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Crystal Methamphetamine Use in Sexual Settings Among German Men Who Have Sex With Men
Henrike Schecke1, Toby Lea2,3, Annette Bohn1
1Department of Psychiatry and Psychotherapy, University of Duisburg-Essen, LVR-Hospital Essen, Essen, Germany.
Frontiers in Psychiatry
|December 24, 2019
Summary
Crystal methamphetamine use in sexual settings is prevalent among German men who have sex with men (MSM), correlating with poorer mental health outcomes. However, many MSM utilize harm reduction and HIV prevention strategies like PrEP.
Area of Science:
- Public Health
- Mental Health
- Substance Use Research
Background:
- Men who have sex with men (MSM) are disproportionately affected by substance use, particularly crystal methamphetamine.
- Chemsex, or drug use in sexual settings, is a growing concern within MSM communities, linked to increased risk of sexually transmitted infections (STIs) including HIV and hepatitis C.
- Adverse mental health outcomes are frequently reported at higher rates among MSM who use methamphetamine.
Purpose of the Study:
- To investigate the prevalence and patterns of crystal methamphetamine use in sexual settings among German MSM.
- To compare mental health outcomes and harm reduction practices between MSM who use crystal methamphetamine in sexual settings and those who do not.
- To assess the utilization of HIV prevention strategies, such as pre-exposure prophylaxis (PrEP), among MSM engaging in chemsex.
Main Methods:
- The study analyzed data from a subset of participants in the German Chemsex Survey, an online self-completed survey.
- Participants who used crystal methamphetamine for sex (n=130) were compared with those who did not use drugs for sex (n=177).
- The survey collected data on recreational substance use, chemsex, harm reduction, mental health, STIs, and healthcare utilization.
Main Results:
- Twenty-seven percent of participants reported crystal methamphetamine use in the past 12 months, with 89% using it in a sexual setting and 50% reporting injection.
- MSM using crystal methamphetamine in sexual settings reported higher rates of depression, somatization, anxiety, and PTSD compared to the general male population.
- These participants were also more likely to report major depression, be HIV positive, and use HIV PrEP.
Conclusions:
- Crystal methamphetamine use is a significant issue within sexual contexts for German MSM.
- A poorer mental health status is observed in this group compared to the general male population.
- MSM engaging in chemsex demonstrate awareness of health risks and utilize harm reduction and biomedical HIV prevention strategies, including PrEP.