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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2022

Open Access 01-12-2022 | Syphilis | Research

Sexual uses of drug and alcohol among men who have sex with men in China: implications for HIV prevention

Authors: Jinshen Wang, Peizhen Zhao, Wenqian Xu, Cheng Wang

Published in: BMC Infectious Diseases | Issue 1/2022

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Abstract

Background

Sexual uses of alcohol and drugs are pervasive among men who have sex with men (MSM) and associated with increased risk of HIV infection. However, there are limited studies related to sexual uses of alcohol and drugs among MSM in China. This study aims to describe the pattern of alcohol use, drug use, and multi-drug use during sex among Chinese MSM and to examine the association between condomless anal intercourse, group sex, commercial sex and HIV infection.

Methods

We conducted an online cross-sectional survey in China. Characteristics on social-demographic, sexual behaviors, and sexual uses of alcohol and drugs were collected. The associations with high-risk sexual behaviors and HIV infection were analyzed with multivariable logistic regression.

Results

A total of 699 MSM were included in this study. About 39.5% (230/582) of men reported sexual alcohol use in the past three months and 50.8% (355/699) reported sexual drug use. Of those reporting sexual drug use, around 10.7% (38/355) reported having multi-drug use. Factors associated with both sexual uses of alcohol and drugs included: reporting more male sexual partners (alcohol: adjusted odds ratio [aOR] = 1.77; drug: aOR = 2.12), reporting condomless anal intercourse in the past three months (alcohol: aOR = 2.08; drug: aOR = 2.08), having ever engaged in group sex (alcohol: aOR = 2.04; drug: aOR = 5.22; multi-drug: aOR = 3.52) and commercial sex (alcohol: aOR = 4.43; drug: aOR = 4.22 multi-drug: aOR = 5.07). Sexual drug use was also correlated with reported HIV-positive status (drug: aOR = 2.53, 95% CI:1.31–4.90).

Conclusion

Sexual uses of alcohol and drugs are prevalent among Chinese MSM. Interventions to reduce the sexual use of alcohol and other drugs may be warranted among MSM in China.
Literature
1.
Rosińska M, Gios L, Nöstlinger C, Vanden Berghe W, Marcus U, Schink S, Sherriff N, Jones AM, Folch C, Dias S, Velicko I, Mirandola M, Sialon II. Network. Prevalence of drug use during sex amongst MSM in Europe: results from a multi-site bio-behavioural survey. Int J Drug Policy. 2018;55:231–41.PubMedCrossRef
2.
Xu W, Zheng Y, Wiginton JM, Kaufman MR. Alcohol use and binge drinking among men who have sex with men in China: prevalence and correlates. Drug Alcohol Depend. 2019;202(1):61–8.PubMedCrossRef
3.
Lawn W, Aldridge A, Xia R, Winstock AR. Substance-linked sex in Heterosexual, Homosexual, and bisexual men and women: an Online, cross-sectional “Global Drug Survey” Report. J Sex Med. 2019 May;16(5):721–32.PubMedCrossRef
4.
Mao X, Leuba SI, Hu Q, Yan H, Wang Z, Lu L, Zhuang M, Chen X, Fu J, Geng W, Jiang Y, Shang H, Xu J. Use of multiple recreational drugs is associated with new HIV infections among men who have sex with men in China: a multicenter cross-sectional survey. BMC Public Health. 2021;21(1):354.PubMedPubMedCentralCrossRef
5.
Kritsanavarin U, Bloss E, Manopaiboon C, et al. HIV incidence among men who have sex with men and transgender women in four provinces in Thailand. Int J STD AIDS. 2020;31(12):1154–60.PubMedCrossRef
6.
7.
Lam CR, Holtz TH, Leelawiwat W, et al. Subtypes and risk behaviors among Incident HIV cases in the Bangkok Men who have sex with men Cohort Study, Thailand, 2006–2014. AIDS Res Hum Retroviruses. 2017;33(10):1004–12.PubMedCrossRef
8.
Chawla N, Sarkar S. Defining “high-risk sexual behavior” in the context of substance use[J]. J Psychosexual Health. 2019;1(1):26–31.CrossRef
9.
Archer NP, Wilkinson AV, Ranjit N, Wang J, Zhao H, Swann AC, Shete S. Genetic, psychosocial, and demographic factors associated with social disinhibition in mexican-origin youth. Brain Behav. 2014;4(4):521–30.PubMedPubMedCentralCrossRef
10.
Weatherburn P, Hickson F, Reid D, Torres-Rueda S, Bourne A. Motivations and values associated with combining sex and illicit drugs (‘chemsex’) among gay men in South London: findings from a qualitative study. Sex Transm Infect. 2017;93(3):203–6.PubMedCrossRef
11.
Deimel D, Stöver H, Hößelbarth 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;13(1):36.PubMedPubMedCentralCrossRef
12.
Cruz SL, Bowen SE. The last two decades on preclinical and clinical research on inhalant effects. Neurotoxicol Teratol. 2021;87:e106999.CrossRef
13.
Zhang H, Teng T, Lu H, Zhao Y, Liu H, Yin L, Sun Z, He X, Qian HZ, Ruan Y, Shao Y, Vermund SH. Poppers use and risky sexual behaviors among men who have sex with men in Beijing, China. Drug Alcohol Depend. 2016;160(1):42–8.PubMedCrossRef
14.
Chen H, Yang Y, Huang Y, Dai Y, Zhang J. Prevalence of poppers use and its sexual risks among men who have sex with men in southwestern China: a cross-sectional study. BMC Public Health. 2018;18(1):1103.PubMedPubMedCentralCrossRef
15.
Bui H, Zablotska-Manos I, Hammoud M, Jin F, Lea T, Bourne A, Iversen J, Bath N, Grierson J, Degenhardt L, Prestage G, Maher L. 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;55:222–30.PubMedCrossRef
16.
Hammoud MA, Jin F, Lea T, Maher L, Grierson J, Prestage G. Off-label use of phosphodiesterase type 5 inhibitor Erectile Dysfunction Medication to Enhance Sex among Gay and Bisexual Men in Australia: results from the FLUX Study. J Sex Med. 2017;14(6):774–84.PubMedCrossRef
17.
Factor R, Kawachi I, Williams DR. Understanding high-risk behavior among non-dominant minorities: a social resistance framework. Soc Sci Med. 2011;73(9):1292–301.PubMedCrossRef
18.
Yi H, Sandfort TG, Shidlo A. Effects of disengagement coping with HIV risk on unprotected sex among HIV-negative gay men in New York City. Health Psychol. 2010;29(2):205–14.PubMedPubMedCentralCrossRef
19.
Martinez O, Wu E, Levine EC, Muñoz-Laboy M, Spadafino J, Dodge B, Rhodes SD, Rios JL, Ovejero H, Moya EM, Baray SC, Carballo-Diéguez A, Fernandez MI. Syndemic factors associated with drinking patterns among latino men and Latina transgender women who have sex with men in New York City. Addict Res Theory. 2016;24(6):466–76.PubMedPubMedCentralCrossRef
20.
Lafortune D, Blais M, Miller G, Dion L, Lalonde F, Dargis L. Psychological and interpersonal factors Associated with Sexualized Drug Use among Men who have sex with men: a mixed-methods systematic review. Arch Sex Behav. 2021;50(2):427–60.PubMedCrossRef
21.
Yu G, Wall MM, Chiasson MA, Hirshfield S. Complex drug use patterns and associated HIV transmission risk behaviors in an internet sample of U.S. men who have sex with men. Arch Sex Behav. 2015;44(2):421–8.PubMedCrossRef
22.
Achterbergh RCA, Drückler S, van Rooijen MS, van Aar F, Slurink IAL, de Vries HJC, Boyd A. Sex, drugs, and sexually transmitted infections: a latent class analysis among men who have sex with men in Amsterdam and surrounding urban regions, the Netherlands. Drug Alcohol Depend. 2020;1;206:107526.CrossRef
23.
Daskalopoulou M, Rodger A, Phillips AN, Sherr L, Speakman A, Collins S, Elford J, Johnson MA, Gilson R, Fisher M, Wilkins E, Anderson J, McDonnell J, Edwards S, Perry N, O’Connell R, Lascar M, Jones M, Johnson AM, Hart G, Miners A, Geretti AM, Burman WJ, Lampe FC. 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;1(1):e22-31.PubMedCrossRef
24.
Dai Y, Musumari PM, Chen H, Huang Y, Techasrivichien T, Suguimoto SP, Zhang J, Ono-Kihara M, Kihara M. Recreational drug Use, Polydrug Use and sexual Behaviors among Men who have sex with men in Southwestern China: a cross-sectional study. Behav Med. 2019;45(4):314–22.PubMedCrossRef
25.
Semple SJ, Strathdee SA, Zians J, Patterson TL. Sexual risk behavior associated with co-administration of methamphetamine and other drugs in a sample of HIV-positive men who have sex with men. Am J Addict. 2009;18(1):65–72.PubMedPubMedCentralCrossRef
26.
Stall R, Paul JP, Greenwood G, Pollack LM, Bein E, Crosby GM, Mills TC, Binson D, Coates TJ, Catania JA. Alcohol use, drug use and alcohol-related problems among men who have sex with men: the Urban Men’s Health Study. Addiction. 2001;96(11):1589–601.PubMedCrossRef
27.
Folch C, Esteve A, Zaragoza K, et al. Correlates of intensive alcohol and drug use in men who have sex with men in Catalonia. Spain Eur J Public Health. 2010;20(2):139–45.PubMedCrossRef
28.
Liu G, Lu H, Wang J, Xia D, Sun Y, Mi G, Wang L. Incidence of HIV and Syphilis among Men Who Have Sex with Men (MSM) in Beijing: An Open Cohort Study. PLoS One. 2015;10(10):0138232.
29.
Thienkrua W, van Griensven F, Mock PA, Dunne EF, Raengsakulrach B, Wimonsate W, Howteerakul N, Ungsedhapand C, Chiwarakorn A, Holtz TH. Young Men who have sex with men at high risk for HIV, Bangkok MSM Cohort Study, Thailand 2006–2014. AIDS Behav. 2018;22(7):2137–46.PubMedPubMedCentralCrossRef
30.
Hegazi A, Lee MJ, Whittaker W, Green S, Simms R, Cutts R, Nagington M, Nathan B, Pakianathan MR. Chemsex and the city: sexualised substance use in gay bisexual and other men who have sex with men attending sexual health clinics. Int J STD AIDS. 2017;28(4):362–6.PubMedCrossRef
31.
Wang Z, Yang X, Mo PKH, Fang Y, Ip TKM, Lau JTF. Influence of Social Media on Sexualized Drug Use and Chemsex among Chinese Men who have sex with men: observational prospective cohort study. J Med Internet Res. 2020;24(7):e17894.CrossRef
32.
Baumann MH. The Changing Face of Recreational Drug Use. Cerebrum. 2016;2016:01–16.
33.
Wei D, Wang X, You X, Luo X, Hao C, Gu J, Peng S, Yang X, Hao Y, Silenzio VMB, Li J, Hou F. Prevalence of depression, anxiety and suicide among men who have sex with men in China: a systematic review and meta-analysis. Epidemiol Psychiatr Sci. 2020;29:136.CrossRef
34.
35.
Li J, Ha TH, Zhang C, Liu H. The chinese government’s response to drug use and HIV/AIDS: a review of policies and programs. Harm Reduct J. 2010;5:4.CrossRef
36.
Tibke P(2017) Drug dependence treatment in China: a policy analysis. International Drug Policy Consortium Publication
37.
Wirtz AL, Zelaya CE, Latkin C, Stall R, Peryshkina A, Galai N, Mogilniy V, Dzhigun P, Kostetskaya I, Beyrer C. Alcohol Use and Associated sexual and Substance Use Behaviors among Men who have sex with men in Moscow, Russia. AIDS Behav. 2016;20(3):523–36.PubMedPubMedCentralCrossRef
38.
World Health Organization (2018) Global status report on alcohol and health 2018. World Health Organization. https://​apps.​who.​int/​iris/​handle/​10665/​274603
39.
Lu H, Liu Y, Dahiya K, Qian HZ, Fan W, Zhang L, Yin L. Effectiveness of HIV risk reduction interventions among men who have sex with men in China: a systematic review and meta-analysis. PLoS ONE. 2013;8(8):e72747.PubMedPubMedCentralCrossRef
40.
41.
Cheatley J, Bertanzetti M, Vuik S, Cecchini M (2021) Policies and best practices for reducing the harmful consumption of alcohol
42.
Liu Y, Vermund SH, Ruan Y, Liu H, Rivet Amico K, Simoni JM, Shepherd BE, Shao Y, Qian HZ. 1Peer counselling versus standard-of-care on reducing high-risk behaviours among newly diagnosed HIV-positive men who have sex with men in Beijing, China: a randomized intervention study. J Int AIDS Soc. 2018;21(2):e25079.PubMedPubMedCentralCrossRef
43.
Chavez K, Palfai TP. Feasibility of a Mobile messaging-enhanced brief intervention for High Risk Heavy drinking MSM: a Pre-Pilot Study. Alcohol Treat Q. 2020;38(1):87–105.PubMedCrossRef
44.
Smith NG, Hart TA, Kidwai A, Vernon JRG, Blais M, Adam B. Results of a pilot study to ameliorate psychological and behavioral outcomes of minority stress among Young Gay and Bisexual Men. Behav Ther. 2017;48(5):664–77.PubMedCrossRef
45.
46.
Queiroz AAFLN, Sousa ÁFL, Araújo TME, Brignol S, Reis RK, Fronteira I, Moura MEB. High rates of unprotected receptive anal sex and vulnerabilities to HIV infection among brazilian men who have sex with men. Int J STD AIDS. 2021;32(4):368–77.PubMedCrossRef
47.
Frankis J, Flowers P, McDaid L, Bourne A. Low levels of chemsex among men who have sex with men, but high levels of risk among men who engage in chemsex: analysis of a cross-sectional online survey across four countries. Sex Health. 2018;15(2):144–50.PubMedPubMedCentralCrossRef
48.
49.
50.
Lauby J, Zhu L, Milnamow M, Batson H, Bond L, Curran-Groome W, Carson L. Get real: evaluation of a community-level HIV Prevention intervention for Young MSM who engage in episodic substance use. AIDS Educ Prev. 2017;29(3):191–204.PubMedCrossRef
51.
Wong NS, Kwan TH, Lee KCK, Lau JYC, Lee SS. Delineation of chemsex patterns of men who have sex with men in association with their sexual networks and linkage to HIV prevention. Int J Drug Policy. 2020;75:102591.PubMedCrossRef
52.
Zheng S. The growing threat of China’s HIV epidemic. Lancet Public Health. 2018;3(7):311.CrossRef
53.
Xu JJ, Zhang C, Hu QH, Chu ZX, Zhang J, Li YZ, Lu L, Wang Z, Fu JH, Chen X, Yan HJ, Zhuang MH, Jiang YJ, Geng WQ, Vermund SH, Shang H, Qian HZ. Recreational drug use and risks of HIV and sexually transmitted infections among chinese men who have sex with men: mediation through multiple sexual partnerships. BMC Infect Dis. 2014;14:8.CrossRef
Metadata
Title
Sexual uses of drug and alcohol among men who have sex with men in China: implications for HIV prevention
Authors
Jinshen Wang
Peizhen Zhao
Wenqian Xu
Cheng Wang
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2022
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-022-07880-8

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