National Health School, Carlos III Health Institute, Av Monforte de Lemos 5, Madrid, 28029, Spain, 34 918222196.
Center for Biomedical Research Network in Epidemiology and Public Health, Madrid, Spain.
JMIR Public Health Surveill. 2024 Sep 27;10:e60012. doi: 10.2196/60012.
Chemsex prevalence is still not well known, and both the lack of homogeneity and cultural component of chemsex practices are usually overlooked.
This study aims to estimate the proportion of sexual minority men (SMM) engaging in chemsex sessions, while understanding the cultural dimension of chemsex, and to analyze distinct session typologies with potential risk differences and the sociodemographic factors associated with engaging in them.
A total of 5711 SMM residing throughout Spain participated in an anonymous web-based survey that assessed chemsex session engagement and characteristics, drug use, and sociodemographic variables. We measured the association of sociodemographic factors with engaging in chemsex sessions by calculating adjusted prevalence ratios, using multivariate Poisson regression analysis. Chemsex typologies were analyzed using latent class analysis, and sociodemographic factors were associated with the different risk classes.
Our results determined that 21.1% (1205/5711; 95% CI 20.0%-22.1%) of SMM engaged in chemsex sessions during their lifetime. Participating in sessions was significantly associated with being a migrant, not having a comfortable financial situation, openly living their sexuality, residing in bigger municipalities, older age, using steroids, and living with HIV (adjusted prevalence ratio: range 1.17-2.01; all P values <.05). Three typologies of sessions with different risks were identified with latent class analysis, with 23.2% of SMM engaging in sessions taking part in higher-risk ones, which was associated with younger age, using steroids, living in bigger municipalities, openly living their sexuality, and living with HIV, compared to SMM engaging in lower-risk sessions (odds ratio: range 2.75-4.99).
Chemsex is relatively common among SMM in Spain, but it is important to differentiate typologies of sessions with varying risks, and the proportion of SMM engaging in high-risk sessions is low. Chemsex is highly associated with sociodemographic factors. Chemsex should be prioritized in public health programs, which should consider the different forms of sessions with their varying risks and prevalence, while also considering the cultural dimension inherent to chemsex.
化学性行为的流行程度仍然不为人知，而且化学性行为的缺乏同质性和文化因素通常被忽视。
本研究旨在估计参与化学性行为的性少数男性（SMM）的比例，同时了解化学性行为的文化维度，并分析具有潜在风险差异的不同类型的性行为，以及与参与这些行为相关的社会人口学因素。
共有 5711 名居住在西班牙各地的 SMM 参与了一项匿名的网络调查，该调查评估了化学性行为的参与情况和特征、药物使用以及社会人口学变量。我们使用多变量泊松回归分析来衡量社会人口学因素与参与化学性行为之间的关联。使用潜在类别分析分析化学性行为类型，并将社会人口学因素与不同风险类别联系起来。
我们的结果确定，5711 名 SMM 中有 21.1%（1205/5711；95%CI 20.0%-22.1%）在他们的一生中参与过化学性行为。参与性行为与移民身份、经济状况不佳、公开表达性取向、居住在较大的城市、年龄较大、使用类固醇和感染艾滋病毒显著相关（调整后的患病率比：范围 1.17-2.01；所有 P 值均<.05）。通过潜在类别分析确定了三种不同风险的性行为类型，其中 23.2%的 SMM 参与了高风险的性行为，与年龄较小、使用类固醇、居住在较大的城市、公开表达性取向和感染艾滋病毒相关，与参与低风险性行为的 SMM 相比（比值比：范围 2.75-4.99）。
在西班牙，SMM 中化学性行为相对普遍，但区分不同风险的性行为类型很重要，而且参与高风险性行为的 SMM 比例较低。化学性行为与社会人口学因素高度相关。在公共卫生计划中应优先考虑化学性行为，这些计划应考虑到不同形式的性行为及其不同的风险和流行程度，同时考虑到化学性行为固有的文化维度。
