Trajectories of Chemsex Engagement Across Time Among PrEP-Using Men Who Have Sex with Men: Results from the French ANRS-Prévenir Cohort.

IF 2.1 4区医学 Q2 PSYCHOLOGY, CLINICAL

International Journal of Sexual Health Pub Date : 2025-06-08 eCollection Date: 2025-01-01 DOI:10.1080/19317611.2025.2511902

Emils Sietins, Luis Sagaon-Teyssier, Adbourahmane Sow, Lambert Assoumou, Marion Mora, Lydie Beniguel, Daniela Rojas-Castro, David Michels, Juan Camilo Jones, Jade Ghosn, Dominique Costagliola, Bruno Spire, Perrine Roux, Jean-Michel Molina, Christel Protiere

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Abstract

Objectives: To identify trajectories of chemsex engagement and their evolution across time among men who have sex with men (MSM) and the associated factors.

Methods: Among 2518 PrEP-using MSM in the French ANRS- Prévenir cohort, a group-based trajectory model was used to identify trajectories of chemsex engagement. A multivariable model was then used to estimate time-constant factors associated with trajectory membership, and time-varying factors associated with the shape of each trajectory. Data were collected quarterly from self-administered online questionnaires and electronic case record forms. The median follow-up time was 21 months [interquartile range: 9-27 months].

Results: Four distinct trajectories were identified: the Null/low (probability of engagement) (N-CX, n = 1881, 75%), the Increasing (I-CX, n = 158, 6%), the Decreasing (D-CX, n = 195, 8%), and the High (H-CX, n = 284, 11%). Compared to N-CX: MSM in the I-CX and D-CX were younger (OR [95%CI]: 0.95[0.93-0.98], p < 0.001 & 0.94[0.91-0.96] p < 0.001 per additional year or point (p/y), respectively), while MSM in the H-CX were older (1.03[1.01-1.05] p/y, p = 0.016); depression score was higher among the D-CX (1.02[1.00-1.04] p/y, p = 0.026) and lower among the I-CX (0.97[0.94-0.99] p/y, p = 0.028). Use of daily PrEP regimen (compared to 'on-demand') was associated with increased and decreased likelihood of chemsex engagement for the H-CX (Coeff.(SE): 0.75(0.33), p = 0.027) and D-CX (-0.41(0.20), p = 0.043), respectively. The likelihood of chemsex engagement increased for the D-CX (0.02(0.01), p = 0.006), H-CX (0.04(0.01), p = 0.004), and N-CX (0.008(0.003), p = 0.011) as their number of casual sex partners increased. Participants in the N-CX and D-CX were more likely to engage in chemsex if they engaged in condomless anal sex during their last sexual encounter [0.86 (0.34), p = 0.011 and 1.63 (0.21), p < 0.001, respectively].

Conclusion: Four different patterns of engagement in chemsex were identified, with specific sexual behaviors and HIV prevention strategies. Differentiated healthcare and prevention approaches could be offered to MSM based on their patterns of chemsex engagement.

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使用prep的男性与男性发生性行为的Chemsex参与的时间轨迹：来自法国anrs - pr venir队列的结果。

目的：确定男男性行为者（MSM）化学性行为参与的轨迹及其随时间的演变及其相关因素。方法：在法国ANRS- prassavenir队列中2518名使用prep的男男性接触者中，采用基于群体的轨迹模型识别化学性接触的轨迹。然后使用多变量模型估计与轨迹隶属度相关的时常数因子和与每条轨迹形状相关的时变因子。每季度从自我管理的在线问卷和电子病例记录表格中收集数据。中位随访时间为21个月[四分位数间距：9-27个月]。结果：确定了四种不同的轨迹：零/低（参与概率）（n - cx, n = 1881, 75%），增加（I-CX, n = 158, 6%），减少（D-CX, n = 195, 8%）和高（H-CX, n = 284, 11%）。与N-CX相比，I-CX和D-CX的MSM更年轻（OR [95%CI]: 0.95[0.93-0.98], p p p = 0.016）；D-CX组抑郁评分较高（1.02[1.00-1.04]p/y, p = 0.026）， I-CX组抑郁评分较低（0.97[0.94-0.99]p/y, p = 0.028）。每日PrEP方案的使用（与“按需”相比）与H-CX化学性接触的可能性增加和降低相关（Coeff）。(SE): 0.75 (0.33), p = 0.027)和D-CX (-0.41 (0.20), p = 0.043),分别。随着随意性伴侣数量的增加，D-CX (0.02(0.01), p = 0.006), H-CX （0.04(0.01), p = 0.004）和N-CX （0.008(0.003), p = 0.011）的化学性行为参与的可能性增加。N-CX和D-CX的参与者如果在最后一次性接触中进行无套肛交，则更有可能进行化学性交[0.86 (0.34),p = 0.011和1.63 (0.21)]，p结论：确定了四种不同的化学性交模式，具有特定的性行为和艾滋病毒预防策略。根据男男性接触化学性行为的模式，可以为其提供差异化的保健和预防方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Sexual Health Multiple-

CiteScore

3.00

自引率

20.00%

发文量

期刊介绍： As the official journal of the World Association for Sexual Health, the International Journal of Sexual Health promotes sexual health as a state of physical, emotional, mental, and social well-being through a positive approach to sexuality and sexual rights. The journal publishes peer-reviewed scientific papers, editorials, and reviews, using quantitative and qualitative methods, descriptive and critical analysis, instrument development, surveys, and case studies to examine the essential elements of this broad concept. Leading experts from around the world present original work that covers a variety of disciplines, including sexology, biology, medicine, psychology, sociology, anthropology, history, and religion.