Trouiller Philippe, Velter Annie, Saboni Leïla, Sommen Cécile, Sauvage Claire, Vaux Sophie, Barin Francis, Chevaliez Stéphane, Lot Florence, Jauffret-Roustide Marie
Cermes 3 (Inserm U988/UMR CNRS 8211/EHESS/Paris Descartes University), 45 rue des Saint Pères, Paris, France; Santé publique france, French national public health agency, Saint-Maurice Cedex, France, 12 rue du Val d'Osne, 94415, Saint-Maurice, France.
Santé publique france, French national public health agency, Saint-Maurice Cedex, France, 12 rue du Val d'Osne, 94415, Saint-Maurice, France.
Int J Drug Policy. 2020 Apr 4;79:102703. doi: 10.1016/j.drugpo.2020.102703.
In the last decade, European cities saw the development of "slamming," a practice related to chemsex that combines three elements: a sexual context, psychostimulant drug use, and injection practices. Epidemiological data on this practice is still sparse and media attention might have unintentionally distorted the size of this phenomenon. Therefore, we aimed to estimate the prevalence of men practicing slam and to identify factors associated with this practice.
We used data from the Prevagay 2015 bio-behavioral survey to estimate the prevalence of slamming practices. A time-location sampling was performed among gay-labeled venues in five French cites. Behavioral information was recorded using a self-administered questionnaire. The HIV and HCV serostatus were investigated using ELISA tests on dried blood spots. The factors associated with slamming were assessed using a multiple logistic regression. We applied a weighting mechanism to enhance the generalizability of the estimates.
Among the 2646 men who have sex with men (MSM) included in our study, 3.1% reported slamming at least once during their lifetime (95% confidence interval (CI) = 2.2-4.3) and 1.6% (95% CI = 1-2.3) said they participated in a slamming session in the last 12 months. In the multivariate analysis, both HCV and HIV biological status were strongly associated with practicing "slam" in the last 12 months (OR = 13.37 (95% CI = 3.26-54.81) and 4.73 (95% CI = 1.58-14.44), respectively). Furthermore, a ten-point decrease in mental health scores was linked with the practice with an OR of 1.37 (95% CI = 1.08-1.73), indicating poorer mental health.
Even though slamming seems to involve a relatively small proportion of MSM, the vulnerability of this sub-group is high enough to justify setting up harm reduction measures and specific care. Training health professionals and creating services combining sexual health and drug dependence could be an effective response.
在过去十年中，欧洲城市出现了“slam行为”，这是一种与化学性行为相关的行为模式，它结合了三个要素：性情境、使用精神兴奋剂药物以及注射行为。关于这种行为的流行病学数据仍然稀少，媒体关注可能无意中扭曲了这一现象的规模。因此，我们旨在估计进行slam行为的男性的患病率，并确定与这种行为相关的因素。
我们使用了2015年Prevagay生物行为调查的数据来估计slam行为的患病率。在法国五个城市的同性恋场所进行了时间-地点抽样。行为信息通过自我填写问卷进行记录。使用酶联免疫吸附试验（ELISA）检测干血斑来调查艾滋病毒（HIV）和丙型肝炎病毒（HCV）血清学状态。使用多元逻辑回归评估与slam行为相关的因素。我们应用了加权机制来提高估计值的普遍性。
在我们研究纳入的2646名男男性行为者（MSM）中，3.1%报告在其一生中至少进行过一次slam行为（95%置信区间（CI）=2.2-4.3），1.6%（95%CI=1-2.3）表示在过去12个月内参加过一次slam行为。在多变量分析中，HCV和HIV生物学状态均与过去12个月内进行“slam行为”密切相关（比值比（OR）分别为13.37（95%CI=3.26-54.81）和4.73（95%CI=1.58-14.44））。此外，心理健康得分每降低10分与该行为的关联度为OR 1.37（95%CI=1.08-1.73），表明心理健康状况较差。
尽管slam行为似乎只涉及相对较小比例的男男性行为者，但这个亚组的脆弱性足够高，足以证明有必要采取减少伤害措施和提供特定护理。培训卫生专业人员并创建结合性健康和药物依赖的服务可能是一种有效的应对措施。
