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. 2018 May;45(5):325-331.
doi: 10.1097/OLQ.0000000000000753.

Chemsex Among Men Who Have Sex With Men: a Sexualized Drug Use Survey Among Clients of the Sexually Transmitted Infection Outpatient Clinic and Users of a Gay Dating App in Amsterdam, the Netherlands

Susanne Drückler, Martijn S van Rooijen, Henry J C de Vries

Chemsex Among Men Who Have Sex With Men: a Sexualized Drug Use Survey Among Clients of the Sexually Transmitted Infection Outpatient Clinic and Users of a Gay Dating App in Amsterdam, the Netherlands

Susanne Drückler et al. Sex Transm Dis. 2018 May.

Abstract

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. Associations were assed using χ test and multivariable regression.

Results: Chemsex in the past 6 months was practiced by 866 (17.6%) of 4925 MSM clients and by 159 (1.5%) of 10857 non-MSM clients. Among gay dating app users, the proportion that reported chemsex engagement was higher than among MSM visiting the STI clinic (29.3% [537/1832] vs. 17.6%; P < 0.001). Chemsex was a significant risk factor for bacterial STI in HIV-negative MSM visiting the STI clinic (adjusted odd ratio, 1.5; 95% confidence interval, 1.2-1.8), but not in HIV-positive MSM. A majority practiced chemsex once a month or less, and 87.0% reported sex without drug use in the past month.

Conclusions: In Amsterdam, chemsex is frequently practiced and significantly associated with bacterial STI in HIV-negative MSM but not in HIV-positive MSM. Future prevention strategies to reduce STI incidence should especially target HIV-negative MSM engaging in chemsex.

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Conflict of interest statement

Conflicts of Interest and Source of Funding: None declared and no funding received.

Figures

Figure 1
Figure 1
Flowchart of all STI clinic consultations in which chemsex practices were asked at the Public Health Service of Amsterdam, the Netherlands; July to December 2016. aChemsex characteristics were not asked when someone was tested: (1) through the online MSM screening program (Man Tot Man), (2) through participation of the Amsterdam Cohort Study, (3) as part of a sexual health (SENSE) consultation for clients till the age of 25 years without STI screening, and (4) through a self-screening test (not applicable to MSM). bNon-MSM are defined as men who have sex with women (MSW), women who have sex with men (WSM), and women who have sex with women (WSW).
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