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Johannes M Hugo, Kevin B Rebe, Evan Tsouroulis, Anthony Manion, Glenn de Swart, Helen Struthers, James A McIntyre
Chemsex is the colloquial term used for a specific pattern of drug use that is increasingly common among men who have sex with men (MSM) globally. The recreational substances employed are used specifically in a sexualized context. The reasons for chemsex among MSM are complex. The Anova Health Institute (Anova) provided harm-reduction services in Cape Town, South Africa in 2013 and 2014. This project, known as Tikking the Boxes had two objectives: first to provide direct harm-reduction services to drug-using MSM in Cape Town, South Africa, and second, to reduce HIV and hepatitis B and C transmission among this population...
March 21, 2018: Sexual Health
Oliver Stevens, Jamie I Forrest
Chemsex is a growing public health concern in urban centres, and few interventions exist to mitigate the significant sexual, drug-related, and social harms potentially experienced by people who participate in chemsex. In much of the world, these immediate harms are further compounded by the criminalisation and stigmatisation of both homosexuality and drug use, preventing participants fully engaging with treatment services or provision of health care. Gay, bisexual and other men who have sex with men participating in chemsex fall between the traditional definitions of key populations and consequently are poorly provided for by existing drug and sexual health frameworks...
March 19, 2018: Sexual Health
Hao-Hsin Wu, Yi-Ting Shen, Chien-Shun Chiou, Chi-Tai Fang, Yi-Chun Lo
OBJECTIVES: Outbreaks of shigellosis among men who have sex with men (MSM) have been reported since the late 1990s. HIV infection is an important risk factor. Since 2014, the global shigellosis epidemic has intensified. Whether chemsex (the use of crystal methamphetamine, γ-hydroxybutyrate or mephedrone to enhance sex) is a new risk factor has not been previously examined. METHODS: We conducted a population-based, case-control study in Taiwan. Acute shigellosis cases diagnosed during the 2015 outbreak among MSM living with HIV were compared with those without shigellosis...
March 13, 2018: Sexually Transmitted Infections
Mohamed A Hammoud, Stefanie Vaccher, Fengyi Jin, Adam Bourne, Bridget Haire, Lisa Maher, Toby Lea, Garrett Prestage
INTRODUCTION: Gay and bisexual men (GBM) often use illicit drugs to enhance sexual pleasure, commonly referred to as 'chemsex' or 'party n play'. In particular, the use of methamphetamine and Viagra™, and other erectile dysfunction medications, both together and separately are strongly predictive of subsequent HIV infection. Truvada™, as pre-exposure prophylaxis (PrEP), virtually eliminates HIV transmission during condomless anal intercourse (CLAI). HIV-negative GBM in intensive sex partying networks may be adding PrEP to their drug regimen to actively reduce the possibility of HIV transmission during chemsex...
March 8, 2018: International Journal on Drug Policy
Agnese Comelli, Ilaria Izzo, Salvatore Casari, Angiola Spinetti, Alberto Bergamasco, Francesco Castelli
Since June 2016, an outbreak of hepatitis A has been reported in Europe. Here we report the HAV outbreak in Brescia (Northern Italy) from July 2016 to July 2017. We actively recorded all HAV cases defined by detection of HAV IgM antibodies in serum. Data on sexual behaviour, travel attitudes, concomitant sexually transmitted diseases (STDs), clinical presentation and laboratory results were collected. Forty-two confirmed cases were recorded: 25 (60%) were MSM and reported sexual contact at risk of STDs. Compared to 2015 and the first half of 2016, when only three hepatitis A cases were recorded, in the 12 months in question the number of cases rose 14-fold...
March 1, 2018: Le Infezioni in Medicina
Ellen Heinsbroek, Rachel Glass, Claire Edmundson, Vivian Hope, Monica Desai
BACKGROUND: Higher levels of drug use have been reported in lesbian, gay, bisexual and transgender (LGBT) communities, some of which can be explained by sexualised drug use, including 'chemsex'; the use of drugs before or during planned sexual activity to sustain, enhance, disinhibit or facilitate sex. We explored injecting and non-injecting drug use by sexual behaviour among people who inject drugs (PWID) in England, Wales and Northern Ireland. METHODS: Data were used from an unlinked-anonymous survey of PWID (2013-2016), where participants recruited through services self-completed a questionnaire...
March 6, 2018: International Journal on Drug Policy
H Wiggins, D Ogaz, H Mebrahtu, A Sullivan, O Bowden-Jones, N Field, G Hughes
BACKGROUND/INTRODUCTION: Chemsex amongst men who have sex with men (MSM) is well documented in major cities within the United Kingdom (UK), but few data from less urban areas exist. We undertook a survey of sexual health clinic (SHC) healthcare workers (HCWs) to explore demand for and availability of chemsex services to understand training needs and inform service planning. METHODS: An online survey was distributed to HCWs in all SHCs across the UK. For English clinics, we explored associations between responses and geo-demographic region using national surveillance data and population statistics...
February 26, 2018: International Journal on Drug Policy
Susanne Drückler, Martijn S van Rooijen, Henry J C de Vries
OBJECTIVES: Chemsex (i.e., drug use during sex) is practiced by some men who have sex with men (MSM) and is associated with high-risk behavior. In a cross-sectional study at the sexually transmitted infection (STI) clinic of Amsterdam, we explored chemsex practices, risk behavior, and STI prevalence. METHOD: A survey on chemsex (γ-hydroxybutyrate, crystal methamphetamine, and/or mephedrone) was offered to clinic clients during routine STI screening and to Amsterdam users of a gay online dating app...
November 15, 2017: Sexually Transmitted Diseases
Magdalena Rosińska, Lorenzo Gios, Christiana Nöstlinger, Wim Vanden Berghe, Ulrich Marcus, Susanne Schink, Nigel Sherriff, Anna-Marie Jones, Cinta Folch, Sonia Dias, Inga Velicko, Massimo Mirandola
BACKGROUND: Substance use has been consistently reported to be more prevalent amongst Men who have Sex with Men (MSM) compared to the general population. Substance use, in particular polydrug use, has been found to be influenced by social and contextual factors and to increase the risk of unprotected intercourse among MSM. The objective of this analysis was to investigate the prevalence and predictors of drug use during a sexual encounter and to identify specific prevention needs. METHODS/DESIGN: A multi-site bio-behavioural cross-sectional survey was implemented in 13 European cities, targeting MSM and using Time-Location Sampling and Respondent-Driven Sampling methods Multivariable multi-level logistic random-intercept model (random effect of study site) was estimated to identify factors associated with the use of alcohol, cannabis, party drugs, sexual performance enhancement drugs and chemsex drugs...
February 2, 2018: International Journal on Drug Policy
Mark O'Reilly
This case discusses a gay male participating in sexualised drug use. It raises several important issues and strengthens the case for routine screening for sexualised drug use in men who have sex with men so that healthcare professionals can provide better-informed and higher-quality health care to this population.
February 6, 2018: Sexual Health
Ingrid Bakker, Leon Knoops
In response to the apparent rise in chemsex in the Netherlands Mainline Foundation interviewed 27 MSM about their crystal meth use and/or experience with injecting in a sexual context. These men were interviewed about their motivation for methamphetamine use, their sexual risk-taking behaviour, methods and context of their drug use, and their information- and care needs. In 2015 this resulted in the status report Tina and Slamming: MSM, Crystal Meth Use and Intravenous Drug Use in a Sexual Context. Following the publication of this report Mainline foundation has been offering harm-reduction intervention for MSM and promoting the development of a continuum of care by building networks, training professionals and investing in advocacy...
February 6, 2018: Sexual Health
G J Melendez-Torres, Adam Bourne, David Reid, Ford Hickson, Chris Bonell, Peter Weatherburn
BACKGROUND: Analysis of specific drug use patterns in men who have sex with men (MSM) is important in targeting HIV prevention and harm reduction interventions and in developing a fuller picture of drug use in context beyond consideration of use of specific drugs in isolation. OBJECTIVES: We sought to develop a typology of recent drug use in MSM, and to explore how distribution of MSM across the classes in this typology differs by socio-sexual characteristics. METHODS: We examined last-year drug use reported by 16,814 MSM as part of a cross-sectional, internet-based survey of MSM living in the UK for which data were collected in late summer 2014...
February 2, 2018: International Journal on Drug Policy
Marie Suzan-Monti, Laurent Cotte, Lisa Fressard, Eric Cua, Catherine Capitant, Laurence Meyer, Gilles Pialoux, Jean-Michel Molina, Bruno Spire
OBJECTIVES: Partner notification (PN) is a useful public health approach to enhance targeted testing of people at high risk of HIV and other STIs, and subsequent linkage to care for those diagnosed. In France, no specific PN guidelines exist and information about current practices is scarce. We used the ANRS-IPERGAY PrEP trial to investigate PN in HIV-negative men who have sex with men (MSM) reporting a bacterial STI. METHODS: This substudy included 275 participants who completed a specific online PN questionnaire during the open-label extension study of the ANRS-Intervention Préventive de l'Exposition aux Risques avec et pour les Gays (IPERGAY) trial...
January 29, 2018: Sexually Transmitted Infections
E L Pufall, M Kall, M Shahmanesh, A Nardone, R Gilson, V Delpech, H Ward
OBJECTIVES: The incidence of sexually transmitted infections (STIs) 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. METHODS: 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...
January 24, 2018: HIV Medicine
David Redondo Domínguez, Luis Picazo, María Luisa Docavo Barrenechea-Moxo, Juan González Del Castillo
Leter to the editor.
January 15, 2018: Adicciones
Monty Moncrieff
The use of drugs in sexual settings among gay men (colloquially referred to as 'chemsex') was first observed in services supporting gay men in London in the late 2000s. A decade on and it now features as a policy issue in the UK Government's latest Drug Strategy, with several actions to support a health system response. However, reaching this point has been a slow and challenging process and much remains to be done to facilitate an environment in which evidence-based chemsex interventions can be delivered. With a view to informing the development of policies and services in other contexts, this case report examines the initiatives that have driven a response to chemsex and contributed to policy development in England and highlights remaining challenges to effective service provision...
January 11, 2018: Sexual Health
Ford Hickson
Sexual sessions between men, organised through mobile technologies and combined with stimulants intended to extend and intensify the session have been reified into the phenomena of 'chemsex'. Understanding chemsex requires multiple levels of analysis and interpretation. This paper considers chemsex through the lens of edgework, a sociological category for voluntary risk taking identified in 1990 by Stephen Lyng. Edgework activities involve a clear and present danger to the self, intense emotions and sensations and an opportunity to exercise specialist skills...
January 11, 2018: Sexual Health
Holly Mitchell, Gwenda Hughes
PURPOSE OF REVIEW: Sexual transmission of enteric pathogens in men who have sex with men (MSM) has been described since the 1970s. Recently, an increasing number of enteric infection outbreaks have been reported in MSM. This article summarizes recent outbreaks and discusses the key issues for prevention and control. RECENT FINDINGS: Sexually transmissible enteric infections (STEIs) can spread rapidly and internationally within highly connected MSM populations and are often associated with antimicrobial resistance (AMR)...
December 14, 2017: Current Opinion in Infectious Diseases
Ronan W Glynn, Niamh Byrne, Siobhan O'Dea, Adam Shanley, Mary Codd, Eamon Keenan, Mary Ward, Derval Igoe, Susan Clarke
BACKGROUND: Drug use for or during sex ('chemsex') among MSM has caused concern, because of the direct effects of the drugs themselves, and because of an increased risk of transmission of sexually transmitted infections (STIs). This study aimed to assess the prevalence of chemsex, associated behaviours and STIs among attendees at Ireland's only MSM-specific sexual health clinic in Dublin over a six week period in 2016. METHODS: The questionnaire collected demographic data, information on sexuality and sexual practice, self-reported history of treatment for STIs, and chemsex use...
February 2018: International Journal on Drug Policy
John M Corkery, Barbara Loi, Hugh Claridge, Christine Goodair, Fabrizio Schifano
Background Misuse of gammahydroxybutrate (GHB) and its prodrugs gammabutyrolactone (GBL) and 1,4 butanediol (1,4-BD) has increased greatly since the early 1990s, particularly amongst lesbian, gay, bisexual and transgender (LGBT) individuals in recreational and sexual settings, e.g. 'chemsex'. Objective and method This paper presents an overview of GHB pharmacotoxicology and provides analyses of cases in the LGBT population associated with use of these substances extracted from the UK's National Programme on Substance Abuse Deaths database, to which notification is voluntary...
November 8, 2017: Current Drug Metabolism
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