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Chemsex on the rise among MSM; needs to be integrated in health care services

Drug use during sex – or chemsex – is on the rise among men who have sex with men. As such, substance use screening at HIV diagnosis and at every routine visit should be integrated into clinical practice for MSM.

Photo by @makvasane from Unsplash.com

Drug use during sex – or chemsex – is on the rise among men who have sex with men (MSM), according to a study coming out of Thailand, where those who reported injecting methamphetamine use increased by 16% from 2009 to 2019. Incidentally, chemsex has been strongly associated with getting other sexually transmitted infections (STIs), including hepatitis C and HIV.

The study – “Rising substance use linked to STI and HCV in Thai MSM after acute HIV infection” – was done by Camilla Muccini et al, and presented at the 11th IAS Conference on HIV Science.

For this study, 604 participants with substance use data were considered, with a median age of 26 years. Over 90 per cent (93.5%) were MSM.

The study found:

  • Alcohol consumption in 83.3% of the participants, and risky alcohol use in 38.1%
  • Recreational drug use in 46.9%

Specifically, from 2017 to 2019, rising trends were observed for risky alcohol use, any recreational drug use, poppers, and methamphetamine injection. Newer recruits to the study (n=137) “were more likely than those enrolled between 2009 and 2016 to report methamphetamine use (30% vs. 19%) and injection of methamphetamine (20% vs. 3.9%.”

Also, participants who used recreational drugs were more likely to have hepatitis C coinfection, syphilis coinfection, gonorrhea, chlamydia, and group sex. Methamphetamine injection was highly associated with group sex.

Since recreational drugs are strongly associated with the acquisition of STIs, “substance use screening at diagnosis and at every routine visit should be integrated into clinical practice for MSM with HIV,” said Muccini. And “for those who screen positive, drug treatment and counseling for harm reduction could potentially mitigate the adverse clinical outcomes.”

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