Recreational Drug Use among Chinese Men Who Have Sex with Men: A Risky Combination with Unprotected Sex for Acquiring HIV Infection

Objective. To investigate the prevalence of recreational drug use and its relationship with HIV infection among Chinese MSM.Methods. A cross-sectional study of 625 MSM was conducted in Shenyang, China. Questionnaires were administered to collect information on recreational drug use and sexual behaviors. Blood specimens were collected to test for HIV and syphilis antibodies.Results. Nearly a quarter (23.2%, 145/625) of participants reported ever using recreational drugs, among which alkyl nitrites (poppers) was the most frequently used drug (19.2%), followed by methylmorphine phosphate (5.1%), methamphetamine (4.0%), and ketamine (0.8%). The overall prevalence of HIV and syphilis was 9.6% and 10.4%, respectively. Multivariate logistic analysis showed that recreational drug use was significantly correlated with age ≤25 year (adjusted odds ratio [aOR] = 1.6, 95% CI, 1.1–2.9), single marital status (aOR = 2.1, 95% CI, 1.2–3.6), and seeking male sexual partners mainly through Internet (aOR = 1.8, 95% CI, 1.8–2.8). Recreational drug use was independently associated with an increased risk of HIV infection (aOR = 3.5, 95% CI, 2.0–6.2).Conclusions. Our study suggests that recreational drug use is popular among Chinese MSM and is associated with significantly increased HIV infection risk. HIV prevention intervention programs should reduce both drug use and risky sexual behaviors in this population.

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Recreational Drug Use, Polydrug Use and Sexual Behaviors Among Men Who Have Sex With Men in Southwestern China: A Cross-Sectional Study

Behavioral Medicine ◽

10.1080/08964289.2018.1538099 ◽

2019 ◽

Vol 45 (4) ◽

pp. 314-322 ◽

Cited By ~ 3

Author(s):

Yingxue Dai ◽

Patou Masika Musumari ◽

Huailiang Chen ◽

Yuling Huang ◽

Teeranee Techasrivichien ◽

...

Keyword(s):

Drug Use ◽

Sexual Behaviors ◽

Cross Sectional Study ◽

Southwestern China ◽

Recreational Drug ◽

Sectional Study ◽

Cross Sectional ◽

Polydrug Use ◽

Recreational Drug Use ◽

Sex With Men

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Recreational drug use and risk of HIV infection among men who have sex with men: A cross-sectional study in Shenzhen, China

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2017.09.004 ◽

2017 ◽

Vol 181 ◽

pp. 30-36 ◽

Cited By ~ 12

Author(s):

Chenlin Duan ◽

Lan Wei ◽

Yitian Cai ◽

Lin Chen ◽

Zhengrong Yang ◽

...

Keyword(s):

Drug Use ◽

Hiv Infection ◽

Cross Sectional Study ◽

Recreational Drug ◽

Sectional Study ◽

Cross Sectional ◽

Recreational Drug Use ◽

Sex With Men

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Recreational Drug use and Risk of HIV Infection Among Young Men Who Have Sex with men: A Cross-Sectional Study in Tianjin, China

10.21203/rs.3.rs-192111/v1 ◽

2021 ◽

Author(s):

Changping Li ◽

Zeyang Yu ◽

Yang Chen ◽

Honglu Zhang ◽

Huijie Huang ◽

...

Keyword(s):

Drug Use ◽

Hiv Infection ◽

Drug Users ◽

Cross Sectional Study ◽

Recreational Drug ◽

Recreational Drugs ◽

Sectional Study ◽

Cross Sectional ◽

Recreational Drug Use ◽

Sex With Men

Abstract Background- Recreational drug use among young men who have sex with men (YMSM) was a public health issue of worldwide concern. Evidence had shown the relevance between recreational drug use and human immunodeficiency virus (HIV) infection. This study aimed to investigate the current prevalence state of recreational drug use among YMSM in Tianjin, discern the characteristics of YMSM who used recreational drugs or not and examine the interaction effect of recreational drug use and unprotected anal intercourse (UAI) on HIV infection.Methods- In 2018, a cross-sectional study was conducted in Tianjin, China. The snowball sampling method was used to recruit YMSM. Participants were recruited from gay bars, gay bathhouses, social network sites (WeChat, QQ, gay chat website), gay apps and peer referrals. Structured questionnaires were used to collect data.Results- A total of 1075 YMSM met the eligibility criteria and were included in the study eventually. The overall HIV prevalence was 4.3% (46/1075). Of all the recreational drugs involved in this study (rush poppers, methamphetamine, capsule No.0), rush poppers (406/517,78.5%) were the most popular among YMSM in Tianjin. Compared with non-drug users, drug users were more likely to have first sex earlier, be bisexual, be male sex worker (MSW), have a higher education level, seek sex partners through physical venues, engage in UAI, have sexually transmitted infection (STI), and receive HIV testing. Moreover, recreational drug use and UAI were associated with the increased risk of HIV infection [adjusted OR:3.6 (95%CI: 1.7-7.6) and 4.9 (95%CI: 2.2-10.4), respectively]. There was additive interaction of recreational drug use and UAI on HIV infection [relative excess risk due to interaction (RERI): 6.949 (95%CI: 0.011‐13.887); attributable proportion due to interaction (AP): 0.809 (95%CI: 0.578‐1.039)].Conclusions- Recreational drug use was common and correlated with HIV infection among YMSM in Tianjin. There was an urgent need to build novel targeted HIV prevention strategies to discern and reduce recreational drug use among YMSM in China.

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Association between recreational drug use and sexual practices among people who inject drugs in Southwest China: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2017-019730 ◽

2018 ◽

Vol 8 (6) ◽

pp. e019730 ◽

Cited By ~ 2

Author(s):

Shu Su ◽

Lei Zhang ◽

Feng Cheng ◽

Shunxiang Li ◽

Shifu Li ◽

...

Keyword(s):

Drug Use ◽

People Who Inject Drugs ◽

Southwest China ◽

Cross Sectional Study ◽

Sexual Practices ◽

Recreational Drug ◽

Sectional Study ◽

Cross Sectional ◽

Recreational Drug Use

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The use of inappropriate anal douching tool associates with increased HIV infection among men who have sex with men: a cross-sectional study in Shenyang, China

BMC Public Health ◽

10.1186/s12889-021-10276-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhen Xing Chu ◽

Guangquan Shen ◽

Qinghai Hu ◽

Hongyi Wang ◽

Jing Zhang ◽

...

Keyword(s):

Risk Factors ◽

Hiv Infection ◽

Sexual Behaviors ◽

Anal Intercourse ◽

Cross Sectional Study ◽

Sectional Study ◽

Anal Sex ◽

Cross Sectional ◽

Increased Risk ◽

Sex With Men

Abstract Background Rectal douching (RD) is widely practiced by men who have sex with men (MSM), and is associated with increased risk of HIV infection. However, the mechanism of how RD increases the risk of HIV infection is not well understood, and there is limited data on RD behavior in MSM practicing anal sex in China. We examine the purpose of RD, its timing in relation to anal sex, the types of RD products used, and risky sexual behaviors among MSM reporting anal sex. Methods Between August 2017 and December 2018, a cross-sectional study was conducted among adult MSM in Shenyang, China. Data were collected on demographics, sexual behaviors, and RD for the most recent sexual intercourse by means of interviewer-administered face-to-face questionnaires. Blood samples were collected to test for antibodies to HIV and syphilis. Multivariable logistic regression models were used to assess the risk factors associated with HIV infection. Results A total of 515 eligible MSM participated in this survey (median age: 31 years). During the most recent anal intercourse, 28.3% (146/515) had condomless receptive anal intercourse (CRAI), 21.4% (110/515) practiced serosorting, and more than half (61.6%, 317/515) reported RD before or after anal sex. Of those practicing RD, 96.8% (307/317) conducted RD before sex, while 62.5% (198/317) conducted RD after sex. The douching devices used were primarily shower hoses (85.3%, 262/307), and relatively few MSM used commercial RD products (8.1%, 25/307) before sex. The prevalence of HIV-1 and syphilis was 11.7% and 13.2%, respectively. HIV infection was positively associated with RD, practicing RD before sex, the interaction between RD and CRAI using a shower hose for RD and other risk factors, practicing RD after sex, CRAI, using nitrite inhalants, main sexual role with males as bottom and syphilis infection. Conclusions RD is popular among Chinese MSM. Improper noncommercial RD tools use (such as shower hose), the interaction effect between RD and CRAI associated with HIV infection. Public health workers and the MSM community should publicize scientific knowledge and prevention approaches relating to RD and HIV transmission to MSM. We recommend that further studies should be conducted to understand the detailed mechanism between RD and increased HIV prevalence.

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The use of inappropriate anal douching tool associates with increased HIV infection among men who have sex with men: a cross-sectional study in Shenyang, China

10.21203/rs.3.rs-17842/v2 ◽

2020 ◽

Author(s):

ZhenXing Chu ◽

Guangquan Shen ◽

Qinghai Hu ◽

Hongyi Wang ◽

Jing Zhang ◽

...

Keyword(s):

Hiv Infection ◽

Sexual Behaviors ◽

Interaction Effect ◽

Anal Intercourse ◽

Cross Sectional Study ◽

Sectional Study ◽

Anal Sex ◽

Cross Sectional ◽

Increased Risk ◽

Sex With Men

Abstract Background: Rectal douching (RD) is widely practiced by men who have sex with men (MSM), and is correlated with increased risk of HIV infection. However, the mechanism of how RD increases the risk of HIV infection is not well understood, and there is limited data on RD behavior in MSM practicing anal sex in China. We examine the purpose of RD, its timing in relation to anal sex, the types of RD products used, and risky sexual behaviors among MSM reporting anal sex.Methods: Between August 2017 and December 2018, a cross-sectional study was conducted among adult MSM in Shenyang, China. Data were collected on demographics, sexual behaviors, and RD for the most recent sexual intercourse by means of interviewer-administered face-to-face questionnaires. Blood samples were collected to test for antibodies to HIV and syphilis. Multivariable logistic regression models were used to assess the risk factors associated with HIV infection.Results: A total of 515 eligible MSM participated in this survey (median age: 31 years). During the most recent anal intercourse, 28.3% (146/515) had condomless receptive anal intercourse (CRAI), 21.4% (110/515) practiced serosorting, and more than half (61.6%, 317/515) reported RD before or after anal sex. Of those practicing RD, 96.8% (307/317) conducted RD before sex, while 62.5% (198/317) conducted RD after sex. The douching devices used were primarily shower hoses (85.3%, 262/307), and relatively few MSM used commercial RD products (8.1%, 25/307) before sex. The prevalence of HIV-1 and syphilis was 11.7% and 13.2%, respectively. HIV infection was positively associated with RD (adjusted odds ratio (AOR), 2.8; 95% confidence interval (CI), 1.4-5.5), practicing RD before sex (AOR, 2.3; 95% CI, 1.2–4.3), practicing RD after sex (AOR, 1.8; 95% CI, 1.0–3.1), using a shower hose for RD (AOR, 3.5; 95% CI, 1.1–13.0), CRAI (AOR, 2.9; 95% CI, 1.6–5.5), and an interaction effect of RD and CRAI (AOR = 4.2; 95 % CI, 2.2- 8.1) in the most recent anal intercourse.Conclusions: RD is popular among Chinese MSM. Improper noncommercial RD tools use (such as shower hose), the interaction effect between RD and CRAI associated with HIV infection. Public health workers and the MSM community should publicize scientific knowledge and prevention approaches relating to RD and HIV transmission to MSM. We recommend that cohort studies should be conducted to confirm the causal relationship between RD and acquiring HIV.

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Recreational drug use among Chinese MSM: results from a national-wide cross-sectional study

The Lancet ◽

10.1016/s0140-6736(16)31996-1 ◽

2016 ◽

Vol 388 ◽

pp. S69 ◽

Cited By ~ 2

Author(s):

Peizhen Zhao ◽

Songyuan Tang ◽

Cheng Wang ◽

Ye Zhang ◽

John Best ◽

...

Keyword(s):

Drug Use ◽

Cross Sectional Study ◽

Recreational Drug ◽

Sectional Study ◽

Cross Sectional ◽

Wide Cross ◽

Recreational Drug Use

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The use of inappropriate anal douching tool associates with increased HIV infection among men who have sex with men: a cross-sectional study in Shenyang, China

10.21203/rs.3.rs-17842/v4 ◽

2021 ◽

Author(s):

ZhenXing Chu ◽

Guangquan Shen ◽

Qinghai Hu ◽

Hongyi Wang ◽

Jing Zhang ◽

...

Keyword(s):

Risk Factors ◽

Hiv Infection ◽

Sexual Behaviors ◽

Anal Intercourse ◽

Cross Sectional Study ◽

Sectional Study ◽

Anal Sex ◽

Cross Sectional ◽

Increased Risk ◽

Sex With Men

Abstract Background: Rectal douching (RD) is widely practiced by men who have sex with men (MSM), and is associated with increased risk of HIV infection. However, the mechanism of how RD increases the risk of HIV infection is not well understood, and there is limited data on RD behavior in MSM practicing anal sex in China. We examine the purpose of RD, its timing in relation to anal sex, the types of RD products used, and risky sexual behaviors among MSM reporting anal sex.Methods: Between August 2017 and December 2018, a cross-sectional study was conducted among adult MSM in Shenyang, China. Data were collected on demographics, sexual behaviors, and RD for the most recent sexual intercourse by means of interviewer-administered face-to-face questionnaires. Blood samples were collected to test for antibodies to HIV and syphilis. Multivariable logistic regression models were used to assess the risk factors associated with HIV infection.Results: A total of 515 eligible MSM participated in this survey (median age: 31 years). During the most recent anal intercourse, 28.3% (146/515) had condomless receptive anal intercourse (CRAI), 21.4% (110/515) practiced serosorting, and more than half (61.6%, 317/515) reported RD before or after anal sex. Of those practicing RD, 96.8% (307/317) conducted RD before sex, while 62.5% (198/317) conducted RD after sex. The douching devices used were primarily shower hoses (85.3%, 262/307), and relatively few MSM used commercial RD products (8.1%, 25/307) before sex. The prevalence of HIV-1 and syphilis was 11.7% and 13.2%, respectively. HIV infection was positively associated with RD, practicing RD before sex, the interaction between RD and CRAI using a shower hose for RD and other risk factors, practicing RD after sex, CRAI, using nitrite inhalants, main sexual role with males as bottom and syphilis infection.Conclusions: RD is popular among Chinese MSM. Improper noncommercial RD tools use (such as shower hose), the interaction effect between RD and CRAI associated with HIV infection. Public health workers and the MSM community should publicize scientific knowledge and prevention approaches relating to RD and HIV transmission to MSM. We recommend that further studies should be conducted to understand the detailed mechanism between RD and increased HIV prevalence.

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The use of inappropriate anal douching tool associates with increased HIV infection among men who have sex with men: a cross-sectional study in Shenyang, China

10.21203/rs.3.rs-17842/v3 ◽

2020 ◽

Author(s):

ZhenXing Chu ◽

Guangquan Shen ◽

Qinghai Hu ◽

Hongyi Wang ◽

Jing Zhang ◽

...

Keyword(s):

Hiv Infection ◽

Sexual Behaviors ◽

Interaction Effect ◽

Anal Intercourse ◽

Cross Sectional Study ◽

Sectional Study ◽

Anal Sex ◽

Cross Sectional ◽

Increased Risk ◽

Sex With Men

Abstract Background: Rectal douching (RD) is widely practiced by men who have sex with men (MSM), and is associated with increased risk of HIV infection. However, the mechanism of how RD increases the risk of HIV infection is not well understood, and there is limited data on RD behavior in MSM practicing anal sex in China. We examine the purpose of RD, its timing in relation to anal sex, the types of RD products used, and risky sexual behaviors among MSM reporting anal sex.Methods: Between August 2017 and December 2018, a cross-sectional study was conducted among adult MSM in Shenyang, China. Data were collected on demographics, sexual behaviors, and RD for the most recent sexual intercourse by means of interviewer-administered face-to-face questionnaires. Blood samples were collected to test for antibodies to HIV and syphilis. Multivariable logistic regression models were used to assess the risk factors associated with HIV infection.Results: A total of 515 eligible MSM participated in this survey (median age: 31 years). During the most recent anal intercourse, 28.3% (146/515) had condomless receptive anal intercourse (CRAI), 21.4% (110/515) practiced serosorting, and more than half (61.6%, 317/515) reported RD before or after anal sex. Of those practicing RD, 96.8% (307/317) conducted RD before sex, while 62.5% (198/317) conducted RD after sex. The douching devices used were primarily shower hoses (85.3%, 262/307), and relatively few MSM used commercial RD products (8.1%, 25/307) before sex. The prevalence of HIV-1 and syphilis was 11.7% and 13.2%, respectively. HIV infection was positively associated with RD (adjusted odds ratio (AOR), 2.8; 95% confidence interval (CI), 1.4-5.5), practicing RD before sex (AOR, 2.3; 95% CI, 1.2–4.3), practicing RD after sex (AOR, 1.8; 95% CI, 1.0–3.1), using a shower hose for RD (AOR, 3.5; 95% CI, 1.1–13.0), CRAI (AOR, 2.9; 95% CI, 1.6–5.5), and an interaction effect of RD and CRAI (AOR = 4.2; 95 % CI, 2.2- 8.1) in the most recent anal intercourse.Conclusions: RD is popular among Chinese MSM. Improper noncommercial RD tools use (such as shower hose), the interaction effect between RD and CRAI associated with HIV infection. Public health workers and the MSM community should publicize scientific knowledge and prevention approaches relating to RD and HIV transmission to MSM. We recommend that further studies should be conducted to understand the detailed mechanism between RD and increased HIV prevalence.

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