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Scheibein F, Wells J, Henriques S, Van Hout MC. "Slam Sex" - Sexualized Injecting Drug Use ("SIDU") Amongst Men Who Have Sex with Men (MSM)-A Scoping Review. JOURNAL OF HOMOSEXUALITY 2021; 68:2344-2358. [PMID: 32875954 DOI: 10.1080/00918369.2020.1804258] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sexualized injecting drug use ("SIDU") is a phenomenon associated with a wide array of high-risk injecting and sex-related practices. This scoping review establishes what is known about MSM and SIDU to assess implications for health care and policy. Characteristics of MSM for "SIDU" may include being on anti-retroviral treatment and urban residency with drivers being challenging social taboos; a search for intimacy; convenience of administration; relationship breakdown and increased restrictions in clubs and saunas. Attraction for use appears to be enhancement or prolongation of sexual experiences/pleasure; intimacy and the facilitation of a range of potentially "unsafe" sexual activity. Traditional services are ill-equipped to address "SIDU" because of a lack of knowledge of practices, lack of associated vocabulary, and a failure to integrate sexual health with drug services. For effective responses, these issues need to be addressed.
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Affiliation(s)
- Florian Scheibein
- School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - John Wells
- School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - Susana Henriques
- Centre for Research and Studies in Sociology, University Institute of Lisbon (Iscte-iul)/centro de Investigação e Estudos de Sociologia (CIES-IUL) and Universidade Aberta, Lisbon, Portugal
| | - Marie Claire Van Hout
- Public Health Institute, Liverpool John Moores, Liverpool John Moores, Liverpool, UK
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Lafortune D, Blais M, Miller G, Dion L, Lalonde F, Dargis L. Psychological and Interpersonal Factors Associated with Sexualized Drug Use Among Men Who Have Sex with Men: A Mixed-Methods Systematic Review. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:427-460. [PMID: 33108566 DOI: 10.1007/s10508-020-01741-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 05/05/2020] [Accepted: 05/12/2020] [Indexed: 06/11/2023]
Abstract
Chemsex-the use of specific drugs during planned sexual activity to sustain or enhance sexual functioning (Bourne et al., 2015)-is widely reported as a major public health issue among gay, bisexual, and other men who have sex with men (GBM) in Western countries. Considering current evidence surrounding Chemsex, we conducted a mixed-methods systematic review regarding psychological and interpersonal factors associated with Chemsex behaviors among GBM. Publications covering Chemsex and psychological or social variables were eligible. Theoretical papers and studies solely presenting physical health outcomes were excluded. 35 English papers published between January 2008 and June 2019 were identified through PubMed, Scopus, and PsycINFO. We performed a parallel-results convergent synthesis (Hong, Pluye, Bujold, & Wassef, 2017) on results extracted from qualitative and quantitative studies comprising the final corpus. Qualitative data suggest that six mechanisms promote Chemsex-related behaviors: dealing with painful emotions or stressful events; normalization and risk minimization of sexualized drug use; giving into interpersonal pressure or fulfilling desire for community belonging; increasing intimacy or connectedness; enhancing sexual performance and functioning; lessening interpersonal and sexual inhibitions. In quantitative reports, six variable categories emerged: sexual control and self-efficacy; sexual functioning; mental health; attitudes toward substance use; life stressors and internalized stressors; and identification with sexual identities or scenes. This review summarizes key psychological and interpersonal correlates of Chemsex among GBM. Further research is needed to replicate current findings and explore new hypotheses across multiple GBM sociodemographic groups and cultural contexts, following best practices in sampling for hard-to-reach populations.
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Affiliation(s)
- David Lafortune
- Département de sexologie, Université du Québec à Montréal, 455, René-Lévesque Est, Montréal, QC, H2L 4Y2, Canada.
| | - Martin Blais
- Département de sexologie, Université du Québec à Montréal, 455, René-Lévesque Est, Montréal, QC, H2L 4Y2, Canada
| | - Geneviève Miller
- Département de sexologie, Université du Québec à Montréal, 455, René-Lévesque Est, Montréal, QC, H2L 4Y2, Canada
| | - Laurence Dion
- Département de sexologie, Université du Québec à Montréal, 455, René-Lévesque Est, Montréal, QC, H2L 4Y2, Canada
| | - Frédérick Lalonde
- Département de sexologie, Université du Québec à Montréal, 455, René-Lévesque Est, Montréal, QC, H2L 4Y2, Canada
| | - Luc Dargis
- Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada
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Tomkins A, George R, Kliner M. Sexualised drug taking among men who have sex with men: a systematic review. Perspect Public Health 2018; 139:23-33. [PMID: 29846139 DOI: 10.1177/1757913918778872] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIMS: Sexualised drug taking is increasingly reported on national and international levels. We aim to review existing evidence of the relationship between recreational drug use (RDU) and sexual intercourse among men who have sex with men (MSM). METHODS: We reviewed published abstracts and full articles identified from Cochrane, MEDLINE and Embase databases from November 2010 to 2017. We included any existing studies investigating RDU in MSM and at least one of the following: high-risk sexual practices, sexually transmitted infections (STIs) or barriers to accessing specialist support. RESULTS: In total, 112 studies were included. Of them, 38 studies specifically reported the prevalence of chemsex-related drug use. Links with sexualised drug taking and high-risk sexual practices including condomless sex and group sex were reported by several studies. Recreational drug use in the sexual setting appears linked to the acquisition of STIs, including hepatitis C, syphilis and gonorrhoea. Reports of adverse mental health outcomes are increasingly described, with several studies documenting chemsex-related inpatient admission. A paucity of research addressing barriers to those accessing specialist drug support services was identified. CONCLUSION: This review demonstrates the complex interplay between recreational drug use, high-risk sexual practices and STIs. It identifies the description of adverse mental health outcomes in the chemsex setting, thus highlighting the need for a multidisciplinary approach across specialties in the management of those adversely affected. Finally, it illuminates the need for future research into perceived barriers of those who require access to support services to ensure timely and comprehensive support provision.
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Affiliation(s)
- Andrew Tomkins
- Manchester University Hospitals NHS Foundation Trust, The Hathersage Centre, Manchester M13 9WL, UK.,The Northern Integrated Contraception, Sexual Health & HIV Service, Manchester, UK
| | - Ryan George
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Merav Kliner
- Public Health England North West, Manchester, UK
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Peters J, Cresswell F, Amor L, Cole K, Dean G, Didelot X, De Silva D, Eyre DW, Paul J. Whole genome sequencing of Neisseria gonorrhoeae reveals transmission clusters involving patients of mixed HIV serostatus. Sex Transm Infect 2017; 94:138-143. [PMID: 29021406 DOI: 10.1136/sextrans-2017-053198] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 08/31/2017] [Accepted: 09/07/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Prevention and control of gonorrhoea depends on understanding the nature of sexual networks and risk factors for infection. We aimed to use high-resolution typing (whole genome sequencing (WGS)) of Neisseria gonorrhoeae isolates plus patient questionnaire data to gain insights into transmission patterns in a high prevalence setting. METHODS During a 9-month period (July 2014-March 2015), patients diagnosed with gonorrhoea attending sexual health service in Brighton, UK, were invited to provide anonymised detailed information by questionnaire about risk factors for infection. Questionnaire data plus WGS data from cultured isolates were analysed to yield information about sexual networks and risk factors for infection. RESULTS 104/149 individuals who consented to participate in the study were culture positive. 97/104 (93%) were male. 80 self-reported to be men who have sex with men (MSM). 35/104 (34%) of patients were HIV positive. 51/104 (49%) individuals reported using geosocial networking applications to facilitate contact. Sex under the influence of drugs was reported by 16/34 (46%) of HIV-positive MSM, 17/41 (41%) of HIV-negative MSM and 5/15 (31%) of heterosexuals. WGS data were available for 100 isolates from 83 patients. 55 isolates (66%) belonged to genetically related subtypes involving one or more patients, who could be plausibly linked through recent direct or indirect transmission. Four transmission clusters containing 3-12 individuals were composed of MSM of mixed HIV serostatus. CONCLUSIONS We show that data obtained from WGS of N. gonorrhoeae and enhanced epidemiological data obtained from patient questionnaires are mutually supportive and reveal insights into sexual networks. Our findings suggest that serosorting may have declined as a practice and indicate the importance of designing public health interventions that target infection risks associated with recreational drug use and contact made using geosocial networking applications.
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Affiliation(s)
- Joanna Peters
- Department of Microbiology, Public Health England Collaborative Centre, Royal Sussex County Hospital, Brighton, UK.,Department of Microbiology and Infection, Royal Sussex County Hospital, Brighton, UK
| | - Fiona Cresswell
- Department of HIV and Sexual Health, Claude Nicol Centre, Royal Sussex County Hospital, Brighton, UK
| | - Lauren Amor
- Brighton and Sussex Medical School, Brighton, UK
| | - Kevin Cole
- Department of Microbiology, Public Health England Collaborative Centre, Royal Sussex County Hospital, Brighton, UK.,Department of Microbiology and Infection, Royal Sussex County Hospital, Brighton, UK
| | - Gillian Dean
- Department of HIV and Sexual Health, Claude Nicol Centre, Royal Sussex County Hospital, Brighton, UK
| | - Xavier Didelot
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Dilrini De Silva
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - David W Eyre
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - John Paul
- Department of Microbiology, Public Health England Collaborative Centre, Royal Sussex County Hospital, Brighton, UK.,Department of Microbiology and Infection, Royal Sussex County Hospital, Brighton, UK
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Kalichman SC, Price D, Eaton LA, Burnham K, Sullivan M, Finneran S, Cornelius T, Allen A. Diminishing Perceived Threat of AIDS and Increasing Sexual Risks of HIV Among Men Who Have Sex with Men, 1997-2015. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:895-902. [PMID: 28168543 PMCID: PMC5967889 DOI: 10.1007/s10508-016-0934-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 11/13/2016] [Accepted: 12/28/2016] [Indexed: 05/15/2023]
Abstract
Community-wide awareness that antiretroviral therapies (ART) provides protection against HIV has the potential to increase perceived safety and thereby increase condomless anal sex among men who have sex with men (MSM). Furthermore, reductions in condom use can increase exposure to sexually transmitted infections, which in turn can reduce the protective effects of ART on HIV transmission. The current study extends previous community-based behavioral surveillance research on beliefs regarding use of ART for HIV prevention and sexual practices among MSM. Anonymous cross-sectional community surveys were collected from 1831 men at the same gay pride event in Atlanta, GA four times over nearly two decades; 1997, 2005-2006 (the 2006 survey over-sampled African-Americans to diversify the study), and 2015. Results indicate clear and consistent trends of increasing beliefs that HIV treatments reduce HIV transmission risks, reflecting the dissemination of HIV prevention research findings. Changes in treatment beliefs coincide with increased rates of condomless anal intercourse. Increased beliefs that treatments prevent HIV and increased condomless anal sex were observed for both HIV positive men and men who had not tested HIV positive. Results illustrate the emergence of an era where ART is the focus of HIV prevention and community-held beliefs and behaviors regarding definitions of risk create a new and potentially problematic environment for HIV transmission.
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Affiliation(s)
- Seth C Kalichman
- Department of Psychology, 406 Babbidge Road, University of Connecticut, Storrs, CT, 06269, USA.
| | - Devon Price
- Department of Psychology, 406 Babbidge Road, University of Connecticut, Storrs, CT, 06269, USA
| | - Lisa A Eaton
- Department of Psychology, 406 Babbidge Road, University of Connecticut, Storrs, CT, 06269, USA
| | - Kaylee Burnham
- Department of Psychology, 406 Babbidge Road, University of Connecticut, Storrs, CT, 06269, USA
| | - Matthew Sullivan
- Department of Psychology, 406 Babbidge Road, University of Connecticut, Storrs, CT, 06269, USA
| | - Stephanie Finneran
- Department of Psychology, 406 Babbidge Road, University of Connecticut, Storrs, CT, 06269, USA
| | - Talea Cornelius
- Department of Psychology, 406 Babbidge Road, University of Connecticut, Storrs, CT, 06269, USA
| | - Aerielle Allen
- Department of Psychology, 406 Babbidge Road, University of Connecticut, Storrs, CT, 06269, USA
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