Kohli Manik, Hickson Ford, Free Caroline, Reid David, Weatherburn Peter
London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7H, UK.
London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7H, UK; and Corresponding author. Email:
Sex Health. 2019 Sep;16(5):464-472. doi: 10.1071/SH18159.
Background Illicit drug use among men who have sex with men (MSM) has been associated with sexual risk and HIV. Less is documented about associations with other sexually transmissible infections (STIs). The aim of the present study was to determine whether the use of drugs commonly associated with chemsex is associated with increased risk of gonorrhoea among MSM.
Using data from 16065 UK-based respondents to the European MSM Internet Survey (2010), we examined associations between a recent diagnosis of gonorrhoea and three chemsex drugs (crystal methamphetamine, γ-hydroxybutyric acid (GHB)/γ-butyrolactone (GBL) and mephedrone). Univariate logistic regression identified determinants of gonorrhoea diagnosis and multivariate logistic regression models calculated adjusted odds ratios (aORs) for independent associations between chemsex drugs and gonorrhoea.
MSM who reported using crystal methamphetamine and GHB/GBL in the previous year had 1.92- and 2.23-fold higher odds of gonorrhoea respectively over the same period (P=0.0001 and P<0.0001; n=15137) after adjusting for age, recruitment website, HIV status, residence and use of other chemsex drugs. MSM reporting the use of all three chemsex drugs had the highest increased odds (aOR 3.58; P<0.0001; n=15174). Mephedrone alone was not associated with gonorrhoea in multivariate models.
Use of chemsex drugs is associated with a higher risk of gonorrhoea. The results of this study complement existing research about crystal methamphetamine and indicate a role for GHB/GBL in adverse sexual health outcomes. The use of mephedrone alongside other chemsex drugs may account for its lack of association with gonorrhoea in multivariate models. Future research should use encounter-level data, examine other STIs and attribute pathways through which chemsex leads to infection.
背景 男男性行为者（MSM）中的非法药物使用与性风险和艾滋病毒有关。关于与其他性传播感染（STIs）的关联记录较少。本研究的目的是确定使用通常与性药滥用相关的药物是否与男男性行为者中淋病风险增加有关。
利用来自欧洲男男性行为者互联网调查（2010年）的16065名英国受访者的数据，我们研究了近期淋病诊断与三种性药滥用药物（冰毒、γ-羟基丁酸（GHB）/γ-丁内酯（GBL）和甲麻黄碱）之间的关联。单因素逻辑回归确定淋病诊断的决定因素，多因素逻辑回归模型计算性药滥用药物与淋病之间独立关联的调整比值比（aORs）。
在调整年龄、招募网站、艾滋病毒状况、居住地和其他性药滥用药物使用情况后，报告在前一年使用冰毒和GHB/GBL的男男性行为者在同一时期患淋病的几率分别高出1.92倍和2.23倍（P = 0.0001和P < 0.0001；n = 15137）。报告使用所有三种性药滥用药物的男男性行为者患淋病的几率增加最高（aOR 3.58；P < 0.0001；n = 15174）。在多因素模型中，单独使用甲麻黄碱与淋病无关。
使用性药滥用药物与淋病风险较高有关。本研究结果补充了关于冰毒的现有研究，并表明GHB/GBL在不良性健康结果中起作用。在多因素模型中，与其他性药滥用药物一起使用甲麻黄碱可能是其与淋病缺乏关联的原因。未来的研究应使用接触层面的数据，检查其他性传播感染，并研究性药滥用导致感染的途径。
