Drug-related and psychopathological symptoms in HIV-positive men who have sex with men who inject drugs during sex (slamsex): Data from the U-SEX GESIDA 9416 Study

English version

Autoři: Helen Dolengevich-Segal ^aff001; Alicia Gonzalez-Baeza ^aff003; Jorge Valencia ^aff004; Eulalia Valencia-Ortega ^aff003; Alfonso Cabello ^aff005; Maria Jesus Tellez-Molina ^aff006; Maria Jesus Perez-Elias ^aff007; Regino Serrano ^aff002; Leire Perez-Latorre ^aff009; Luz Martin-Carbonero ^aff003; Sari Arponen ^aff010; Jose Sanz-Moreno ^aff011; Sara De la Fuente ^aff012; Otilia Bisbal ^aff013; Ignacio Santos ^aff014; Jose Luis Casado ^aff007; Jesus Troya ^aff015; Miguel Cervero-Jimenez ^aff016; Sara Nistal ^aff017; Guillermo Cuevas ^aff015; Javier Correas-Lauffer ^aff001; Marta Torrens ^aff018; Pablo Ryan ^aff015;
Působiště autorů: Psychiatry Service, Henares University Hospital, Madrid, Spain ^aff001; Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain ^aff002; HIV Unit, La Paz University Hospital, IdiPAZ, Madrid, Spain ^aff003; Harm Reduction Unit, SERMAS, Madrid, Spain ^aff004; Infectious Diseases and HIV Unit, Fundación Jimenez Díaz, Madrid, Spain ^aff005; HIV Unit, Clínico San Carlos University Hospital, Madrid, Spain ^aff006; Infectious Diseases, Ramón y Cajal University Hospital, Madrid, Spain ^aff007; HIV Unit, Henares University Hospital, Madrid, Spain ^aff008; HIV Unit, Gregorio Marañón University Hospital, Madrid, Spain ^aff009; Internal Medicine Service, Torrejon Hospital, Madrid, Spain ^aff010; Internal Medicine, Príncipe de Asturias Hospital, Alcala de Henares, Spain ^aff011; Internal Medicine Service, Puerta de Hierro Hospital, Madrid, Spain ^aff012; HIV Unit, 12 de Octubre University Hospital, Madrid, Spain ^aff013; Infectious Diseases Unit, La Princesa University Hospital, Madrid, Spain ^aff014; Internal Medicine Service, Infanta Leonor Hospital, Madrid, Spain ^aff015; Internal Medicine Service, Severo Ochoa Hospital, Madrid, Spain ^aff016; Internal Medicine Service, Mostoles University Hospital, Madrid, Spain ^aff017; Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain ^aff018; School of Medicine, Complutense University, Madrid, Spain ^aff019; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain ^aff020
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0220272

Souhrn

Objectives

Sexualized intravenous drug use, also known as slamsex, seems to be increasing among HIV-positive men who have sex with men (MSM). Physical and psychopathological symptoms have previously been reported in this population, although research on the subject of slamsex is scarce. The objectives of our study were to describe the psychopathological background of a sample of HIV-positive MSM who engaged in slamsex during the previous year and to compare physical, psychopathological, and drug-related symptoms between these participants and those who engaged in non-injecting sexualized drug use.

Design and methods

Participants (HIV-positive MSM) were recruited from the U-Sex study in 22 HIV clinics in Madrid during 2016–17. All participants completed an anonymous cross-sectional online survey on sexual behavior and recreational drug use. When participants met the inclusion criteria, physicians offered them the opportunity to participate and gave them a card with a unique code and a link to access the online survey. The present analysis is based on HIV-positive MSM who had engaged in slamsex and non-injecting sexualized drug use.

Results

The survey sample comprised 742 participants. Of all the participants who completed the survey, 216 (29.1%) had engaged in chemsex, and of these, 34 (15.7%) had engaged in slamsex. Participants who engaged in slamsex were more likely to have current psychopathology (depression, anxiety, and drug-related disorders) than participants who engaged in non-injecting sexualized drug use. In addition, participants who engaged in slamsex more frequently reported high-risk sexual behaviors and polydrug use and were more often diagnosed with sexually transmitted infections (STIs) and hepatitis C than those who did not inject drugs. Compared with participants who did not inject drugs, participants who engaged in slamsex experienced more severe drug-related symptoms (withdrawal and dependence), symptoms of severe intoxication (loss of consciousness), and severe psychopathological symptoms during or after slamsex (eg, paranoid thoughts and suicidal behaviors).

Conclusion

Slamsex is closely associated with current psychiatric disorders and severe drug-related and psychiatric symptoms.

Klíčová slova:

Drug dependence – Depression – Suicide – Men who have sex with men – Consciousness – Drug addiction – Syncope – Sex addiction

Zdroje

1. McCall H, Adams N, Mason D, Willis J. What is chemsex and why does it matter? BMJ. 2015 Nov;351:h5790. doi: 10.1136/bmj.h5790 26537832

2. Bourne A, Reid D, Hickson F, Torres-Rueda S, Steinberg P, Weatherburn P. “Chemsex” and harm reduction need among gay men in South London. Int J Drug Policy. 2015 Dec;26(12):1171–1176. doi: 10.1016/j.drugpo.2015.07.013 26298332

3. Schmidt AJ, Bourne A, Weatherburn P, Reid D, Marcus U, Hickson F, et al. Illicit drug use among gay and bisexual men in 44 cities: Findings from the European MSM Internet Survey (EMIS). Int J Drug Policy. 2016;38:4–12. doi: 10.1016/j.drugpo.2016.09.007 27788450

4. Dolengevich-Segal H, Rodríguez-Salgado B, Bellesteros-López J, Molina-Prado R. Chemsex. An emergent phenomenon. Adicciones. 2017 Jun 28;29(3):207–9. doi: 10.20882/adicciones.894 28492961

5. Lehmiller JJ, Ioerger M. Social networking smartphone applications and sexual health outcomes among men who have sex with men. PloS One. 2014;9(1):e86603. doi: 10.1371/journal.pone.0086603 24466166

6. Glass R, Hope VD, Tanner C, Desai M. “Slamming” among men who have sex with men accessing general drug services, in response to Schmidt, AJ et al., 2016, Illicit drug use among gay and bisexual men in 44 cities: Findings from the European MSM Internet Survey (EMIS). Int J Drug Policy. 2017;49:24–5. doi: 10.1016/j.drugpo.2017.07.028 28873358

7. Ottaway Z, Finnerty F, Amlani A, Pinto-Sander N, Szanyi J, Richardson D. Men who have sex with men diagnosed with a sexually transmitted infection are significantly more likely to engage in sexualised drug use. Int J STD AIDS. 2016 Aug;

8. Abdulrahim D, Bowden-Jones O. Guidance on the Management of Acute and Chronic Harms of Club Drugs and Novel Psychoactive Substances. Novel Psychoactive Treatment UK Network (NEPTUNE). Novel Psychoactive Treatment UK Network (NEPTUNE).; 2015.

9. Darke S, Kaye S, McKetin R, Duflou J. Major physical and psychological harms of methamphetamine use. Drug Alcohol Rev. 2008 May;27(3):253–62. doi: 10.1080/09595230801923702 18368606

10. Kapitány-Fövény M, Kertész M, Winstock A, Deluca P, Corazza O, Farkas J, et al. Substitutional potential of mephedrone: an analysis of the subjective effects. Hum Psychopharmacol. 2013 Jul;28(4):308–316. doi: 10.1002/hup.2297 23881878

11. Dolengevich-Segal H, Rodríguez-Salgado B, Gómez-Arnau J, Sánchez-Mateos D. Severe Psychosis, Drug Dependence, and Hepatitis C Related to Slamming Mephedrone. Case Rep Psychiatry. 2016;2016:8379562. doi: 10.1155/2016/8379562 27247820

12. Lea T, Mao L, Hopwood M, Prestage G, Zablotska I, de Wit J, et al. Methamphetamine use among gay and bisexual men in Australia: Trends in recent and regular use from the Gay Community Periodic Surveys. Int J Drug Policy. 2016 Mar;29:66–72. doi: 10.1016/j.drugpo.2016.01.003 26851066

13. González-Baeza A, Dolengevich-Segal H, Pérez-Valero I, Cabello A, Téllez MJ, Sanz J, et al. Sexualized Drug Use (Chemsex) Is Associated with High-Risk Sexual Behaviors and Sexually Transmitted Infections in HIV-Positive Men Who Have Sex with Men: Data from the U-SEX GESIDA 9416 Study. AIDS Patient Care STDs. 2018 Mar;32(3):112–8. doi: 10.1089/apc.2017.0263 29620925

14. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009 Apr;42(2):377–81. doi: 10.1016/j.jbi.2008.08.010 18929686

15. Bui H, Zablotska-Manos I, Hammoud M, Jin F, Lea T, Bourne A, et al. Prevalence and correlates of recent injecting drug use among gay and bisexual men in Australia: Results from the FLUX study. Int J Drug Policy. 2018 Feb;

16. Daskalopoulou M, Rodger A, Phillips AN, Sherr L, Speakman A, Collins S, et al. Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study. Lancet HIV. 2014 Oct;1(1):e22–31. doi: 10.1016/S2352-3018(14)70001-3 26423813

17. Pufall EL, Kall M, Shahmanesh M, Nardone A, Gilson R, Delpech V, et al. Sexualized drug use ('chemsex’) and high-risk sexual behaviours in HIV-positive men who have sex with men. HIV Med. 2018 Apr;19(4):261–70. doi: 10.1111/hiv.12574 29368440

18. EMCDDA. 'Perspectives on drugs’ (PODs) series, launched alongside the annual European Drug Report, these designed-for-the-web interactive analyses aim to provide deeper insights into a selection of important issues [Internet]. 2016 May. Available from: http://www.emcdda.europa.eu/topics/pods/controlling-new-psychoactive-substances

19. German CL, Fleckenstein AE, Hanson GR. Bath salts and synthetic cathinones: an emerging designer drug phenomenon. Life Sci. 2014 Feb 27;97(1):2–8. doi: 10.1016/j.lfs.2013.07.023 23911668

20. Van Hout MC, Bingham T. “A costly turn on”: patterns of use and perceived consequences of mephedrone based head shop products amongst Irish injectors. Int J Drug Policy. 2012 May;23(3):188–97. doi: 10.1016/j.drugpo.2012.01.008 22342322

21. Kapitány-Fövény M, Mervó B, Kertész M, Corazza O, Farkas J, Kökönyei G, et al. Is there any difference in patterns of use and psychiatric symptom status between injectors and non-injectors of mephedrone? Hum Psychopharmacol. 2015 Jul;30(4):233–243. doi: 10.1002/hup.2490 26216556

22. Kirby T, Thornber-Dunwell M. High-risk drug practices tighten grip on London gay scene. Lancet. 2013 Jan;381(9861):101–102. doi: 10.1016/s0140-6736(13)60032-x 23320280

23. Rajasingham R, Mimiaga MJ, White JM, Pinkston MM, Baden RP, Mitty JA. A systematic review of behavioral and treatment outcome studies among HIV-infected men who have sex with men who abuse crystal methamphetamine. AIDS Patient Care STDs. 2012 Jan;26(1):36–52. doi: 10.1089/apc.2011.0153 22070609

24. Grant KM, LeVan TD, Wells SM, Li M, Stoltenberg SF, Gendelman HE, et al. Methamphetamine-associated psychosis. J Neuroimmune Pharmacol Off J Soc NeuroImmune Pharmacol. 2012 Mar;7(1):113–39.

25. Corazza O, Assi S, Schifano F. From “Special K” to “Special M”: the evolution of the recreational use of ketamine and methoxetamine. CNS Neurosci Ther. 2013 Jun;19(6):454–60. doi: 10.1111/cns.12063 23421859

26. Pufall EL, Kall M, Shahmanesh M, Nardone A, Gilson R, Delpech V, et al. Sexualized drug use ('chemsex’) and high-risk sexual behaviours in HIV-positive men who have sex with men. HIV Med. 2018 Jan;

27. Deimel D, Stover H, Hosselbarth S, Dichtl A, Graf N, Gebhardt V. Drug use and health behaviour among German men who have sex with men: Results of a qualitative, multi-centre study. Harm Reduct J. 2016 Dec;13(1):36. doi: 10.1186/s12954-016-0125-y 27938393