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Low levels of chemsex amongst men who have sex with men, but high levels of risk amongst men who engage in chemsex: analysis of a cross-sectional online survey across four countries.
Aim: This paper establishes the prevalence of chemsex drug use amongst men who have sex with men (MSM), the extent to which these drugs are used in a sexual context, as well as their associated behaviours and circumstances of use. Methods: Data from a cross-sectional, online survey of 2428 MSM recruited via gay sociosexual media in Scotland, Wales, Northern Ireland and the Republic of Ireland were analysed. Results: Whilst almost half (48.8%) of participants had ever taken illicit drugs, lifetime chemsex drug use was less common (18.0%) and far fewer reported chemsex drug use in the last year (8.2%) or last 4 weeks (3.0%). One quarter (27.1%) of men who used chemsex drugs in the last year reported no sexualized drug use, but almost three-quarters (72.9%) did. Only 6.1% of the whole sample reported sexualized chemsex drug use in the last year. The odds of reporting chemsex in the last year were significantly higher for men aged 36-45 (AOR=1.96), single men (AOR=1.83), men who were HIV positive (AOR=4.01), men who report high risk sex (AOR=4.46), being fisted (AOR=7.77), or sex in exchange for goods other than money (AOR=4.7) in the last year and men who reported an HIV test in the last 3 months (AOR=1.53). Discussion: Only a small proportion of MSM in these four countries reported chemsex, and, for the first time, we demonstrate that not all chemsex drug use was sexualized. Nevertheless, MSM who engage in chemsex (MWEC) reported substantial sexual risk inequalities. These novel findings highlight several opportunities for intervention, particularly around the multiple vulnerabilities of MWEC, opportunities for early identification of those most vulnerable to chemsex-related harm and the potential to develop a specialized responsive patient pathway.
SH17159 Accepted 08 December 2017
© CSIRO 2017