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Chemsex, sexual behaviour and STI-PrEP use among HIV-PrEP users during the COVID-19 pandemic in Brighton, UK
  1. Miriam Ringshall1,
  2. Richard Cooper1,
  3. Waseem Rawdah1,
  4. Sean Perera1,
  5. Alan Bannister1,
  6. Kayleigh Nichols1,
  7. Colin Fitzpatrick1,
  8. Daniel Richardson1,2
  1. 1 University Hospitals Sussex NHS Foundation Trust, Brighton, UK
  2. 2 Brighton and Sussex Medical School, Brighton, UK
  1. Correspondence to Dr Daniel Richardson, Sexual Health & HIV, University Hospitals Sussex NHS Foundation Trust, Brighton BN2 5BE, UK; docdanielr{at}

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The COVID-19 pandemic and social distancing restrictions have been associated with changes in use of HIV pre-exposure prophylaxis (HIV-PrEP), use of doxycycline as STI-PrEP and sexual behaviour including chemsex behaviour among men who have sex with men (MSM).1 2 As part of a local service needs assessment for the provision of services for MSM using PrEP and MSM engaging in chemsex, we asked MSM to complete a short anonymous online electronic survey after their PrEP monitoring appointment.

Of the 269 MSM who attended for HIV-PrEP monitoring between May and June 2021, 109 (41%) completed the survey: 105 cis-men and 4 transgender individuals. Thirty-four (31%) reported using recreational drugs in the previous 3 months, of whom 18 (17%) used drugs for sex (chemsex) and 12 (11%) as part of group sex; and 2 (2%) reported injecting drug use. All 18 were polydrug users: 9 used crystal methamphetamine, 9 gamma-hydroxybutyrate, 4 mephedrone, 3 ketamine and 4 Phosphodiesterase-5 inhibitorsPDE5 inhibitors. Of the 109 individuals, 5 (5%) reported buying doxycycline online for use as STI-PrEP. During the COVID-19 pandemic, 10 (9%) reported having the same or more non-household, non-steady sexual partners than before the pandemic, 57 (52%) less than before the pandemic, and 41 (38%) reported not meeting partners for sex at all during the pandemic. MSM engaging in chemsex were significantly more likely to use doxycycline PrEP (22% v 1%, p=0.003) and to have continued to see non-steady sexual partners (50% v 1%, p=0.0001) throughout the COVID-19 pandemic.

A small but significant proportion of MSM using HIV-PrEP during the COVID-19 pandemic continued to see the same or increased number of non-steady sexual partners. These MSM were more likely to have engaged in chemsex and use STI-PrEP. Provision needs to be made by services to facilitate adequate harm reduction interventions for this group.

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  • Handling editor Anna Maria Geretti

  • Contributors DR, MR and RC designed the study. DR and MR analysed the data. DR, MR, RC, WR, SP, AB, KN and CF contributed to data collection and to the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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