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RESEARCH ARTICLE

Aspects associated with sexualised drug use among gay men and other men who have sex with men: a cross-sectional study from the Latin America MSM Internet Survey 2018 – Chile

Cristian Lisboa Donoso https://orcid.org/0000-0001-8913-0925 A and Valeria Stuardo Ávila https://orcid.org/0000-0001-9861-0285 B C
+ Author Affiliations
- Author Affiliations

A MD School of Public Health, University of Chile, Av. Independencia 939, Santiago 8380000, Chile.

B PhD Epidemiology Program, School of Public Health, University of Chile, Av. Independencia 939, Santiago 8380000, Chile.

C Corresponding author. Email: valeria.stuardo@uchile.cl

Sexual Health 17(6) 493-502 https://doi.org/10.1071/SH20089
Submitted: 25 May 2020  Accepted: 30 September 2020   Published: 8 December 2020

Abstract

Background: Sexualised drug use has attracted interest due to the role it could play in increasing exposure to the transmission of HIV and other sexually transmissible infections. It also carries risks inherent to substance use and may influence psychosocial factors. This study characterised sexualised drug use among Latin America MSM Internet Survey (LAMIS) respondents in Chile, in order to identify aspects associated with the phenomenon. Methods: LAMIS data were used to analyse: drug use (in any context, in sexual context and sexualised drug use), epidemiological aspects and psychosocial aspects. In addition, the associations between the sexualised drug use and these aspects were estimated. Results: The prevalence of sexualised drug use was 24% (n = 4945). The drugs most used in a sexual context (n = 3365) were cannabis, poppers and viagra. Cocaine, ecstasy/MDMA (3,4-Methylenedioxymethamphetamine) and ketamine use were reported in sexual encounters with multiple partners. Living with HIV (adjusted odds ratio (AOR) = 1.92), having had sex with three or more casual partners in the past year (AOR = 2.02) and having engaged in sex without a condom with three or more casual partners in this period (AOR = 1.61) were aspects associated with sexualised drug use. Less social integration (AOR = 0.76) and internalised homonegativity (AOR = 0.85) were aspects associated with a decrease of possibility of practising sexual drug use. Conclusion: Sexualised drug use is an emerging phenomenon in Chile, whose complexity needs to be studied in all its dimensions to have a complete understanding of its effect on people’s health.

Keywords: chemsex, HIV, sexualised drug use, sexually transmissible infections.


References

[1]  Instituto de Salud Pública. Resultados confirmación de infección por VIH en Chile, 2010 - 2015. Report No.: Bol ISP 2016; 6: 1–13 [in Spanish]. Santiago: Ministerio de Salud; 2016. Available online at: http://www.ispch.cl/sites/default/files/BoletinVIH-15112017A.pdf [verified 08 08 2018].

[2]  Serie Guías Clínicas MINSAL. Guía clínica Síndrome de Inmunodeficiencia Adquirida VIH/SIDA [in Spanish]. Santiago: Ministerio de Salud; 2010. Available online at: http://web.minsal.cl/sites/default/files/files/GPCVIH.pdf [verified 08 08 2018].

[3]  WHOSecond generation surveillance for HIV: the next decade. UNAIDS/WHO working group on global HIV/AIDS and STI surveillance. 2000 p. 43. Report No.: WHO/CDS/CSR/EDC/2000.5. Geneva: World Health Organization and Joint United Nations Programme on HIV/AIDS; 2000. Available online at: http://www.who.int/reproductivehealth/publications/rtis/CDS_CSR_EDC_2000_5/es/ [verified 08 08 2018].

[4]  Joint United Nations Programme on HIV/AIDS (UNAIDS). Country factsheets Chile 2017. 2018. Available online at: http://www.unaids.org/es/regionscountries/countries/chile [verified 08 08 2018].

[5]  Instituto de Salud Pública. Resultados confirmación de infección por VIH. Chile 2010–2018. Agosto 2019 p. 1–17. Reporte No8 [in Spanish]. Santiago: Ministerio de Salud; 2019. Available online at: http://www.ispch.cl/sites/default/files/BoletinVIH-final_2019.pdf [verified 10 03 2020].

[6]  Stuardo Ávila V, Fuentes Alburquenque M, Muñoz R, Lobos L, Faba A, Belmar J. Prevalence and risk factors for HIV infection in a population of homosexual, bisexual, and other men who have sex with men in the Metropolitan Region of Chile: a re-emerging health problem. AIDS Behav 2020; 24 827–38.
Prevalence and risk factors for HIV infection in a population of homosexual, bisexual, and other men who have sex with men in the Metropolitan Region of Chile: a re-emerging health problem.Crossref | GoogleScholarGoogle Scholar | 30953301PubMed |

[7]  Guimarães MDC, Kendall C, Magno L, Rocha GM, Knauth DR, Leal AF, et al. Comparing HIV risk-related behaviors between 2 RDS national samples of MSM in Brazil, 2009 and 2016 Medicine 2018; 97 S62–8.
Comparing HIV risk-related behaviors between 2 RDS national samples of MSM in Brazil, 2009 and 2016Crossref | GoogleScholarGoogle Scholar | 29912816PubMed |

[8]  Falla AM, Hofstraat SHI, Duffell E, Hahné SJM, Tavoschi L, Veldhuijzen IK. Hepatitis B/C in the countries of the EU/EEA: a systematic review of the prevalence among at-risk groups. BMC Infect Dis. December 2018. Available online at: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-018-2988-x [verified 08 08 2018].

[9]  Fernández-Dávila P, Zaragoza Lorca K. Hombres jóvenes que tienen sexo con hombres: ¿un colectivo en alto riesgo para la infección por el VIH? Gac Sanit 2011; 25 372–8.
Hombres jóvenes que tienen sexo con hombres: ¿un colectivo en alto riesgo para la infección por el VIH?Crossref | GoogleScholarGoogle Scholar | 21820764PubMed |

[10]  Somia IKA, Teeratakulpisarn N, Jeo WS, Yee IA, Pankam T, Nonenoy S, et al. Prevalence of and risk factors for anal high-risk HPV among HIV-negative and HIV-positive MSM and transgender women in three countries at South-East Asia: Medicine. 2018. Available online at: http://Insights.ovid.com/crossref?an=00005792-201803090-00043 [verified 08 08 2018].

[11]  Ndumbi P, Freidl GS, Williams CJ, Mårdh O, Varela C, Avellón A, et al. Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017. Euro Surveill 2018; 23 1700641
Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017.Crossref | GoogleScholarGoogle Scholar | 30131095PubMed |

[12]  Mitchell H, Hughes G. Recent epidemiology of sexually transmissible enteric infections in men who have sex with men Curr Opin Infect Dis 2018; 31 50–6.
Recent epidemiology of sexually transmissible enteric infections in men who have sex with menCrossref | GoogleScholarGoogle Scholar | 29251673PubMed |

[13]  Zhang X, Wang C, Hengwei W, Li X, Li D, Ruan Y, et al. Risk factors of HIV infection and prevalence of co-infections among men who have sex with men in Beijing, China AIDS 2007; 21 S53–7.
Risk factors of HIV infection and prevalence of co-infections among men who have sex with men in Beijing, ChinaCrossref | GoogleScholarGoogle Scholar | 18172392PubMed |

[14]  Koblin BA, Husnik MJ, Colfax G, Huang Y, Madison M, Mayer K, et al. Risk factors for HIV infection among men who have sex with men AIDS 2006; 20 731–9.
Risk factors for HIV infection among men who have sex with menCrossref | GoogleScholarGoogle Scholar | 16514304PubMed |

[15]  Zhang L, Zhang D, Yu B, Wang S, Liu Y, Wang J, et al. Prevalence of HIV infection and associated risk factors among men who have sex with men (MSM) in Harbin, P. R. China. PLoS ONE 2013; 8 e58440
| 24386442PubMed |

[16]  Cloete A, Simbayi LC, Kalichman SC, Strebel A, Henda N. Stigma and discrimination experiences of HIV-positive men who have sex with men in Cape Town, South Africa. AIDS Care 2008; 20 1105–10.
Stigma and discrimination experiences of HIV-positive men who have sex with men in Cape Town, South Africa.Crossref | GoogleScholarGoogle Scholar | 18608067PubMed |

[17]  Hernández-Rosete D. La otra migración. Historias de discriminación de personas que vivieron con VIH en México Salud Ment 2008; 31 253–60.

[18]  Kerr L, Kendall C, Guimarães MDC, Salani Mota R, Veras MA, Dourado I, et al. HIV prevalence among men who have sex with men in Brazil: results of the 2nd national survey using respondent-driven sampling. Medicine 2018; 97 S9–15.
HIV prevalence among men who have sex with men in Brazil: results of the 2nd national survey using respondent-driven sampling.Crossref | GoogleScholarGoogle Scholar | 29794604PubMed |

[19]  Décimo segundo estudio nacional de drogas en población general de Chile [in Spanish]. Observatorio Chileno de Drogas del Servicio nacional para la prevención y rehabilitación del Consumo de Drogas y Alcohol (SENDA). Santiago: Ministerio del Interior y Seguridad Pública; 2017. Available online at: https://www.senda.gob.cl/wp-content/uploads/media/estudios/PG/2016_Estudio_Drogas_Poblacion_General.pdf [verified 08 11 2020].

[20]  Principales resultados Estudio Cualitativo de Caracterización de la Población Consumidora de Drogas Sintéticas en la Región Metropolitana [in Spanish]. Observatorio Chileno de Drogas del Servicio Nacional para la Prevención y Rehabilitación del Consumo de Drogas y Alcohol (SENDA). Santiago: Ministerio del Interior y Seguridad Pública; 2018 Mar p. 1–3. (Apuntes de drogas). Report No.: 2. Available online at: http://www.senda.gob.cl/wp-content/uploads/2018/03/2018_apuntes02.pdf [verified 08 08 2018].

[21]  Desai M, Bourne A, Hope V, Halkitis PN. Sexualised drug use: LGTB communities and beyond. Int J Drug Policy 2018; 55 128–30.
Sexualised drug use: LGTB communities and beyond.Crossref | GoogleScholarGoogle Scholar | 29801810PubMed |

[22]  Bourne A, Reid D, Hickson F, Torres-Rueda S, Weatherburn P. Illicit drug use in sexual settings (‘chemsex’) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study: Table 1. Sex Transm Infect 2015; 91 564–8.
Illicit drug use in sexual settings (‘chemsex’) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study: Table 1.Crossref | GoogleScholarGoogle Scholar | 26163510PubMed |

[23]  Schmidt AJ, Bourne A, Weatherburn P, Reid D, Marcus U, Hickson F. Illicit drug use among gay and bisexual men in 44 cities: Findings from the European MSM Internet Survey (EMIS). Int J Drug Policy 2016; 38 4–12.
Illicit drug use among gay and bisexual men in 44 cities: Findings from the European MSM Internet Survey (EMIS).Crossref | GoogleScholarGoogle Scholar | 27788450PubMed |

[24]  Ávila R, Casero P, Cetó J, Fernández-Dávila P, Roca-Balagué S, Mora R, et al. ChemSex support. Una respuesta desde y para la comunidad LGTB [in Spanish]. Stop Sida; Nov 2017; p. 1–30. Barcelona: Stop Sida; 2017. Available online at: https://chemsex.info/wp-content/uploads/2018/02/chemsex-dossier.pdf [verified 08 08 2018].

[25]  Pakianathan M, Whittaker W, Lee M, Avery J, Green S, Nathan B, et al. Chemsex and new HIV diagnosis in gay, bisexual and other men who have sex with men attending sexual health clinics. HIV Med 2018; 19 485–90.
Chemsex and new HIV diagnosis in gay, bisexual and other men who have sex with men attending sexual health clinics.Crossref | GoogleScholarGoogle Scholar |

[26]  Fernández-Dávila P. ChemSex en España: reflexiones sobre buena praxis. Revista Multidisciplinar del Sida

[27]  Coll J, Fumaz CR. Drogas recreativas y sexo en hombres que tienen sexo con hombres: chemsex. Riesgos, problemas de salud asociados a su consumo, factores emocionales y estrategias de intervención. Rev Enf Emerg. 2016; 15 77–84.

[28]  Weatherburn P, Hickson F, Reid DS, Schink SB, Marcus U, Schmidt AJ. The EMIS Network. EMIS-2017 – The European Men-Who-Have-Sex-With-Men Internet Survey. Key findings from 50 countries. Stockholm: European Centre for Disease Prevention and Control; 2019. Stockholm, August 2019. Available online at: https://www.ecdc.europa.eu/sites/default/files/documents/European-MSM-internet-survey-2017-findings.pdf [verified 10 03 2020].

[29]  Marcus U, Hickson F, Weatherburn P, Schmidt AJ, EMIS Network Estimating the size of the MSM populations for 38 European countries by calculating the survey-surveillance discrepancies (SSD) between self-reported new HIV diagnoses from the European MSM internet survey (EMIS) and surveillance-reported HIV diagnoses among MSM in 2009. BMC Public Health 2013; 13 919
Estimating the size of the MSM populations for 38 European countries by calculating the survey-surveillance discrepancies (SSD) between self-reported new HIV diagnoses from the European MSM internet survey (EMIS) and surveillance-reported HIV diagnoses among MSM in 2009.Crossref | GoogleScholarGoogle Scholar | 24088198PubMed |

[30]  Campo-Arias A, Barros-Bermudez JA, Rueda-Jaimes GE. Propiedades psicométricas del cuestionario CAGE para consumo abusivo de alcohol: Resultados de tres análisis. Rev Colomb Psiquiatr 2009; 38 294–303.

[31]  Moreira JA, Moleiro C, Aguiar S, Bernardes S. Questionário de apoio social (versão portuguesa do “Social Support Questionnaire”): Tradução e estudos de validade. [in Portugese] Revista Iberoamericana de Diagnóstico y Evaluación - e Avaliação Psicológica RIDEP 1998; 13 55–70.

[32]  Smolenski DJ, Diamond PM, Ross MW, Rosser BRS. Revision, criterion validity, and multigroup assessment of the reactions to homosexuality scale. J Pers Assess 2010; 92 568–76.
Revision, criterion validity, and multigroup assessment of the reactions to homosexuality scale.Crossref | GoogleScholarGoogle Scholar | 20954058PubMed |

[33]  Pan American Health Organization. Drug use epidemiology in Latin America and the Caribbean: a public health approach. Washington D.C.: Pan American Health Organization; 2009. Available online at: http://new.paho.org/hq/dmdocuments/2009/drug_use_epidemiology_web.pdf [verified 08 08 2018].

[34]  Fernandez-Rollan L, Stuardo Ávila V, Strömdahl S. Correlates of condomless anal intercourse among men who have sex with men in Santiago de Chile. Int J STD AIDS 2018; 30 095646241880292
| 30392462PubMed |

[35]  Logan L, Fakoya I, Howarth A, Murphy G, Johnson AM, Rodger AJ, et al. Combination prevention and HIV: a cross-sectional community survey of gay and bisexual men in London, October to December 2016. Euro Surveill 2019; 24 1800312
Combination prevention and HIV: a cross-sectional community survey of gay and bisexual men in London, October to December 2016.Crossref | GoogleScholarGoogle Scholar | 31241039PubMed |

[36]  Stevens O, Moncrieff M, Gafos M. Chemsex-related drug use and its association with health outcomes in men who have sex with men: a cross-sectional analysis of Antidote clinic service data. Sex Transm Infect. 2020; 96 124–30.
Chemsex-related drug use and its association with health outcomes in men who have sex with men: a cross-sectional analysis of Antidote clinic service data.Crossref | GoogleScholarGoogle Scholar | 31171592PubMed |

[37]  Maxwell S, Shahmanesh M, Gafos M. Chemsex behaviours among men who have sex with men: a systematic review of the literature. Int J Drug Policy 2019; 63 74–89.
Chemsex behaviours among men who have sex with men: a systematic review of the literature.Crossref | GoogleScholarGoogle Scholar | 30513473PubMed |

[38]  González-Baeza A, Dolengevich-Segal H, Pérez-Valero I, Cabello A, Téllez MJ, Sanz J, et al. Sexualized drug use (chemsex) is associated with high-risk sexual behaviors and sexually transmitted infections in HIV-positive men who have sex with men: data from the U-SEX GESIDA 9416 study. AIDS Patient Care STDS 2018; 32 112–8.
Sexualized drug use (chemsex) is associated with high-risk sexual behaviors and sexually transmitted infections in HIV-positive men who have sex with men: data from the U-SEX GESIDA 9416 study.Crossref | GoogleScholarGoogle Scholar | 29620925PubMed |

[39]  Deimel D, Stöver H, Hößelbarth S, Dichtl A, Graf N, Gebhardt V. Drug use and health behaviour among German men who have sex with men: results of a qualitative, multi-centre study. Harm Reduct J 2016; 13 36
Drug use and health behaviour among German men who have sex with men: results of a qualitative, multi-centre study.Crossref | GoogleScholarGoogle Scholar | 27938393PubMed |

[40]  Race K, Lea T, Murphy D, Pienaar K. The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men. Sex Health 2017; 14 42–50.
The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 27712616PubMed |

[41]  Barrientos J, Cárdenas M. Homofobia y Calidad de Vida de Gay y Lesbianas: Una Mirada Psicosocial. Psykhe 2013; 22 3–14.
Homofobia y Calidad de Vida de Gay y Lesbianas: Una Mirada Psicosocial.Crossref | GoogleScholarGoogle Scholar |

[42]  Cárdenas M, Barrientos J. Actitudes explícitas e implícitas hacia los hombres homosexuales en una muestra de estudiantes universitarios en Chile. Psykhe 2008; 17 17–25.
Actitudes explícitas e implícitas hacia los hombres homosexuales en una muestra de estudiantes universitarios en Chile.Crossref | GoogleScholarGoogle Scholar |