Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
J Med Internet Res. 2020 Jul 24;22(7):e17894. doi: 10.2196/17894.
Sexualized drug use (SDU; the use of any psychoactive substance before or during sexual intercourse) is prevalent among men who have sex with men (MSM) and may aggravate the worsening HIV epidemic in this key population.
This observational prospective cohort study investigated factors predicting the occurrence of SDU within a 6-month follow-up period among a sample of MSM in Hong Kong. We hypothesized that perceptions related to SDU would mediate the association between the influence of social media/gay social networking apps and SDU during the follow-up period.
Participants were Chinese-speaking men in Hong Kong, China who had anal intercourse with at least one man in the past year. Among 600 participants who completed the baseline telephone survey, 407 (67.8%) completed another telephone survey 6 months later. Logistic regression models and path analysis were fitted.
At Month 6, 6.9% (28/407) and 4.4% (18/407) of participants reported SDU and chemsex during the follow-up period. After adjustment for significant baseline background variables (use of pre-exposure prophylaxis; history of HIV and other sexually transmitted infections; anal intercourse with nonregular male sex partners, condomless anal intercourse with men, multiple male sex partnerships, and SDU at baseline), three constructs of the Theory of Planned Behavior (TPB) were significantly associated with SDU during the follow-up period: (1) positive attitudes toward SDU (adjusted odds ratio [AOR] 1.19, 95% CI 1.05-1.36), (2) perceived support for SDU from significant others (AOR 1.15, 95% CI 1.01-1.30), and (3) perceived behavioral control of refraining from SDU (AOR 0.76, 95% CI 0.59-0.98). Exposure to information supporting SDU on social media and gay social networking apps was also significantly associated with SDU (AOR 1.11, 95% CI 1.01-1.22). Bootstrapping analyses indicated that social media influence was indirectly associated with SDU through TPB-related perceptions of SDU (β=.04; B=.002, 95% CI 0.001-0.01).
Social media and gay social networking apps may be a major source of influence on MSM's perceptions and actual behaviors related to SDU.
性化药物使用（SDU；在性交前或性交期间使用任何精神活性物质）在男男性行为者（MSM）中很普遍，可能会加剧这一关键人群中 HIV 疫情的恶化。
本观察性前瞻性队列研究调查了香港 MSM 样本中，在 6 个月随访期间预测 SDU 发生的因素。我们假设，与 SDU 相关的认知会调节社交媒体/男同性恋社交应用程序对随访期间 SDU 的影响。
参与者为过去一年中与至少一名男性发生过肛交的中国香港的汉族男性。在完成基线电话调查的 600 名参与者中，有 407 名（67.8%）在 6 个月后完成了另一项电话调查。拟合了逻辑回归模型和路径分析。
在第 6 个月时，6.9%（28/407）和 4.4%（18/407）的参与者报告在随访期间发生了 SDU 和化学性行为。在调整了显著的基线背景变量（使用暴露前预防；艾滋病毒和其他性传播感染史；与非固定男性性伴侣的肛交、与男性的无保护肛交、多个男性性伴侣以及基线时的 SDU）后，计划行为理论（TPB）的三个构念与随访期间的 SDU 显著相关：（1）对 SDU 的积极态度（调整后的优势比[OR]1.19，95%置信区间[CI]1.05-1.36），（2）来自重要他人对 SDU 的支持感知（OR 1.15，95%CI 1.01-1.30），以及（3）避免 SDU 的感知行为控制（OR 0.76，95%CI 0.59-0.98）。在社交媒体和男同性恋社交应用程序上接触支持 SDU 的信息也与 SDU 显著相关（OR 1.11，95%CI 1.01-1.22）。自举分析表明，社交媒体的影响通过与 SDU 相关的 TPB 认知间接与 SDU 相关（β=0.04；B=0.002，95%CI 0.001-0.01）。
社交媒体和男同性恋社交应用程序可能是影响 MSM 与 SDU 相关认知和实际行为的主要来源。
