Eustaquio Patrick C, Smyth Jamie, Salisi James A
School of Public Health, Imperial College London, London, W2 1PG, UK.
LoveYourself Inc, 3rd floor, 715-A Shaw Boulevard, Barangay Wack-wack, Mandaluyong, Metro Manila, 1552, Philippines.
AIDS Behav. 2024 Sep;28(9):3060-3079. doi: 10.1007/s10461-024-04393-0. Epub 2024 Jun 15.
Chemsex, the use of drugs during and/or prior to sex, has been found to increase the risk of HIV and sexually transmitted infections (STI) among men who have sex with men (MSM). Many studies and reviews on chemsex were focused among MSM in high-income countries (HIC), with less attention given to understanding chemsex in low- and middle-income countries (LMIC). We estimated the prevalence of chemsex and its association with sexual risk behaviors, HIV, and STI among MSM in LMIC. We searched MEDLINE, Embase, GlobalHealth, PsychINFO, and CINAHL for quantitative, qualitative, and mixed-methods studies describing chemsex and its association with sexual risk behaviors, HIV, and STI among MSM in LMIC, published January 1, 2000-October 15, 2023. We used the Mixed Methods Appraisal Tool to assess study quality. We developed a narrative review and performed meta-analysis using a random effects model and the DerSimonian and Laird approach (PROSPERO #CRD42022339663). Thirty-two studies from LMIC, particularly from Asia, Africa, Latin America, and the Middle East, were included. MSM who engaged in chemsex had higher prevalence of condomless anal intercourse, group sex, having multiple sexual partners, and of HIV and STI compared to MSM who did not. We estimated a pooled prevalence for recent chemsex (≤ 12 months) of 16% (95% CI 11%-22%, τ = 0.01, I = 99.07%, p < 0.01). Chemsex and its associated behaviors are associated with HIV and STI among MSM in LMIC. Integration of harm reduction and sexual health services and structural changes could prevent HIV and STI prevention among MSM who engage in chemsex in LMIC.
化学性行为，即在性行为期间和/或之前使用毒品，已被发现会增加男男性行为者（MSM）感染艾滋病毒和性传播感染（STI）的风险。许多关于化学性行为的研究和综述都集中在高收入国家（HIC）的男男性行为者中，而对中低收入国家（LMIC）化学性行为的了解较少。我们估计了中低收入国家男男性行为者中化学性行为的患病率及其与性风险行为、艾滋病毒和性传播感染的关联。我们在MEDLINE、Embase、GlobalHealth、PsychINFO和CINAHL中检索了2000年1月1日至2023年10月15日发表的关于描述中低收入国家男男性行为者中化学性行为及其与性风险行为、艾滋病毒和性传播感染关联的定量、定性和混合方法研究。我们使用混合方法评估工具来评估研究质量。我们进行了叙述性综述，并使用随机效应模型和DerSimonian和Laird方法进行荟萃分析（PROSPERO #CRD42022339663）。纳入了来自中低收入国家的32项研究，特别是来自亚洲、非洲、拉丁美洲和中东的研究。与未进行化学性行为的男男性行为者相比，进行化学性行为的男男性行为者无保护肛交、群交、拥有多个性伴侣以及感染艾滋病毒和性传播感染的患病率更高。我们估计近期（≤12个月）化学性行为的合并患病率为16%（95%CI 11%-22%，τ = 0.01，I = 99.07%，p < 0.01）。在中低收入国家，化学性行为及其相关行为与男男性行为者中的艾滋病毒和性传播感染有关。减少伤害和性健康服务的整合以及结构变革可以预防中低收入国家进行化学性行为的男男性行为者中的艾滋病毒和性传播感染。
