Department of Public Health, College of Medicine, National Cheng Kung University, 8F-8068, No. 138, ShengLi Rd., North Dist., Tainan City, 704, Taiwan.
Taiwan Love and Hope Association, Kaohsiung, Taiwan.
Harm Reduct J. 2023 Apr 16;20(1):52. doi: 10.1186/s12954-023-00777-y.
The intention of chemsex-practicing gay and bisexual men and other men who have sex with men (GBMSM) to reduce their drug use is an important factor for the utilization of harm reduction services. This study aimed to examine data from an integrated sexual health services center to understand the relationship between the intention to reduce chemsex behavior and chemsex-related utilization of mental health services among GBMSM who engage in chemsex.
We used data collected from Healing, Empowerment, Recovery of Chemsex (HERO), an integrated health center in Taiwan, between November 2017 and December 2021. As the baseline, clients were asked to rate the current and ideal proportions of their sexual activities that involved the use of MDMA, ketamine, methamphetamine, GHB/GBL, or mephedrone. Having the intention to reduce chemsex was defined as having a lower proportion of ideal engagement compared to actual engagement. The data on the use of the services provided at HERO were linked to the survey responses and compared to information gathered during regular follow-up visits. Univariable and multivariable logistic regression analyses and a Poisson regression analysis were performed on the data.
A total of 152 GBMSM reported engaging in chemsex, of whom 105 (69.1%) expressed the intention to reduce their chemsex behavior. Service utilization ranged from 23.0% for participating in meetings of a chemsex recovery group, 17.1% for visiting a mental health clinic, and 10.5% for using both of these services. The intention to reduce chemsex behavior significantly associated with visiting a mental health clinic (aOR = 4.68, p < 0.05), but its association with attending meetings of a chemsex recovery group was only marginally significant (aOR = 2.96, p < 0.1). Other factors that remained significantly associated with service use were a high frequency of substance use and living with HIV.
Comprehensive harm reduction strategies, which touch on mental health, drug use management and recovery, are needed for those who want to reduce their chemsex behavior. Public health practitioners should endeavor to raise awareness of resources that are available for people who engage in chemsex and to minimize the barriers blocking their access to the appropriate services.
进行化学性行为的男同性恋和双性恋者及其他男男性行为者（GBMSM）意图减少药物使用是他们利用减少伤害服务的一个重要因素。本研究旨在通过分析来自综合性性健康服务中心的数据，了解进行化学性行为的 GBMSM 中，减少化学性行为的意图与他们寻求与化学性行为相关的心理健康服务之间的关系。
我们使用了 2017 年 11 月至 2021 年 12 月期间在台湾综合性健康中心“治疗、赋权、减少化学性行为（HERO）”收集的数据。作为基线，参与者被要求评估他们目前和理想的涉及使用摇头丸、氯胺酮、冰毒、GHB/GBL 或 4-甲基甲卡西酮的性行为比例。有减少化学性行为的意图是指与实际参与相比，理想参与的比例较低。HERO 提供的服务使用数据与调查回复相关联，并与定期随访时收集的信息进行比较。对数据进行单变量和多变量逻辑回归分析以及泊松回归分析。
共有 152 名 GBMSM 报告进行了化学性行为，其中 105 名（69.1%）表示有减少其化学性行为的意图。服务利用率范围从参加化学性行为康复小组会议的 23.0%、到访问心理健康诊所的 17.1%，以及同时使用这两种服务的 10.5%。减少化学性行为的意图与访问心理健康诊所显著相关（调整后的比值比[aOR] = 4.68，p < 0.05），但与参加化学性行为康复小组会议的关系仅具有边际显著性（aOR = 2.96，p < 0.1）。与服务使用仍显著相关的其他因素是物质使用频率高和 HIV 阳性。
对于那些想要减少其化学性行为的人，需要综合的减少伤害策略，涉及心理健康、药物使用管理和康复。公共卫生从业者应努力提高人们对可供化学性行为者使用的资源的认识，并尽量减少他们获得适当服务的障碍。
