Illicit Drug Use & Its Association with Sexual Risk Behavior among MSM: More Questions Than Answers?
PURPOSE OF REVIEW:
Illicit
drug use before or during sex - known as sexualized drug use (colloquially
'chemsex' or 'party and play') - has evolved as novel psychoactive substances
have entered the market in many parts of the world. Here, we review key
conceptual issues in associations between illicit drug use and sexual
risk-behaviour in MSM.
RECENT FINDINGS:
Although
many studies have confirmed that MSM use drugs with greater prevalence than the
general population, evidence is of variable quality and a sampling frame is
difficult to establish. Moreover, psychosocial hypotheses linking drug use and
sexual risk, including cognitive escape and sensation seeking, are unsatisfactory
and generally ignore strategic use of drugs for sexual aims. Person-level
associations between drug use history and both sexual risk behaviour and HIV
infection tend to be consistent around the world, but evidence comparing
encounters within subjects is generally unclear and out of date.
SUMMARY:
There
is a need for interventions for harm reduction targeted at MSM that account
specifically for the social and cultural contexts of sexualized drug use.
Expanded attention to surveillance of emerging drug use trends can help
clinicians in sexual health and infectious diseases best anticipate the needs
of their service users.
- 1Warwick Medical School, University of Warwick, Coventry bDepartment of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
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