City Research Online

Sexualized drug use ("chemsex') and high-risk sexual behaviours in HIV-positive men who have sex with men

Pufall, E. L., Kall, M., Shahmanesh, M. , Nardone, A., Gilson, R., Delpech, V., Ward, H., Grp, Positive Voices Study & Elford, J. (2018). Sexualized drug use ("chemsex') and high-risk sexual behaviours in HIV-positive men who have sex with men. HIV Medicine, 19(4), pp. 261-270. doi: 10.1111/hiv.12574


The incidence of sexually transmitted infections (STI s) and HIV infection remains high in gay, bisexual, and other men who have sex with men (MSM ) in the UK , and sexualized drug use (“chemsex”) and injecting drug use (“slamsex”) may play a part in this. We aimed to characterize HIV ‐positive MSM engaging in chemsex/slamsex and to assess the associations with self‐reported STI diagnoses and sexual behaviours.

Data from a 2014 survey of people attending HIV clinics in England and Wales were linked to clinical data from national HIV surveillance records and weighted to be nationally representative. Multivariable logistic regression assessed the associations of chemsex and slamsex with self‐reported unprotected anal intercourse (UAI ), serodiscordant UAI (sdUAI ) (i.e. UAI with an HIV ‐negative or unknown HIV status partner), sdUAI with a detectable viral load (>50 HIV ‐1 RNA copies/mL ), hepatitis C, and bacterial STI s.

In the previous year, 29.5% of 392 sexually active participants engaged in chemsex, and 10.1% in slamsex. Chemsex was significantly associated with increased odds of UAI [adjusted odds ratio (AOR ) 5.73; P < 0.001], sdUAI (AOR 2.34; P < 0.05), sdUAI with a detectable viral load (AOR 3.86; P < 0.01), hepatitis C (AOR 6.58; P < 0.01), and bacterial STI diagnosis (AOR 2.65; P < 0.01). Slamsex was associated with increased odds of UAI (AOR 6.11; P < 0.05), hepatitis C (AOR 9.39; P < 0.001), and bacterial STI diagnosis (AOR 6.11; P < 0.001).

Three in ten sexually active HIV ‐positive MSM engaged in chemsex in the past year, which was positively associated with self‐reported depression/anxiety, smoking, nonsexual drug use, risky sexual behaviours, STI s, and hepatitis C. Chemsex may therefore play a role in the ongoing HIV and STI epidemics in the UK.

Publication Type: Article
Additional Information: © 2018 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
Publisher Keywords: hepatitis C, HIV transmission, men who have sex with men, recreational drugs, sexually transmitted infections
Subjects: H Social Sciences > HN Social history and conditions. Social problems. Social reform
Q Science > QD Chemistry
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: School of Health & Psychological Sciences > Healthcare Services Research & Management
Text - Published Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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