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Epidemiology
Original research
Characteristics and sexual health service use of MSM engaging in chemsex: results from a large online survey in England
  1. Paula Bianca Blomquist1,2,3,
  2. Hamish Mohammed4,5,
  3. Amy Mikhail1,
  4. Peter Weatherburn3,6,
  5. David Reid3,6,
  6. Sonali Wayal3,5,
  7. Gwenda Hughes3,4,
  8. Catherine H Mercer3,5
  1. 1 UK Field Epidemiology Training Programme, Global Public Health Division, Public Health England, London, United Kingdom
  2. 2 Field Service North West, National Infection Service, Public Health England, Liverpool, United Kingdom
  3. 3 National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England (PHE), in collaboration with London School of Hygiene & Tropical Medicine, London, United Kingdom
  4. 4 Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, Public Health England, London, United Kingdom
  5. 5 Centre for Population Research in Sexual Health and HIV, Institute for Global Health, University College London, London, United Kingdom
  6. 6 Sigma Research, Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
  1. Correspondence to Paula Bianca Blomquist, Field Service North West, National Infection Service, Public Health England, Liverpool L3 1DS, UK; paula.blomquist{at}phe.gov.uk

Abstract

Background Chemsex, the use of select psychoactive drugs to enhance sexual experience, typically among men who have sex with men (MSM), is associated with sexual behaviours with higher STI risk. Understanding patterns of chemsex among MSM as well as the characteristics and sexual health service engagement of chemsex participants is important for developing interventions.

Methods Between 5/2016 to 5/2017, 3933 MSM completed an online survey, recruited in sexual health clinics (SHCs) in England (n=421) and via four social networking/dating apps (n=3512). We described patterns of chemsex in the past year and used multivariable logistic regression to investigate differences in demographics and sexual behaviours by chemsex history. We described history of SHC attendance and STI test in the past year among app-recruited chemsex participants.

Results Chemsex in the past year was reported by 10% of respondents; 19% of SHC-recruited and 9% of app-recruited. Among chemsex participants, 74% had used ≥2 chemsex drugs. In the multivariable model, MSM engaging in chemsex had a raised odds of being HIV-positive (adjusted OR (aOR): 3.6; 95% CI 2.1 to 6.1), aged 30–44 (aOR 1.5 vs <30 years; 95% CI 1.0 to 2.1), being born outside the UK and having engaged in higher risk sexual behaviours in the past 3 months. Chemsex participants also had higher odds of condomless anal sex with partners of different or unknown HIV status, but only among HIV-negative/untested. In the past year, 66% of app-recruited chemsex participants had attended a SHC and 81% had had an STI test.

Conclusion One in 10 MSM recruited through community and clinical settings across England had engaged in chemsex in the past year. Those that did appear to be at greater STI risk but engaged more actively with sexual health services. This highlights the need and opportunity for chemsex-related services in SHCs and robust referral pathways to drug treatment services.

  • sexual health
  • gay men
  • injecting drug use
  • HIV
  • sexual behaviour
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/sextrans-2019-054345

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    Footnotes

    • GH and CHM are joint senior authors.

    • Handling editor Sevgi O Aral

    • Twitter @sigmaresearch1, @sonaliwl

    • Contributors SW, DR and PBB set up and coordinated the study in sexual health clinics, and PW and DR established and ran the app-recruited survey. The work was managed by PW, GH and CHM. SW and DR secured ethics and R&D permissions. PBB analysed the quantitative data and wrote the majority of the paper, with contributions by CHM, GH, HM, AM, PW, SW and DR. All authors approved the final version. CHM and GH secured funding from the National Institute for Health Research for the Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England (PHE), in collaboration with London School of Hygiene & Tropical Medicine.

    • Funding This research was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England (PHE), in collaboration with London School of Hygiene & Tropical Medicine (LSHTM).

    • Disclaimer The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care, or Public Health England.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study was approved by the National Research Ethics Service Committee South Central-Oxford C (reference:15/SC/0223) and LSHTM ethics committee (reference: 11999).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement The data that support the findings of this study are available from University College London (UCL) on reasonable request and with permission of Public Health England.