Sexualized drug use (‘chemsex’) and high-risk sexual behaviours in HIV-positive men who have sex with men

The Positive Voices study group

Research output: Contribution to journalArticlepeer-review

91 Citations (Scopus)

Abstract

Objectives: The incidence of sexually transmitted infections (STIs) and HIV infection remains high in gay, bisexual, and other men who have sex with men (MSM) in the UK, and sexualized drug use (“chemsex”) and injecting drug use (“slamsex”) may play a part in this. We aimed to characterize HIV-positive MSM engaging in chemsex/slamsex and to assess the associations with self-reported STI diagnoses and sexual behaviours. Methods: Data from a 2014 survey of people attending HIV clinics in England and Wales were linked to clinical data from national HIV surveillance records and weighted to be nationally representative. Multivariable logistic regression assessed the associations of chemsex and slamsex with self-reported unprotected anal intercourse (UAI), serodiscordant UAI (sdUAI) (i.e. UAI with an HIV-negative or unknown HIV status partner), sdUAI with a detectable viral load (>50 HIV-1 RNA copies/mL), hepatitis C, and bacterial STIs. Results: In the previous year, 29.5% of 392 sexually active participants engaged in chemsex, and 10.1% in slamsex. Chemsex was significantly associated with increased odds of UAI [adjusted odds ratio (AOR) 5.73; P < 0.001], sdUAI (AOR 2.34; P < 0.05), sdUAI with a detectable viral load (AOR 3.86; P < 0.01), hepatitis C (AOR 6.58; P < 0.01), and bacterial STI diagnosis (AOR 2.65; P < 0.01). Slamsex was associated with increased odds of UAI (AOR 6.11; P < 0.05), hepatitis C (AOR 9.39; P < 0.001), and bacterial STI diagnosis (AOR 6.11; P < 0.001). Conclusions: Three in ten sexually active HIV-positive MSM engaged in chemsex in the past year, which was positively associated with self-reported depression/anxiety, smoking, nonsexual drug use, risky sexual behaviours, STIs, and hepatitis C. Chemsex may therefore play a role in the ongoing HIV and STI epidemics in the UK.

Original languageEnglish
Pages (from-to)261-270
Number of pages10
JournalHIV Medicine
Volume19
Issue number4
DOIs
Publication statusPublished - Apr 2018

Bibliographical note

Funding Information:
Positive Voices was funded by the National Institute for Health Research and was reviewed by the London Harrow NHS Research Ethics Committee (Project ID 13/LO/0279). The funder had no role in the design, analysis or interpretation of the study.

Funding Information:
The authors thank all of the Positive Voices participants and staff at the participating HIV clinics who were involved in the study. The Positive Voices project was funded by a grant from the National Institute for Health Research’s Centre for Health Protection Research (CHPR). The contributions of EP and HW were supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London. The views expressed are those of the authors and not necessarily those of the NHS, PHE, the NIHR, or the Department of Health.

Funding Information:
The authors thank all of the Positive Voices participants and staff at the participating HIV clinics who were involved in the study. The Positive Voices project was funded by a grant from the National Institute for Health Research's Centre for Health Protection Research (CHPR). The contributions of EP and HW were supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London. The views expressed are those of the authors and not necessarily those of the NHS, PHE, the NIHR, or the Department of Health.

Publisher Copyright:
© 2018 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association

Keywords

  • HIV transmission
  • hepatitis C
  • men who have sex with men
  • recreational drugs
  • sexually transmitted infections

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