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Rosas Cancio-Suárez M, Ron R, Díaz-Álvarez J, Martínez-Sanz J, Serrano-Villar S, Moreno S, Sánchez-Conde M. Prevalence, characteristics, and associated risk factors of drug consumption and chemsex use among individuals attending an STI clinic (EpITs STUDY). Front Public Health 2023; 11:1285057. [PMID: 38026436 PMCID: PMC10644726 DOI: 10.3389/fpubh.2023.1285057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Sex-related drug consumption and its health-related consequences have gained relevance in the assessment of patients with sexually transmitted infections (STIs), which pose a significant challenge to public health. We aim to assess the prevalence and characteristics of drug consumption and chemsex practices, describe the associated risk factors among general individuals attending an STI clinic, and evaluate the psychological impact associated with these behaviors. We conducted an online anonymous survey offered to patients with a diagnosis of STI in a tertiary hospital in Spain. Data included sociodemographic characteristics, sexual preferences and behavior, and assessment of drug use, chemsex, and psychological and mental health symptoms. Data from 145 subjects was collected, with a higher proportion of cis-gender men (71%), and a median age of 32 years. 64 participants (44%) reported drug use in the last year, with an observed 33.8% prevalence of chemsex consumption. Drug use and chemsex were more frequent among cis-gender men, Men who have Sex with Men (MSM), people living with HIV (PLHIV), and those reporting previous group sex. Poppers and cannabis were the most frequently reported drugs, with a prevalence close to 20% for cocaine, mephedrone, extasis, and GHB. Consequences related to drug use included unpleasant physical sensations, sexual dysfunction, and impaired sexual experience after reduction or drug discontinuation. The prevalence of drug use and chemsex practices are high among patients evaluated for STIs, especially between men, MSM, and subjects practicing group sex. The study highlights the urgent need for targeted interventions on prevention and reduction of their impact on health and social well-being.
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Affiliation(s)
- Marta Rosas Cancio-Suárez
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Raquel Ron
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Jorge Díaz-Álvarez
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Javier Martínez-Sanz
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Sergio Serrano-Villar
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Santiago Moreno
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Department of Medicine, University of Alcalá de Henares, Madrid, Spain
| | - Matilde Sánchez-Conde
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
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Parekh T, Gimm G, Kitsantas P. Sexually Transmitted Infections in Women of Reproductive Age by Disability Type. Am J Prev Med 2023; 64:393-404. [PMID: 36528453 DOI: 10.1016/j.amepre.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The objectives of this study were to estimate the prevalence of sexually transmitted infections in women of reproductive age by disability type and examine the association between disability types, participant characteristics, and the prevalence of sexually transmitted infections (STIs). METHODS Pooled data from 2015 to 2019 National Survey on Drug Use and Health were analyzed in 2022. The analytic sample included 90,233 women of reproductive age (18-49 years). Disability was defined as having any sensory, cognitive, physical, or ≥2 disabilities.. A total of 15% of women reported having a disability. Descriptive analyses were used to estimate the prevalence of STI, and logistic regression analyses were conducted to examine the association of disability type and other participant characteristics with the odds of having STIs. RESULTS The prevalence of STIs was more than twice as high for women of reproductive age with cognitive disabilities (6.8%) or ≥2 disabilities (6.7%) as for those without disabilities (2.7%). Women with sensory disabilities (AOR=1.47; 95% CI=1.17, 1.85), cognitive disabilities (AOR=1.89; 95% CI=1.65, 2.17), or ≥2 disabilities (AOR=1.78; 95% CI=1.49, 2.14) had greater odds of STIs than those without disabilities. Bisexual women had higher odds (AOR=1.31; 95% CI=1.14, 1.50) of STIs than straight women, whereas lesbian/gay women had lower odds (AOR=0.41; 95% CI=0.27, 0.63). The odds of STIs were higher among non-Hispanic Blacks (AOR=1.42; 95% CI=1.24, 1.63) and lower among Asian women (AOR=0.62; 95% CI=0.43, 0.90) than among non-Hispanic Whites. The odds of STIs were also greater among participants having any alcohol, cannabis, or illicit drug use. CONCLUSIONS Women of reproductive age with disabilities have a higher prevalence of sexually transmitted infections. In addition to disability type, the odds of sexually transmitted infections varied by race/ethnicity, sexual orientation, and substance use.
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Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia.
| | - Gilbert Gimm
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Panagiota Kitsantas
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
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Javanbakht M, Miller AP, Moran A, Ragsdale A, Bolan R, Shoptaw S, Gorbach PM. Changes in Substance Use and Sexual Behaviors After a Sexually Transmitted Infection Diagnosis Among a Cohort of Men Who Have Sex With Men in Los Angeles, CA. Sex Transm Dis 2023; 50:112-120. [PMID: 36342834 PMCID: PMC9839596 DOI: 10.1097/olq.0000000000001733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background: Sexually transmitted infections (STIs), STI reinfection, Human Immunodeficiency Virus (HIV) acquisition and changes in behaviors following an STI were examined in a cohort of men who have sex with men (MSM) in Los Angeles, CA. Methods: Data from a longitudinal study of MSM enrolled from 2014 with at least one follow-up visit through March 2020 were analyzed (n=447; 1,854 visits). Study visits every 6 months included self-interviews for sexual behaviors, substance use, and specimen collection for chlamydia, gonorrhea, syphilis, and HIV testing. Changes in behaviors were assessed using McNemar’s test and participants not diagnosed with an STI served as controls for a difference-in-differences (DiD) analysis of changes over time. Results: Cumulative incidence of an STI was 55% (248/447). At 24-months post STI diagnosis methamphetamine use declined from 50% to 35% (p<.01), and median number of sex partners declined from 5 (IQR: 2–11) to 2 (IQR: 1–6)(p<.01). Among participants at risk for HIV and diagnosed with an STI (n=102), PrEP use was 35% and HIV-seroconversion was 6%. Based on DiD analyses, participants diagnosed with an STI had higher levels of substance and higher number of sex partners when compared to those with no STIs, however, declines in these behaviors were comparable to participants not diagnosed with an STI (pDID>0.05). Conclusions: Despite behavior modifications following an STI diagnosis, STI/HIV incidence was high, suggesting that MSM with STIs occupy sexual networks where reductions in sexual and substance using behaviors do not protect them from ongoing exposure to STIs and HIV. Despite declines in substance use and sexual behaviors following an STI, reinfections were high suggesting that MSM with STIs occupy sexual networks with high transmission probabilities and prevention efforts should consider sexual network characteristics.
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Affiliation(s)
- Marjan Javanbakht
- UCLA Fielding School of Public Health, Department of Epidemiology, Los Angeles, CA
| | - Amanda P. Miller
- UCLA David Geffen School of Medicine, Division of Infectious Diseases Los Angeles, CA
| | - Alexander Moran
- UCLA Fielding School of Public Health, Department of Epidemiology, Los Angeles, CA
| | - Amy Ragsdale
- UCLA Fielding School of Public Health, Department of Epidemiology, Los Angeles, CA
| | | | - Steve Shoptaw
- UCLA David Geffen School of Medicine, Department of Family Medicine, Los Angeles, CA
| | - Pamina M. Gorbach
- UCLA Fielding School of Public Health, Department of Epidemiology, Los Angeles, CA
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Strathdee SA, Bristow CC, Gaines T, Shoptaw S. Collateral Damage: A Narrative Review on Epidemics of Substance Use Disorders and Their Relationships to Sexually Transmitted Infections in the United States. Sex Transm Dis 2021; 48:466-473. [PMID: 33315749 PMCID: PMC8184578 DOI: 10.1097/olq.0000000000001341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
ABSTRACT Associations between substance use disorders and outbreaks of HIV and acute viral hepatitis have received considerable attention, but less research has focused on links between substance use disorders and sexually transmitted infections, apart from alcohol misuse. This narrative review describes the history of this public health crisis in the United States and direct and indirect effects opioids and specific stimulants have on high-risk sexual behaviors. We also review the epidemiology of sexually transmitted infections associated with opioids and stimulants in the United States and discuss opportunities for integrated interventions.
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Affiliation(s)
- Steffanie Ann Strathdee
- From the Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla
| | - Claire C Bristow
- From the Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla
| | - Tommi Gaines
- From the Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla
| | - Steven Shoptaw
- Department of Family Medicine, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
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