The Kirby Institute, UNSW, Sydney, Australia.
Australian Research Centre in Sex Health and Society, La Trobe University, Australia.
Int J Drug Policy. 2018 May;55:197-204. doi: 10.1016/j.drugpo.2018.02.021. Epub 2018 Mar 8.
Gay and bisexual men (GBM) often use illicit drugs to enhance sexual pleasure, commonly referred to as 'chemsex' or 'party n play'. In particular, the use of methamphetamine and Viagra™, and other erectile dysfunction medications, both together and separately are strongly predictive of subsequent HIV infection. Truvada™, as pre-exposure prophylaxis (PrEP), virtually eliminates HIV transmission during condomless anal intercourse (CLAI). HIV-negative GBM in intensive sex partying networks may be adding PrEP to their drug regimen to actively reduce the possibility of HIV transmission during chemsex.
We describe the prevalence and context of concurrent use of methamphetamine, Truvada™ (or its generic formulations), and Viagra™ or other erectile dysfunction medication (collectively, MTV).
The Following Lives Undergoing Change study is an online prospective observational study of licit and illicit drug use among Australian GBM. Between January and July 2017, 1831 GBM provided details about their use of MTV. Binary logistic multiple regression analysis were used to estimate adjusted odds ratios (aOR) and associated 95% confidence intervals (95%CI).
Concurrent MTV use was reported by 6.0% of participants; 3.1% used methamphetamine and Viagra™ or other erectile dysfunction medication ('MV only') and 11.2% used Truvada™ as PrEP ('T only'). In multivariate analysis, compared to use of 'MV only', MTV was independently associated with CLAI with casual partners (aOR = 6.78;95%CI = 1.42-32.34) and 'fuckbuddies' (aOR = 3.47;95%CI = 1.41-8.56) in the previous six months. Compared to use of 'T only', MTV was independently associated with being older (aOR = 3.95;95%CI = 1.55-10.03) and engaging in group sex (aOR = 3.31;95%CI = 1.82-6.00). Greater social engagement with other gay men (aOR = 1.44;95%CI = 1.18-1.76) and having more sexual partners (aOR = 2.30;95%CI = 1.10-4.82) were independently associated with use of MTV compared to use of 'MV only' or 'T only'.
GBM in intensive sex partying networks are increasingly adding PrEP alongside other drugs they use to enhance sexual experiences. Interventions that promote the use of PrEP during chemsex could mitigate HIV risk.
男同性恋和双性恋者（GBM）经常使用非法药物来增强性快感，通常称为“嗑药性行为”或“派对性行为”。特别是，同时使用安非他命和伟哥，以及其他勃起功能障碍药物，都强烈预示着随后会感染 HIV。特鲁瓦达（Truvada）作为暴露前预防（PrEP）药物，在无保护肛交（CLAI）中几乎可以完全消除 HIV 传播。在密集性派对网络中的 HIV 阴性 GBM 可能会在他们的药物治疗方案中添加 PrEP，以积极降低嗑药性行为期间 HIV 传播的可能性。
我们描述了安非他命、特鲁瓦达（或其通用制剂）和伟哥或其他勃起功能障碍药物（统称 MTV）同时使用的流行情况和背景。
“正在改变的生活”研究是一项针对澳大利亚 GBM 人群中合法和非法药物使用情况的在线前瞻性观察性研究。2017 年 1 月至 7 月期间，1831 名 GBM 提供了他们使用 MTV 的详细信息。使用二元逻辑多回归分析估计调整后的优势比（aOR）和相关的 95%置信区间（95%CI）。
报告同时使用 MTV 的参与者占 6.0%；3.1%同时使用安非他命和伟哥或其他勃起功能障碍药物（“MV 仅”），11.2%使用特鲁瓦达（Truvada）作为 PrEP（“T 仅”）。在多变量分析中，与“MV 仅”相比，MTV 与与偶然伴侣（aOR=6.78；95%CI=1.42-32.34）和“炮友”（aOR=3.47；95%CI=1.41-8.56）进行无保护肛交（CLAI）独立相关在过去六个月中。与使用“T 仅”相比，MTV 与年龄较大（aOR=3.95；95%CI=1.55-10.03）和发生群交（aOR=3.31；95%CI=1.82-6.00）独立相关。与仅使用“MV”相比，与其他男同性恋者有更多社交互动（aOR=1.44；95%CI=1.18-1.76）和有更多性伴侣（aOR=2.30；95%CI=1.10-4.82）与使用 MTV 独立相关。
在密集性派对网络中的 GBM 人群越来越多地在他们用于增强性体验的其他药物中添加 PrEP。在嗑药性行为期间促进使用 PrEP 的干预措施可能会降低 HIV 风险。
