Article Text
Abstract
Background Men who have sex with men (MSM) are increasingly using drugs during sex (‘chemsex’) and this has been associated with several health harms, including an increased risk for sexually transmitted infections (STI) and addiction. Little evidence exists on whether chemsex is perceived as problematic by MSM. This study assessed a wide range of social and behavioral aspects in MSM engaging in chemsex.
Methods In 2018, 785 MSM were recruited at eight Dutch STI clinics, of which 511 (65%) completed the online questionnaire. Chemsex was defined as using cocaine, crystal meth, designer drugs, GHB/GBL, ketamine, speed or XTC/MDMA during sex in the preceding six months. Characteristics of MSM intending to change chemsex behaviour and MSM with a need for professional counselling were described using χ2-tests.
Results Chemsex was reported by 41% (209/511). Among MSM engaging in chemsex, intention to change was reported by 19% (40/209); decreasing the frequency of drug use was mostly reported (70% (28/40)). Intention to change was highest among MSM who had no sex without drugs <3 months (44%(12/47) vs 15%, p<0.001), reported unwanted sexual experiences (36%(14/39) vs 15%, p=0.01), and used ≥5 drugs <6 months (31%(16/51) vs 16%, p=0.03). The need for professional counselling was reported by 23% (48/209). The majority wanted to be counselled on increasing self-control (52%(25/48)). The need for professional counselling was highest among MSM who had an intention to change (45%(18/40) vs 18%, p<0.001), had no sex without drugs <3 months (41%(11/27) vs 20%, p=0.04), and engaged in chemsex ≥2 times per month (30%(28/93) vs 17%, p=0.03).
Conclusion Our study shows that one in five MSM engaging in chemsex reported an intention to change or expressed a need for professional counselling. STI healthcare providers should discuss chemsex frequency, multiple drug use, sober sex and unwanted sexual experiences, and if necessary refer to professional addiction-or mental healthcare.
Disclosure No significant relationships.