Prevalence, Patterns and Implications of Chemsex Substance Use Among Gay and Bisexual Men Who Have Sex With Men: A Cohort-Collaboration Between the Swiss HIV Cohort Study and the SwissPrEPared Study

IF 5.2 1区医学 Q2 IMMUNOLOGY

Journal of the International AIDS Society Pub Date : 2026-09-15 DOI:10.1002/jia2.70199

Bashkim Jaha, Andrea Farnham, Roger Kouyos, Jan Fehr, Babette L. Winter, Irene A. Abela, Marcel Stöckle, Bernard Surial, Matteo Reymond, Matthias Cavassini, David Jackson-Perry, Luigia Elzi, Julia Notter, Benjamin Hampel, Katharina Kusejko

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引用次数: 0

Abstract

Introduction

Global awareness to chemsex, a specific form of sexualized psychoactive substance (“chems”) use among gay, bisexual and other men who have sex with men (gbMSM), is increasing. We aimed to assess prevalence, patterns and implications of “chems” use on chemsex-related outcomes.

Methods

We conducted a Swiss-wide longitudinal study using individual-level data from April 2019 to December 2024 of adult gbMSM with HIV, enrolled in the Swiss HIV Cohort Study (SHCS), or taking HIV pre-exposure prophylaxis (PrEP), enrolled in SwissPrEPared. Determinants of “chems” (methamphetamine, new psychoactive stimulants, GHB/GBL) use and clinical implications were analysed using logistic regression. Longitudinal “chems” use patterns were distinguished by rule-based classification. Point-prevalences of “chems” use, including COVID-19 and mpox periods, were analysed using interrupted time series analysis.

Results

We analysed 107,855 follow-up visits from 13,304 gbMSM. “Chems” were used by 17.2% of gbMSM (21.4% in SwissPrEPared vs. 11.2% in the SHCS). Age below 26 (compared to 26−37, adjusted odds ratio [aOR]: 0.82, 95%-confidence interval: 0.68−0.96), over 37 (aOR for 38−48: 0.84, 0.75−0.94; aOR for over 48: 0.54, 0.47−0.62) and bisexual orientation showed lower odds (aOR: 0.78, 0.66−0.90), while participation in French-speaking SwissPrEPared centres (aOR compared to SHCS Eastern Switzerland: 1.41, 1.22−1.64) and sex with non-steady partners showed higher odds for “chems” use (aOR: 12.44, 8.85−18.17). “Chems” use was associated with depression, inconsistent condom use, high non-steady partner count and sexually transmitted infections (STIs). Comparing longitudinal use patterns, temporally restricted use, that is, recovering from stable use, reported “chems” use only once, or for a single episode shorter than 1 year, showed the lowest risk for STIs and high partner count, whereas intermittent use showed lower risk only for syphilis. “Chems” use decreased marginally during COVID-19 and mpox, with a quick return and no difference to levels before COVID-19.

Conclusions

A large proportion of gbMSM use “chems,” with congruent determinants across both cohorts but heterogeneous impact on sexual and mental health that varies by specific substance and longitudinal use patterns. Further understanding of underlying mechanisms driving this heterogeneity is needed before delivering mechanism-informed interventions tailored to “chems” use patterns, like STI and depression screening, harm-reduction counselling and linkage to addiction care.

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男同性恋和双性恋男性中化学性物质使用的流行、模式和含义：瑞士HIV队列研究和swisspreared研究之间的队列合作

导语：全球对化学性行为的认识正在增加，化学性行为是同性恋、双性恋和其他男男性行为者（gbMSM）使用的一种特定形式的性化精神活性物质（“化学物质”）。我们的目的是评估“化学品”使用对化学品相关结果的流行程度、模式和影响。方法：我们在瑞士范围内进行了一项纵向研究，使用2019年4月至2024年12月的个人水平数据，这些数据来自瑞士HIV队列研究（SHCS）的成年HIV携带者，或参加swisspreared的HIV暴露前预防（PrEP）。使用逻辑回归分析了“化学品”（甲基苯丙胺、新型精神活性兴奋剂、GHB/GBL）使用和临床影响的决定因素。纵向“化学物质”使用模式通过基于规则的分类来区分。使用中断时间序列分析“化学品”使用的点流行率，包括COVID-19和m痘期间。结果：我们分析了来自13304名gbMSM的107,855次随访。17.2%的gbMSM使用“Chems”（swisspreared组21.4%，SHCS组11.2%）。年龄小于26岁（与26-37岁相比，调整比值比[aOR]: 0.82, 95%可信区间：0.68-0.96）、37岁以上（38-48岁的aOR: 0.84, 0.75-0.94；超过48岁的aOR: 0.54, 0.47-0.62）和双性恋倾向的比值较低（aOR: 0.78, 0.66-0.90），而参加法语瑞士spreared中心（与瑞士东部SHCS相比，aOR: 1.41, 1.22-1.64）和性伴侣不稳定的“化学品”使用的比值较高（aOR: 12.44, 8.85-18.17）。“化学品”的使用与抑郁、不一致的避孕套使用、高不稳定的伴侣数量和性传播感染（STIs）有关。比较纵向使用模式，暂时限制使用，即从稳定使用中恢复，报告的“化学品”仅使用一次，或短于1年的单次发作，显示性传播感染风险最低，性伴侣数量高，而间歇性使用仅显示梅毒风险较低。“化学品”的使用在COVID-19和m痘期间略有下降，迅速恢复，与COVID-19之前的水平没有差异。结论：很大比例的gbMSM使用“化学品”，在两个队列中具有一致的决定因素，但对性和心理健康的影响不同，因具体物质和纵向使用模式而异。在提供针对“化学品”使用模式的机制知情干预措施（如性传播感染和抑郁症筛查、减少伤害咨询以及与成瘾治疗的联系）之前，需要进一步了解驱动这种异质性的潜在机制。

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来源期刊

Journal of the International AIDS Society IMMUNOLOGY-INFECTIOUS DISEASES

CiteScore

8.60

自引率

10.00%

发文量

186

审稿时长

>12 weeks

期刊介绍： The Journal of the International AIDS Society (JIAS) is a peer-reviewed and Open Access journal for the generation and dissemination of evidence from a wide range of disciplines: basic and biomedical sciences; behavioural sciences; epidemiology; clinical sciences; health economics and health policy; operations research and implementation sciences; and social sciences and humanities. Submission of HIV research carried out in low- and middle-income countries is strongly encouraged.