Aix Marseille University, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.
ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
J Acquir Immune Defic Syndr. 2018 Oct 1;79(2):e69-e75. doi: 10.1097/QAI.0000000000001781.
Chemsex-the use of psychoactive substances during sexual encounters-among men who have sex with men is a growing concern. On-demand HIV pre-exposure prophylaxis (PrEP) may be a suitable tool to prevent HIV transmission among "chemsexers." We used the open-label extension study of the ANRS-IPERGAY trial to describe chemsexers and their PrEP use.
Among the 361 men who have sex with men enrolled in ANRS-IPERGAY's open-label extension study, we selected the 331 with available data on drug use. A 2-monthly web questionnaire on sociobehavioral data was used to compare sexual behaviors between questionnaires where chemsex was reported and those where it was not. Using a generalized estimating equation logistic regression, we studied whether practicing chemsex was associated with correct PrEP use.
Among the 331 participants, 30% reported chemsex practice at least once during follow-up and were considered chemsexers. Chemsex was reported in 16% of all questionnaires. Chemsexers were not significantly different from nonchemsexers regarding sociodemographic characteristics, although they reported greater use of anxiolytics and more sensation-seeking. Reporting chemsex was associated with more high-risk sexual practices and a higher perception of risk. After adjustment for other potential correlates, chemsex remained associated with correct PrEP use [odds ratio (95% confidence interval) = 2.24 (1.37 to 3.66)].
Our findings show that chemsexers were more likely to report high-risk sexual practices but also had a higher perception of risk. They were also more likely to use PrEP correctly when practicing chemsex. Consequently, PrEP may be a suitable tool to reduce HIV-risk transmission among chemsexers.
男男性行为者（MSM）中的化学性行为（使用精神活性物质进行性行为）引起了越来越多的关注。按需给予艾滋病毒暴露前预防（PrEP）可能是预防“化学性行为者”中艾滋病毒传播的合适工具。我们使用了 ANRS-IPERGAY 试验的开放性扩展研究来描述化学性行为者及其 PrEP 使用情况。
在 ANRS-IPERGAY 的开放性扩展研究中，共招募了 361 名 MSM，我们选择了 331 名有可用药物使用数据的参与者。使用每两个月一次的网络问卷调查社会行为数据，比较报告化学性行为和未报告化学性行为的问卷之间的性行为。使用广义估计方程逻辑回归，我们研究了进行化学性行为是否与正确使用 PrEP 相关。
在 331 名参与者中，30%在随访期间至少报告过一次化学性行为，被认为是化学性行为者。化学性行为在所有问卷中的报告率为 16%。化学性行为者与非化学性行为者在社会人口统计学特征方面没有显著差异，尽管他们报告了更多使用镇静剂和寻求更多刺激。报告化学性行为与更高风险的性行为和更高的风险感知相关。在调整其他潜在相关因素后，化学性行为仍然与正确使用 PrEP 相关（比值比（95%置信区间）=2.24（1.37 至 3.66））。
我们的研究结果表明，化学性行为者更有可能报告高风险性行为，但也有更高的风险感知。当进行化学性行为时，他们也更有可能正确使用 PrEP。因此，PrEP 可能是减少化学性行为者中艾滋病毒传播风险的合适工具。
