Comparing the impact of sexualised drug use with and without chemsex on sexual behaviours among men who have sex with men in China: a national multi-site cross-sectional study

Jiajun Sun; Bingyang She; Phyu M. Latt; Jason J. Ong; Xianglong Xu; Yining Bao; Christopher K. Fairley; Lin Zhang; Weiming Tang; Lei Zhang

doi:10.1071/SH24173

RESEARCH ARTICLE (Open Access)

Previous Contents Vol 21(6)

Comparing the impact of sexualised drug use with and without chemsex on sexual behaviours among men who have sex with men in China: a national multi-site cross-sectional study

Jiajun Sun

^A ^B , Bingyang She ^C , Phyu M. Latt ^A ^B , Jason J. Ong

^A ^B , Xianglong Xu ^A ^B ^D , Yining Bao ^A ^B ^C , Christopher K. Fairley

^A ^B , Lin Zhang ^E ^F , Weiming Tang

^G ^H ^* and Lei Zhang

^A ^B ^C ^*

+ Author Affiliations

- Author Affiliations

^A Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic, Australia.

^B School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia.

^C China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Centre, Xi’an, Shaanxi 710061, China.

^D School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

^E Suzhou Industrial Park Monash Research Institute of Science and Technology, Suzhou, China.

^F School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Vic, Australia.

^G Dermatology Hospital of Southern Medical University, Guangzhou, China.

^H Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

^* Correspondence to: weiming_tang@med.unc.edu, lei.zhang1@monash.edu

Handling Editor: Kevan Wylie

Sexual Health 21, SH24173 https://doi.org/10.1071/SH24173

Submitted: 1 September 2024 Accepted: 19 November 2024 Published: 12 December 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

Sexualised drug use (SDU) is common in men who have sex with men (MSM). Chemsex, a form of psychoactive SDU, is a strong risk factor for sexually transmitted infections (STIs). We investigated the associations of SDU and chemsex with the sexual behaviours in Chinese MSM.

Methods

From 23 March 2022 to 22 April 2022, we recruited participants (male, >18 years old) via WeChat across five Chinese cities to an online cross-sectional survey on sexual behaviour preferences, pre-exposure prophylaxis, SDU, and chemsex. One-way ANOVA and chi-squared tests were used to compare sexual behaviour patterns across the groups.

Results

We included the responses from 796 eligible participants, who were aged 18–70 years, and mostly single. Three groups of participants were identified, the largest was the ‘non-SDU group’ (71.7%), followed by the ‘SDU without chemsex’ group (19.7%), and the ‘chemsex’ group (8.5%). Poppers (8.4%) were the most used drugs in the ‘chemsex’ group. The ‘chemsex’ group also had the highest number of sexual partners, and reported the highest frequency of self-masturbation (38.2%). The ‘chemsex’ group also exhibited the highest Shannon diversity index value of 2.32 (P = 0.03), indicating a greater diversity of sexual acts. For sequential sex act pairs, the ‘chemsex’ group was more likely to self-masturbate than perform receptive oral sex, perform receptive oral sex than self-masturbate, being masturbated or perform receptive oral sex than being rimmed by another man.

Conclusion

Our findings identify the urgent need for targeted HIV/STI interventions for MSM who practice chemsex.

Keywords: chemsex, cross-sectional study, men who have sex with men, sequential sexual acts, sexual behaviours, sexual diversity, sexual transmitted infection, sexualised drug use.

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