Harm reduction and multidisciplinary consultations for gay, bisexual, and other men who have sex with men practising chemsex based in a French infectious disease unit: patients’ characteristics and perceptions

Alexandre Aslan; David Lessard; Bertrand Lebouché; Iris Bichard; Bénédicte Loze; Eleonore Laussat; Jean-Michel Molina

doi:10.1071/SH23165

RESEARCH ARTICLE (Open Access)

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Harm reduction and multidisciplinary consultations for gay, bisexual, and other men who have sex with men practising chemsex based in a French infectious disease unit: patients’ characteristics and perceptions

Alexandre Aslan ^A , David Lessard

^B ^* , Bertrand Lebouché ^B ^C ^D , Iris Bichard ^A , Bénédicte Loze ^A , Eleonore Laussat ^A and Jean-Michel Molina ^A ^E

+ Author Affiliations

- Author Affiliations

^A Unité des maladies infectieuses et tropicales, Hôpital Saint-Louis (Hopitaux de Paris - Assistance Publique de Paris), Paris, France.

^B Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.

^C Chronic and Viral Illness Service, Division of Infectious Disease, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada.

^D Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.

^E Université Paris Cité, Paris, France.

^* Correspondence to: david.lessard2@mail.mcgill.ca

Handling Editor: Eric Chow

Sexual Health 21, SH23165 https://doi.org/10.1071/SH23165

Submitted: 16 September 2023 Accepted: 19 February 2024 Published: 12 March 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

Chemsex, a type of sexualised drug use, is expanding among gay, bisexual, and other men who have sex with men (GBMSM), with physical and mental health risks. Health-seeking behaviours of GBMSM practising chemsex is not clear.

Methods

Harm reduction (HR) consultations for GBMSM engaging in chemsex and seeking comprehensive services including HR were offered in a Parisian infectious disease unit. From December 2021 to January 2022, HR consultation patients completed an online survey on their consumption, health, used services, and perspective on consultations. We generated descriptive statistics, and tested (χ²) the relationship between reporting a specialised follow-up and perceived usefulness of intervention.

Results

Of 172 patients, a total of 96 GBMSM (55.2%) completed the survey. Most ever consumed substance was 3-methylmethcathinone (3MMC; 92/96; 95.8%). Before consultations, about half consumed at least once a week (50/96; 52%), most reported negative impacts of chemsex on their social (60/96, 62.5%), professional (56/96, 58.3%), intimate (53/96; 55.21%), or sexual life (52/96; 54.17%). Also, more than two-thirds (n = 57; 69.38%) had received a follow-up in specialised services: one-third had been followed in addictology (28/96, 29.2%) and/or psychotherapy (32/96, 33.3%), and one-fourth (24/96, 25.0%) had used emergency services. After consultations, three-quarters perceived the intervention as useful (n = 74; 77.08%); we found no significant relationship with receiving a specialised follow-up; and most were satisfied with professionals’ listening (90/96; 93.8%), and reported reduced risks (80/96; 83.3%).

Discussion

Multidisciplinary HR, preventive, diagnostical, and therapeutic sexological and psychiatric interventions are greatly needed among GBMSM practising chemsex. HR interventions accessible in services already attended by GBMSM are a valuable option.

Keywords: chemsex, evaluation and quality improvement, France, harm reduction, men who have sex with men, sexual behaviour, sexualised substance use, substance-related disorders.

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