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Men who have Sex with Men and Chemsex: A Clinic-Based Cross-sectional Study in South Australia

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Abstract

Background

Chemsex, the intentional combining of sex with the use of particular psychoactive substances typically crystal methamphetamine, gamma-hydroxybutyrate(GHB)/gamma butyrolactone(GBL), mephedrone, and ketamine has been reported among men who have sex with men (MSM). Chemsex is more common among MSM than in the general population. We aimed to determine the prevalence and factors associated with chemsex in a sample of MSM attending three clinical settings in South Australia (SA).

Methods

MSM attending three urban clinics in South Australia between 1 February 2017 and 31 August 2017 were invited to complete questionnaires reporting socio-demographic information, sexual practices, drug use, and HIV/STI status. We determined the proportion of respondents reporting chemsex and evaluated factors associated with this practice using unadjusted and adjusted logistic regression.

Results

Chemsex was reported by 29% of this sample and was associated with being Australian-born (APR = 1.45; 95%CI: 1.02–2.06), engaging in group sex once/a few times (APR = 1.86; 95%CI 1.35–2.57) or at least monthly (APR = 2.30; 95%CI 1.23–4.29), hooking-up for sex online and on mobile phone applications (APR = 1.70; 95%CI 1.19–2.43), being HIV positive (APR = 2.46; 95%CI 1.62–3.73) and taking PrEP (APR = 1.85; 95%CI 1.06–3.23). Condom-less anal sex (CAS) was significantly associated with chemsex (APR = 1.44; 95%CI 1.04–1.99).

Conclusion

The practice of chemsex in MSM in our clinical settings was associated with HIV-positive status and with certain sexual practices. This practice by HIV-negative and HIV-positive men may play a role in STI and HIV transmission. There is a need to better understand this practice and our findings may inform the development of clinically based STI/HIV prevention and health promotion interventions for MSM in similar settings.

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Acknowledgments

Dr. Lynne Raw who decided to withdraw as an author due to retirement but contributed to the project in data collection and collation as well as the initial draft of the manuscript. Dr. Alison Ward, Ms Emma Clements, the medical, nursing, and administrative team at Adelaide Sexual Health Centre (formerly Clinic 275). Mr. Adrian Booth, Dr. William Donoghue, and reception staff at O’Brien Street Practice. Dr. Helen Calebreto, Mr Wills Logue, and team from SAMESH for the support of this project.

Funding

ViiV Healthcare provided an unrestricted education grant for this research project.

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Authors and Affiliations

  1. Adelaide Sexual Health Clinic (Formerly Clinic 275), Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia

    Carole Khaw

  2. School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia

    Carole Khaw & Mark A. Boyd

  3. Faculty of Medicine and Health, The University of Sydney, NSW, Camperdown, Australia

    Iryna Zablotska-Manos

  4. SA Health, Adelaide, South Australia, Australia

    Carole Khaw & Mark A. Boyd

Authors
  1. Carole Khaw
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  2. Iryna Zablotska-Manos
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  3. Mark A. Boyd
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Correspondence to Carole Khaw.

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Conflict of Interest

MA Boyd—research grants from Merck and Gilead, honoraria from Gilead, ViiV Health Care. Mylan. C Khaw—research grant from ViiV Healthcare, honoraria from Gilead, Merck, and ViiV Health Care. I Zablotska—research grants from Gilead.

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Khaw, C., Zablotska-Manos, I. & Boyd, M.A. Men who have Sex with Men and Chemsex: A Clinic-Based Cross-sectional Study in South Australia. Sex Res Soc Policy 18, 1014–1022 (2021). https://doi.org/10.1007/s13178-020-00505-2

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