{"title":"化学性与衣原体、淋病和梅毒感染风险的关系:一项系统综述和荟萃分析","authors":"Prakasini Satapathy , Abhay M. Gaidhane , Nasir Vadia , Soumya V. Menon , Kattela Chennakesavulu , Rajashree Panigrahi , Manpreet Kaur , Ganesh Bushi , Muhammed Shabil , Diptismita Jena , Mayank Goyal , Harish Kumar , Anju Rani , Sanjit Sah , Mahendra Singh , Khang Wen Goh","doi":"10.1016/j.puhe.2025.105971","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>Chemsex, the use of psychoactive substances to enhance sexual experiences, is increasingly recognized as a public health concern, particularly among men who have sex with men (MSM). This behavior is associated with risky sexual practices, including condomless sex, multiple partners, and prolonged sexual sessions, which may elevate the risk of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, and syphilis. This systematic review and meta-analysis aim to quantify the association between chemsex and these bacterial STIs.</div></div><div><h3>Study design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Embase, and Web of Science was conducted to identify studies reporting associations between chemsex and chlamydia, gonorrhea, or syphilis until November 10, 2024. Eligible studies included observational designs with chemsex participants and STI outcomes. Random-effects meta-analyses were performed to estimate pooled odds ratios (ORs) with 95 % confidence intervals (CIs). Statistical analysis was performed by using R software version 4.4.</div></div><div><h3>Results</h3><div>A total of 13 studies were included across multiple countries. The meta-analysis revealed a significant association between chemsex and syphilis (pooled OR: 1.741, 95 % CI: 1.337–2.267), gonorrhea (pooled OR: 1.784, 95 % CI: 1.428–2.228), and chlamydia (pooled OR: 1.429, 95 % CI: 1.195–1.710). Two studies reporting hazard ratios for gonorrhea (pooled HR: 1.699, 95 % CI: 1.361–2.121) and chlamydia (pooled HR: 1.202, 95 % CI: 0.972–1.487) showed consistent findings. Heterogeneity across studies was minimal for most outcomes (I<sup>2</sup> = 0 %), and prediction intervals supported stable effect sizes.</div></div><div><h3>Conclusion</h3><div>This study confirms that chemsex is significantly associated with an increased risk of bacterial STIs, particularly syphilis and gonorrhea. The findings highlight the urgent need for interventions addressing chemsex behaviors, including harm reduction strategies, STI prevention programs, and culturally competent healthcare services. Future research should focus on standardizing definitions of chemsex, expanding investigations to low- and middle-income countries, and addressing publication bias to ensure global relevance and reliability of evidence.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"249 ","pages":"Article 105971"},"PeriodicalIF":3.2000,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of chemsex and risk of chlamydia, gonorrhoea, and syphilis infections: a systematic review and meta-analysis\",\"authors\":\"Prakasini Satapathy , Abhay M. Gaidhane , Nasir Vadia , Soumya V. Menon , Kattela Chennakesavulu , Rajashree Panigrahi , Manpreet Kaur , Ganesh Bushi , Muhammed Shabil , Diptismita Jena , Mayank Goyal , Harish Kumar , Anju Rani , Sanjit Sah , Mahendra Singh , Khang Wen Goh\",\"doi\":\"10.1016/j.puhe.2025.105971\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>Chemsex, the use of psychoactive substances to enhance sexual experiences, is increasingly recognized as a public health concern, particularly among men who have sex with men (MSM). This behavior is associated with risky sexual practices, including condomless sex, multiple partners, and prolonged sexual sessions, which may elevate the risk of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, and syphilis. This systematic review and meta-analysis aim to quantify the association between chemsex and these bacterial STIs.</div></div><div><h3>Study design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Embase, and Web of Science was conducted to identify studies reporting associations between chemsex and chlamydia, gonorrhea, or syphilis until November 10, 2024. Eligible studies included observational designs with chemsex participants and STI outcomes. Random-effects meta-analyses were performed to estimate pooled odds ratios (ORs) with 95 % confidence intervals (CIs). Statistical analysis was performed by using R software version 4.4.</div></div><div><h3>Results</h3><div>A total of 13 studies were included across multiple countries. The meta-analysis revealed a significant association between chemsex and syphilis (pooled OR: 1.741, 95 % CI: 1.337–2.267), gonorrhea (pooled OR: 1.784, 95 % CI: 1.428–2.228), and chlamydia (pooled OR: 1.429, 95 % CI: 1.195–1.710). Two studies reporting hazard ratios for gonorrhea (pooled HR: 1.699, 95 % CI: 1.361–2.121) and chlamydia (pooled HR: 1.202, 95 % CI: 0.972–1.487) showed consistent findings. Heterogeneity across studies was minimal for most outcomes (I<sup>2</sup> = 0 %), and prediction intervals supported stable effect sizes.</div></div><div><h3>Conclusion</h3><div>This study confirms that chemsex is significantly associated with an increased risk of bacterial STIs, particularly syphilis and gonorrhea. The findings highlight the urgent need for interventions addressing chemsex behaviors, including harm reduction strategies, STI prevention programs, and culturally competent healthcare services. Future research should focus on standardizing definitions of chemsex, expanding investigations to low- and middle-income countries, and addressing publication bias to ensure global relevance and reliability of evidence.</div></div>\",\"PeriodicalId\":49651,\"journal\":{\"name\":\"Public Health\",\"volume\":\"249 \",\"pages\":\"Article 105971\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-10-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Public Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0033350625004172\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0033350625004172","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Association of chemsex and risk of chlamydia, gonorrhoea, and syphilis infections: a systematic review and meta-analysis
Objectives
Chemsex, the use of psychoactive substances to enhance sexual experiences, is increasingly recognized as a public health concern, particularly among men who have sex with men (MSM). This behavior is associated with risky sexual practices, including condomless sex, multiple partners, and prolonged sexual sessions, which may elevate the risk of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, and syphilis. This systematic review and meta-analysis aim to quantify the association between chemsex and these bacterial STIs.
Study design
Systematic review and meta-analysis.
Methods
A systematic search of PubMed, Embase, and Web of Science was conducted to identify studies reporting associations between chemsex and chlamydia, gonorrhea, or syphilis until November 10, 2024. Eligible studies included observational designs with chemsex participants and STI outcomes. Random-effects meta-analyses were performed to estimate pooled odds ratios (ORs) with 95 % confidence intervals (CIs). Statistical analysis was performed by using R software version 4.4.
Results
A total of 13 studies were included across multiple countries. The meta-analysis revealed a significant association between chemsex and syphilis (pooled OR: 1.741, 95 % CI: 1.337–2.267), gonorrhea (pooled OR: 1.784, 95 % CI: 1.428–2.228), and chlamydia (pooled OR: 1.429, 95 % CI: 1.195–1.710). Two studies reporting hazard ratios for gonorrhea (pooled HR: 1.699, 95 % CI: 1.361–2.121) and chlamydia (pooled HR: 1.202, 95 % CI: 0.972–1.487) showed consistent findings. Heterogeneity across studies was minimal for most outcomes (I2 = 0 %), and prediction intervals supported stable effect sizes.
Conclusion
This study confirms that chemsex is significantly associated with an increased risk of bacterial STIs, particularly syphilis and gonorrhea. The findings highlight the urgent need for interventions addressing chemsex behaviors, including harm reduction strategies, STI prevention programs, and culturally competent healthcare services. Future research should focus on standardizing definitions of chemsex, expanding investigations to low- and middle-income countries, and addressing publication bias to ensure global relevance and reliability of evidence.
期刊介绍:
Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.