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基于法国传染病科的男男性行为者化学性行为的减少危害和多学科咨询:患者特征和认知。

Harm reduction and multidisciplinary consultations for gay, bisexual, and other men who have sex with men practising chemsex based in a French infectious disease unit: patients' characteristics and perceptions.

机构信息

Unité des maladies infectieuses et tropicales, Hôpital Saint-Louis (Hopitaux de Paris - Assistance Publique de Paris), Paris, France.

Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.

出版信息

Sex Health. 2024 Mar;21. doi: 10.1071/SH23165.

Abstract

BACKGROUND

Chemsex, a type of sexualised drug use, is expanding among gay, bisexual, and other men who have sex with men (GBMSM), with physical and mental health risks. Health-seeking behaviours of GBMSM practising chemsex is not clear.

METHODS

Harm reduction (HR) consultations for GBMSM engaging in chemsex and seeking comprehensive services including HR were offered in a Parisian infectious disease unit. From December 2021 to January 2022, HR consultation patients completed an online survey on their consumption, health, used services, and perspective on consultations. We generated descriptive statistics, and tested (χ 2 ) the relationship between reporting a specialised follow-up and perceived usefulness of intervention.

RESULTS

Of 172 patients, a total of 96 GBMSM (55.2%) completed the survey. Most ever consumed substance was 3-methylmethcathinone (3MMC; 92/96; 95.8%). Before consultations, about half consumed at least once a week (50/96; 52%), most reported negative impacts of chemsex on their social (60/96, 62.5%), professional (56/96, 58.3%), intimate (53/96; 55.21%), or sexual life (52/96; 54.17%). Also, more than two-thirds (n =57; 69.38%) had received a follow-up in specialised services: one-third had been followed in addictology (28/96, 29.2%) and/or psychotherapy (32/96, 33.3%), and one-fourth (24/96, 25.0%) had used emergency services. After consultations, three-quarters perceived the intervention as useful (n =74; 77.08%); we found no significant relationship with receiving a specialised follow-up; and most were satisfied with professionals' listening (90/96; 93.8%), and reported reduced risks (80/96; 83.3%).

DISCUSSION

Multidisciplinary HR, preventive, diagnostical, and therapeutic sexological and psychiatric interventions are greatly needed among GBMSM practising chemsex. HR interventions accessible in services already attended by GBMSM are a valuable option.

摘要

背景

性化药物使用的一种形式——化学性行为(Chemsex),在男同性恋、双性恋和其他与男性发生性关系的男性(GBMSM)中不断蔓延,存在身心健康风险。目前尚不清楚从事 Chemsex 的 GBMSM 的健康寻求行为。

方法

在巴黎传染病科,为从事 Chemsex 并寻求包括健康风险干预在内的综合服务的 GBMSM 提供减少伤害(HR)咨询。2021 年 12 月至 2022 年 1 月,接受 HR 咨询的患者在线完成了关于其消费、健康、使用的服务以及对咨询看法的调查。我们生成了描述性统计数据,并测试了报告专门随访和干预措施有用性之间的关系(卡方检验)。

结果

在 172 名患者中,共有 96 名 GBMSM(55.2%)完成了调查。大多数曾使用过的物质是 3-甲氧基甲卡西酮(3MMC;92/96;95.8%)。在咨询前,大约一半的人每周至少使用一次(50/96;52%),大多数人报告说 Chemsex 对他们的社交(60/96,62.5%)、职业(56/96,58.3%)、亲密关系(53/96;55.21%)或性生活(52/96;54.17%)有负面影响。此外,超过三分之二的人(n=57;69.38%)接受过专门服务的随访:三分之一的人在成瘾学(28/96,29.2%)和/或心理治疗(32/96,33.3%)方面接受过随访,四分之一(24/96,25.0%)的人使用过急诊服务。咨询后,75%的人认为干预措施有用(n=74;77.08%);我们发现与接受专门随访之间没有显著关系;大多数人对专业人员的倾听表示满意(90/96;93.8%),并报告风险降低(80/96;83.3%)。

讨论

在从事 Chemsex 的 GBMSM 中,急需多学科的 HR、预防、诊断和治疗性学和精神病学干预措施。在已经接受 GBMSM 就诊的服务中提供 HR 干预措施是一个有价值的选择。

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