Muccini Camilla, Pinyakorn Suteeraporn, Kolsteeg Christy, Kroon Eugène, Sacdalan Carlo, Crowell Trevor A, Chan Phillip, Paul Robert, Hsu Denise, Phanuphak Nittaya, Colby Donn J
Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
SEARCH Research Foundation, Bangkok, Thailand.
IJID Reg. 2024 Sep 28;13:100465. doi: 10.1016/j.ijregi.2024.100465. eCollection 2024 Dec.
We report longitudinal trends in alcohol and recreational drug use, and their associations with sexual behaviors and clinical outcomes in a Thai cohort of predominantly men who have sex with men (MSM) living with HIV.
From 2017 to 2019, participants in the RV254/SEARCH010 acute HIV cohort answered questions every 24 weeks about drug use and sexual behaviors. Longitudinal trends were assessed using the χ2 test for trend. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors potentially associated with recreational drug and alcohol use.
Among 604 participants, the median age was 26 (interquartile range 23-31) years, and 93.5% were MSM. Alcohol consumption was reported in 83.3% and recreational drug use in 46.9% during the study period, with rising trends in both over the years. Participants who reported recreational drug use were more likely to have hepatitis C (OR 3.42, 95% CI 1.88-6.21), syphilis (OR 2.69, 1.75-4.13), gonorrhea (OR 7.74, 5.04-11.89), and chlamydia (OR 1.61, 1.12-2.31), and to engage in group sex (OR 7.74, 5.04-11.89). Participants who used any recreational drugs had more frequent viral blips (23.1% vs 14.2%, = 0.007) and reported missed doses of antiretroviral drugs more often (52.4% vs 36.9%, <0.001), but had no significant difference in viral suppression (94.1% vs 97.4%, = 0.06).
Among MSM living with HIV in Bangkok, recreational drug use has increased in recent years and was associated with hepatitis C and sexually transmitted infections, especially among men who participate in group sex. Prevention strategies and other interventions may improve treatment adherence and other HIV outcomes.
我们报告了泰国一个以感染艾滋病毒的男男性行为者（MSM）为主的队列中酒精和娱乐性药物使用的纵向趋势，以及它们与性行为和临床结果的关联。
2017年至2019年期间，RV254/SEARCH010急性艾滋病毒队列的参与者每24周回答一次关于药物使用和性行为的问题。使用χ2趋势检验评估纵向趋势。采用逻辑回归估计与娱乐性药物和酒精使用潜在相关因素的比值比（OR）和95%置信区间（CI）。
在604名参与者中，年龄中位数为26岁（四分位间距23 - 31岁），93.5%为男男性行为者。在研究期间，83.3%的人报告饮酒，46.9%的人报告使用娱乐性药物，且这两者在多年来均呈上升趋势。报告使用娱乐性药物的参与者更有可能感染丙型肝炎（OR 3.42，95% CI 1.88 - 6.21）、梅毒（OR 2.69，1.75 - 4.13）、淋病（OR 7.74，5.04 - 11.89）和衣原体（OR 1.61，1.12 - 2.31），并参与群交（OR 7.74，5.04 - 11.89）。使用任何娱乐性药物的参与者病毒小波动更频繁（23.1%对14.2%，P = 0.007），且更频繁报告漏服抗逆转录病毒药物（52.4%对36.9%，P <0.001），但在病毒抑制方面无显著差异（94.1%对97.4%，P = 0.06）。
在曼谷感染艾滋病毒的男男性行为者中，近年来娱乐性药物使用有所增加，且与丙型肝炎和性传播感染有关，尤其是在参与群交的男性中。预防策略和其他干预措施可能会改善治疗依从性和其他艾滋病毒相关结果。
