Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service South Limburg, Heerlen, The Netherlands.
Department of Social Medicine and Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center, Maastricht, The Netherlands.
PLoS One. 2020 Jul 1;15(7):e0235467. doi: 10.1371/journal.pone.0235467. eCollection 2020.
Drug use during sex, 'chemsex', is common among men who have sex with men (MSM) and related to sexual and mental health harms. This study assessed associations between chemsex and a wide range of determinants among MSM visiting STI clinics to increase understanding of characteristics and beliefs of MSM practicing chemsex.
In 2018, 785 MSM were recruited at nine Dutch STI clinics; 368 (47%) fully completed the online questionnaire. All participants reported to have had sex in the past six months. Chemsex was defined as using cocaine, crystal meth, designer drugs, GHB/GBL, ketamine, speed or XTC/MDMA during sex in the past six months. Associations between chemsex and psychosocial determinants, socio-demographics, sexual behaviour and using tobacco or alcohol were assessed by multivariable logistic regression analyses.
Chemsex was reported by 44% of MSM (161/368) and was not associated with socio-demographics. Independent determinants were 'believing that the majority of friends/sex partners use drugs during sex' (descriptive norm) (aOR: 1.95, 95%CI: 1.43-2.65), 'believing that sex is more fun when using drugs' (attitude) (aOR: 2.06, 95%CI: 1.50-2.84), using tobacco (aOR: 2.65, 95%CI: 1.32-5.32), multiple sex partners (aOR: 2.69, 95%CI: 1.21-6.00), group sex (aOR: 4.65, 95%CI: 1.54-14.05) and using online dating platforms (aOR: 2.73, 95%CI: 1.13-6.62).
MSM are likely to find themselves in distinct social networks where it is the norm to use drugs when having sex and pleasure is linked to chemsex. Health services should acknowledge the social influence and pleasurable experiences to increase acceptability of strategies aimed at minimizing the possible harms of chemsex.
性用药物（“嗑药性行为”）在男男性行为者（MSM）中很常见，与性健康和心理健康危害有关。本研究评估了 MSM 中嗑药性行为与广泛的决定因素之间的关联，以增加对 MSM 嗑药性行为特点和信念的理解。
2018 年，9 家荷兰性传播感染（STI）诊所招募了 785 名 MSM；368 名（47%）完全完成了在线问卷调查。所有参与者报告在过去六个月中有过性行为。在过去六个月中，在性行为中使用可卡因、冰毒、设计药物、GHB/GBL、氯胺酮、安非他命或摇头丸被定义为嗑药性行为。通过多变量逻辑回归分析评估了嗑药性行为与心理社会决定因素、社会人口统计学、性行为以及使用烟草或酒精之间的关联。
44%的 MSM（161/368）报告了嗑药性行为，与社会人口统计学无关。独立的决定因素包括“相信大多数朋友/性伴侣在性行为中使用药物”（描述性规范）（比值比[OR]：1.95，95%置信区间[CI]：1.43-2.65），“相信使用药物会使性行为更有趣”（态度）（OR：2.06，95%CI：1.50-2.84），使用烟草（OR：2.65，95%CI：1.32-5.32），多个性伴侣（OR：2.69，95%CI：1.21-6.00），群交（OR：4.65，95%CI：1.54-14.05）和使用在线约会平台（OR：2.73，95%CI：1.13-6.62）。
MSM 可能会发现自己处于特定的社交网络中，在这些网络中，性行为中使用药物是一种常态，而嗑药性行为与快感有关。卫生服务机构应该认识到社会影响和愉悦体验，以提高人们对旨在最大限度减少嗑药性行为可能危害的策略的接受度。
