Health characteristics associated with chemsex among men who have sex with men: Results from a cross-sectional clinic survey in Norway

PLoS One. 2022 Oct 5;17(10):e0275618. doi: 10.1371/journal.pone.0275618. eCollection 2022.

Abstract

Background: Chemsex typically involves drugs such as GHB/GBL, crystal meth and mephedrone, and is increasingly common among MSM. The behaviour has been found to be associated with sexually transmitted infections (STIs) and mental health problems. We aimed to assess the extent of chemsex engagement and associations with different aspects of health, among MSM attending a free specialist walk-in clinic for STIs in Oslo, Norway.

Methods: Anonymous cross-sectional survey data was collected from June to October 2016. Differences in STI health (chlamydia, gonorrhoea, syphilis, HIV diagnoses), mental health (depression/anxiety) and internalised homonegativity between MSM using and not using GHB/GBL, crystal meth, mephedrone, cocaine or ketamine with sex in the last year were assessed descriptively and in a multivariate logistic regression model. The predictors were number of self-reported chlamydia, gonorrhoea or syphilis diagnoses, HIV diagnosis, depression/anxiety, and degree of internalised homonegativity. We adjusted for age, education level and having lived abroad.

Results: Of the 518 MSM respondents, 17% reported sexualised use of either GHB/GBL, crystal meth, mephedrone, cocaine or ketamine in the last year (chemsex). We found significant positive associations between chemsex and self-reported HIV diagnoses (adjusted odds ratio [aOR] = 3.26, 95%CI = 1.37-7.76), number of reported chlamydia, gonorrhoea or syphilis diagnoses in the last year (aOR = 1.63, 95%CI = 1.18-2.12), having lived more than one year abroad (aOR = 2.10, 95%CI = 1.20-3.65), but no significant association with depression/anxiety (aOR = 1.02, 95%CI = 0.53-1.93), nor internalised homonegativity (aOR = 0.62, 95%CI = 0.33-1.19).

Conclusion: Chemsex engagement in Norway is relatively low compared to findings from STI clinics in other European countries, and GHB/GBL and cocaine the two most commonly used drugs with sex. Chemsex was more common among MSM having lived more than one year abroad, reporting HIV diagnoses and a higher number of either chlamydia, gonorrhoea or syphilis diagnoses in the last year. Health care providers need to be made aware of chemsex as a behavioural phenomenon among MSM, and special care should be afforded to MSM living with HIV and being diagnosed with STIs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cocaine*
  • Cross-Sectional Studies
  • Gonorrhea* / complications
  • HIV Infections* / complications
  • HIV Infections* / diagnosis
  • HIV Infections* / epidemiology
  • Homosexuality, Male
  • Humans
  • Ketamine*
  • Male
  • Methamphetamine / analogs & derivatives
  • Sexual Behavior
  • Sexual and Gender Minorities*
  • Sexually Transmitted Diseases* / complications
  • Sexually Transmitted Diseases* / diagnosis
  • Sexually Transmitted Diseases* / epidemiology
  • Sodium Oxybate*
  • Substance-Related Disorders* / psychology
  • Syphilis* / complications

Substances

  • Methamphetamine
  • Ketamine
  • Sodium Oxybate
  • mephedrone
  • Cocaine

Grants and funding

EA is employed by UiT The Arctic University of Norway as a PhD researcher. The publication charges for this article have been funded by a grant from the publication fund of UiT The Arctic University of Norway. In 2016 ÅH was awarded the Novartis stipend for dissemination of dermatological and venereological knowledge and research (https://www.legeforeningen.no/foreningsledd/fagmed/norsk-forening-for-dermatologi-og-venerologi/aktuelt/2020/novartis-stipend-forlenget-frist/), amounting to approximately €2000. The award was spent on activities relating to another publication based on data from the same survey. Novartis had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.