respondents reporting poppers use within the prior three months. In addition, we found that popper users were more likely than non-users to practice CAI, engage in group sex, and report a diagnosis of an STI within the past three months, reaffirming the argument that MSM who use poppers represent a subgroup at higher than average risk for HIV seroconversion, and therefore would be appropriate candidates for PrEP.…”

“…Although popper use has been shown to be highly correlated with HIV seropositivity, due to both high rates of sexual risk behavior (24–26, 33) and direct vasodilatory effects of inhaled nitrites (32), we found that popper users were not more likely to be using PrEP than non-popper users. Indeed, while 26.4% of popper users reported themselves as “definitely” an appropriate candidate for PrEP, only 7.2% reported current PrEP use.…”

“…Nevertheless, we are not aware of any literature that has examined the association of poppers use with attitudes towards PrEP, specifically assessing the extent of PrEP use, knowledge of PrEP, and self-perceived candidacy for PrEP among MSM. We are aware that MSM commonly use other drugs during sex, including stimulants (e.g., methamphetamines, cocaine), and erectile dysfunction medications (e.g., phosphodiesterase inhibitors, injected prostaglandin E 1 ) (22, 34, 35), and indeed in our prior analysis of this sample (33), MSM who used poppers were more likely to use other drugs or alcohol during sex than those who did not use poppers. Given however the marked prevalence of popper use when compared with other drugs in this sample (46.7% reporting popper use versus 1.6% reporting methamphetamine use, for example) and the relative dearth of literature devoted specifically to popper use, we chose to focus the present analyses on poppers use alone.…”

HIV self-testing for men who have sex with men in Sweden. A cross-sectional study concerning interest to use HIV self-tests

“…Use of intoxicants during sex was selected by respondents from a pre-defined list consisting of alcohol, amphetamine, cannabis, gamma-hydroxybutyrate (GHB) or gamma-butyrolactone (GBL), heroin, ketamine, cocaine, mephedrone, methylenedioxy-methamphetamine (MDMA) or ecstasy, methamphetamine/ice, poppers (alkyl nitrate inhalants), or other substance. Two variables regarding intoxicants were recoded for analysis; Hard drug use during sex , where alcohol, poppers, cannabis, and ‘other’ were excluded, and Poppers use during sex , motivated by the debated association between poppers use and behaviors associated with HIV and STI [ 34 ]. Sex abroad was assessed by asking the respondents if they had had sex outside Sweden during the previous 12 months, motivated by the high proportion of new HIV diagnoses in Sweden being contracted abroad [ 26 ].…”

Nitrite inhalants use, sexual behaviors and HIV/syphilis infection among men who have sex with men in Chongqing, China

“…Evidence from specific countries revealed nitrite inhalants use was significantly associated with risky sexual behaviors [ 13 , 24 , 25 ]. However, only a small number of studies in China reported the association between nitrite inhalants use and sexual behaviors, like seeking male sexual partners via the internet, having multiple sex partners and practicing UAI [ 16 , 17 , 26 ].…”