男男性行为者（MSM）化学性行为特征及性健康服务利用情况：来自英国一项大型网络调查的结果。
Characteristics and sexual health service use of MSM engaging in chemsex: results from a large online survey in England.
机构信息
UK Field Epidemiology Training Programme, Global Public Health Division, Public Health England, London, United Kingdom
Field Service North West, National Infection Service, Public Health England, Liverpool, United Kingdom.
出版信息
Sex Transm Infect. 2020 Dec;96(8):590-595. doi: 10.1136/sextrans-2019-054345. Epub 2020 Mar 5.
BACKGROUND
Chemsex, the use of select psychoactive drugs to enhance sexual experience, typically among men who have sex with men (MSM), is associated with sexual behaviours with higher STI risk. Understanding patterns of chemsex among MSM as well as the characteristics and sexual health service engagement of chemsex participants is important for developing interventions.
METHODS
Between 5/2016 to 5/2017, 3933 MSM completed an online survey, recruited in sexual health clinics (SHCs) in England (n=421) and via four social networking/dating apps (n=3512). We described patterns of chemsex in the past year and used multivariable logistic regression to investigate differences in demographics and sexual behaviours by chemsex history. We described history of SHC attendance and STI test in the past year among app-recruited chemsex participants.
RESULTS
Chemsex in the past year was reported by 10% of respondents; 19% of SHC-recruited and 9% of app-recruited. Among chemsex participants, 74% had used ≥2 chemsex drugs. In the multivariable model, MSM engaging in chemsex had a raised odds of being HIV-positive (adjusted OR (aOR): 3.6; 95% CI 2.1 to 6.1), aged 30-44 (aOR 1.5 vs <30 years; 95% CI 1.0 to 2.1), being born outside the UK and having engaged in higher risk sexual behaviours in the past 3 months. Chemsex participants also had higher odds of condomless anal sex with partners of different or unknown HIV status, but only among HIV-negative/untested. In the past year, 66% of app-recruited chemsex participants had attended a SHC and 81% had had an STI test.
CONCLUSION
One in 10 MSM recruited through community and clinical settings across England had engaged in chemsex in the past year. Those that did appear to be at greater STI risk but engaged more actively with sexual health services. This highlights the need and opportunity for chemsex-related services in SHCs and robust referral pathways to drug treatment services.
背景
性化学，即使用特定的精神活性药物来增强性体验，通常发生在男男性行为者（MSM）中，与性传播感染（STI）风险更高的性行为有关。了解 MSM 中的性化学模式以及性化学参与者的特征和性健康服务参与情况，对于制定干预措施非常重要。
方法
在 2016 年 5 月至 2017 年 5 月期间，3933 名 MSM 通过英格兰的性健康诊所（SHC）（n=421）和四个社交网络/约会应用程序（n=3512）完成了在线调查。我们描述了过去一年中性化学的模式，并使用多变量逻辑回归调查了化学史对人口统计学和性行为的差异。我们描述了过去一年中通过应用程序招募的性化学参与者中 SHC 就诊和 STI 检测的历史。
结果
过去一年中有 10%的受访者报告有性化学行为；SHC 招募的参与者中有 19%，应用程序招募的参与者中有 9%。在性化学参与者中，74%的人使用了≥2 种性化学药物。在多变量模型中，进行性化学的 MSM 感染艾滋病毒的几率增加（调整后的比值比（aOR）：3.6；95%置信区间 2.1 至 6.1），年龄在 30-44 岁（aOR 1.5 与 <30 岁；95%置信区间 1.0 至 2.1），出生于英国以外地区，并且在过去 3 个月内进行了更高风险的性行为。性化学参与者也有更高的几率与不同或未知 HIV 状态的伴侣进行无保护肛交，但仅在 HIV 阴性/未检测的情况下。在过去一年中，66%的通过应用程序招募的性化学参与者曾到 SHC 就诊，81%的人曾接受过性传播感染检测。
结论
在英格兰通过社区和临床环境招募的 MSM 中，每 10 人中就有 1 人在过去一年中进行过性化学。那些人似乎有更高的性传播感染风险，但更积极地参与性健康服务。这凸显了性化学相关服务在性健康诊所中的需求和机会，以及向毒品治疗服务的稳健转介途径。
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