与男男性行为者的化学性行为相关的健康特征：来自挪威一项横断面诊所调查的结果。
Health characteristics associated with chemsex among men who have sex with men: Results from a cross-sectional clinic survey in Norway.
机构信息
Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
The Olafia Clinic and the National Advisory Unit on Sexually Transmitted Infections, Oslo University Hospital, Oslo, Norway.
出版信息
PLoS One. 2022 Oct 5;17(10):e0275618. doi: 10.1371/journal.pone.0275618. eCollection 2022.
BACKGROUND
Chemsex typically involves drugs such as GHB/GBL, crystal meth and mephedrone, and is increasingly common among MSM. The behaviour has been found to be associated with sexually transmitted infections (STIs) and mental health problems. We aimed to assess the extent of chemsex engagement and associations with different aspects of health, among MSM attending a free specialist walk-in clinic for STIs in Oslo, Norway.
METHODS
Anonymous cross-sectional survey data was collected from June to October 2016. Differences in STI health (chlamydia, gonorrhoea, syphilis, HIV diagnoses), mental health (depression/anxiety) and internalised homonegativity between MSM using and not using GHB/GBL, crystal meth, mephedrone, cocaine or ketamine with sex in the last year were assessed descriptively and in a multivariate logistic regression model. The predictors were number of self-reported chlamydia, gonorrhoea or syphilis diagnoses, HIV diagnosis, depression/anxiety, and degree of internalised homonegativity. We adjusted for age, education level and having lived abroad.
RESULTS
Of the 518 MSM respondents, 17% reported sexualised use of either GHB/GBL, crystal meth, mephedrone, cocaine or ketamine in the last year (chemsex). We found significant positive associations between chemsex and self-reported HIV diagnoses (adjusted odds ratio [aOR] = 3.26, 95%CI = 1.37-7.76), number of reported chlamydia, gonorrhoea or syphilis diagnoses in the last year (aOR = 1.63, 95%CI = 1.18-2.12), having lived more than one year abroad (aOR = 2.10, 95%CI = 1.20-3.65), but no significant association with depression/anxiety (aOR = 1.02, 95%CI = 0.53-1.93), nor internalised homonegativity (aOR = 0.62, 95%CI = 0.33-1.19).
CONCLUSION
Chemsex engagement in Norway is relatively low compared to findings from STI clinics in other European countries, and GHB/GBL and cocaine the two most commonly used drugs with sex. Chemsex was more common among MSM having lived more than one year abroad, reporting HIV diagnoses and a higher number of either chlamydia, gonorrhoea or syphilis diagnoses in the last year. Health care providers need to be made aware of chemsex as a behavioural phenomenon among MSM, and special care should be afforded to MSM living with HIV and being diagnosed with STIs.
背景
Chemsex 通常涉及 GHB/GBL、冰毒和苯丙胺等药物，在男男性行为者（MSM）中越来越普遍。这种行为与性传播感染（STI）和心理健康问题有关。我们旨在评估在挪威奥斯陆一家免费的性传播感染专科门诊就诊的 MSM 中，Chemsex 的参与程度以及与不同健康方面的关联。
方法
2016 年 6 月至 10 月期间，我们收集了匿名横断面调查数据。使用和不使用 GHB/GBL、冰毒、苯丙胺、可卡因或氯胺酮进行性行为的 MSM 之间在性传播感染健康（衣原体、淋病、梅毒、HIV 诊断）、心理健康（抑郁/焦虑）和内化的同性恋恐惧症方面的差异，分别进行描述性评估和多变量逻辑回归模型评估。预测因子为自我报告的衣原体、淋病或梅毒诊断、HIV 诊断、抑郁/焦虑和内化的同性恋恐惧症的数量。我们调整了年龄、教育水平和在国外居住的情况。
结果
在 518 名 MSM 受访者中，17%的人报告在过去一年中曾进行过性化使用 GHB/GBL、冰毒、苯丙胺、可卡因或氯胺酮（Chemsex）。我们发现 Chemsex 与自我报告的 HIV 诊断之间存在显著的正相关关系（调整后的优势比[aOR] = 3.26，95%CI = 1.37-7.76），与过去一年中报告的衣原体、淋病或梅毒诊断的数量（aOR = 1.63，95%CI = 1.18-2.12），在国外居住一年以上（aOR = 2.10，95%CI = 1.20-3.65），但与抑郁/焦虑（aOR = 1.02，95%CI = 0.53-1.93）或内化的同性恋恐惧症（aOR = 0.62，95%CI = 0.33-1.19）没有显著关联。
结论
与其他欧洲国家的性传播感染诊所的发现相比，挪威的 Chemsex 参与度相对较低，GHB/GBL 和可卡因是最常与性行为一起使用的两种药物。Chemsex 在在国外居住一年以上、报告 HIV 诊断以及过去一年中报告衣原体、淋病或梅毒诊断数量较高的 MSM 中更为常见。医疗保健提供者需要意识到 Chemsex 是 MSM 中的一种行为现象，并且应该特别关注感染 HIV 和被诊断出性传播感染的 MSM。
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