Evers Y J, Hoebe C J P A, Dukers-Muijrers N H T M, Kampman C J G, Kuizenga-Wessel S, Shilue D, Bakker N C M, Schamp S M A A, Van Buel H, Van Der Meijden W C J P M, Van Liere G A F S
Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service South Limburg, The Netherlands.
Department of Social Medicine and Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center, The Netherlands.
Prev Med Rep. 2020 Mar 6;18:101074. doi: 10.1016/j.pmedr.2020.101074. eCollection 2020 Jun.
Drug use during sex ('chemsex') has been associated with sexually transmitted infections (STIs) and mental health harms. Little quantitative evidence exists on the health care needs of MSM practicing chemsex from a patient perspective. This study assessed self-perceived benefits and harms and the needs for professional counselling among MSM practicing chemsex. In 2018, 785 MSM were recruited at nine Dutch STI clinics and 511 (65%) completed the online questionnaire. Chemsex was defined as using cocaine, crystal meth, designer drugs, GHB/GBL, ketamine, speed and/or XTC/MDMA during sex <6 months. Chemsex was reported by 41% (209/511), of whom 23% (48/209) reported a need for professional counselling. The most reported topic to discuss was increasing self-control (52%, 25/48). Most MSM preferred to be counselled by sexual health experts (56%, 27/48). The need for professional counselling was higher among MSM who engaged in chemsex ≥2 times per month (30% vs. 17%, p = 0.03), did not have sex without drugs (sober sex) in the past three months (41% vs. 20%, p = 0.04), experienced disadvantages of chemsex (28% vs. 15%, p = 0.03), had a negative change in their lives due to chemsex (53% vs. 21%, p = 0.002), and/or had an intention to change chemsex behaviours (45% vs. 18%, p < 0.001). Our study shows that almost one in four MSM practicing chemsex expressed a need for professional counselling on chemsex-related issues. STI healthcare providers should assess the need for professional counselling in MSM practicing chemsex, especially in MSM with above mentioned characteristics, such as frequent users.
性行为期间吸毒（“化学性行为”）与性传播感染（STIs）及心理健康危害有关。从患者角度来看，关于进行化学性行为的男男性行为者（MSM）的医疗保健需求，几乎没有定量证据。本研究评估了进行化学性行为的男男性行为者自我感知的益处和危害以及对专业咨询的需求。2018年，在荷兰的9家性传播感染诊所招募了785名男男性行为者，511人（65%）完成了在线问卷。化学性行为被定义为在6个月内的性行为期间使用可卡因、冰毒、合成毒品、γ-羟基丁酸/γ-丁内酯、氯胺酮、安非他明和/或摇头丸/3,4－亚甲基二氧甲基苯丙胺。41%（209/511）的人报告有化学性行为，其中23%（48/209）的人表示需要专业咨询。报告最多的讨论话题是增强自我控制（52%，25/48）。大多数男男性行为者希望由性健康专家提供咨询（56%，27/48）。每月进行化学性行为≥2次的男男性行为者（30%对17%，p = 0.03）、在过去三个月没有无毒品性行为（清醒性行为）的男男性行为者（41%对20%，p = 0.04）、经历过化学性行为弊端的男男性行为者（28%对15%，p = 0.03）、因化学性行为生活发生负面变化的男男性行为者（53%对21%，p = 0.002）和/或有改变化学性行为意图的男男性行为者（45%对18%，p < 0.001）中，对专业咨询的需求更高。我们的研究表明，几乎四分之一进行化学性行为的男男性行为者表示需要就与化学性行为相关的问题接受专业咨询。性传播感染医疗服务提供者应评估进行化学性行为的男男性行为者对专业咨询的需求，尤其是对具有上述特征（如频繁使用者）的男男性行为者。
