Recreational Drug Use among Chinese MSM and Transgender Individuals: Results from a National Online Cross-Sectional Study

PLOS ONE, Dec 2019

Background Recreational drug use has increased considerably among Chinese men who have sex with men (MSM). The phenomenon has the potentially to increase HIV transmission among Chinese MSM. The aims of this study were: 1) to investigate the prevalence of recreational drug use among Chinese MSM, and 2) to explore the correlation between gay smartphone based sex-seeking applications (gay apps), HIV/STIs testing, group sex, commercial sex, sexual roles and poppers use among Chinese MSM. Methods MSM who were born biologically male, were at least 16 years of age and had engaged in anal sex with a man at least once were recruited through a nation-wide online survey in 2014. Information regarding socio-demographics, risk behaviors, recreational drug use, HIV and other STIs testing history and gay app use were collected. Univariate and multivariate analysis were used to determine factors associated with recreational drug use among Chinese MSM. Results Among 1424 participating MSM, 1100 (77.3%) reported ever using recreational drugs in their lifetime. In the last 12 months, 303 (21.3%) used poppers, 34 (2.4%) used crystal meth and 15 (1.0%) used ecstasy. The mean age of respondents was 25.6±6.8 years, 72.9% identified as gay, 41.3% were students, and 83.8% had never been married. Multiple logistic regression models revealed that compared with non-popper users, popper users were more likely to have been tested for HIV (adjusted OR (aOR) = 1.50, 95% CI: 1.15–1.96) and other STIs (aOR = 1.65, 95% CI: 1.26–2.17). In addition, popper users were more likely to engage in group sex (aOR = 2.63, 95% CI:1.80–3.86), commercial sex (aOR = 1.86, 95% CI:1.13–3.06) and used gay mobile apps to seek sexual partners (aOR = 2.10, 95% CI:1.58–2.80). Conclusion Chinese MSM has a high rate of recreational drug use, including poppers. Public health programs serving MSM may consider integrating intervention programs to decrease recreational drug use related harms.

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Recreational Drug Use among Chinese MSM and Transgender Individuals: Results from a National Online Cross-Sectional Study

January Recreational Drug Use among Chinese MSM and Transgender Individuals: Results from a National Online Cross-Sectional Study Peizhen Zhao 0 1 2 Songyuan Tang 0 2 Cheng Wang 0 1 2 Ye Zhang 0 1 2 John Best 0 2 Thitikarn May Tangthanasup 0 2 Shujie Huang 0 1 2 Bin Yang 0 1 2 Chongyi Wei 0 2 Joseph D. Tucker 0 2 Weiming Tang 0 1 2 0 Institutes of Health [National Institute of Allergy and Infectious Diseases 1R01AI114310]; UNC- South China STD Research Training Centre [Fogarty International Centre 1D43TW009532 to JT]; UNC Center for AIDS Research [National Institute of Allergy and Infectious Diseases 5P30AI050410]; University of California San Francisco Centre for AIDS Research [National , USA 1 Guangdong Center for Skin Diseases and STI Control , Guangzhou , China , 2 University of North Carolina at Chapel Hill Project-China , Guangzhou , China , 3 SESH study group of University of North Carolina at Chapel Hill , Guangzhou , China , 4 Kunming Medical University , Kunming , China , 5 School of Medicine, University of California, San Francisco, San Francisco, United States of America, 6 School of Medicine of University of North Carolina at Chapel Hill , Chapel Hill , United States of America 2 Editor: Zhefeng Meng, Fudan University , CHINA Recreational drug use has increased considerably among Chinese men who have sex with men (MSM). The phenomenon has the potentially to increase HIV transmission among Chinese MSM. The aims of this study were: 1) to investigate the prevalence of recreational drug use among Chinese MSM, and 2) to explore the correlation between gay smartphone based sex-seeking applications (gay apps), HIV/STIs testing, group sex, commercial sex, sexual roles and poppers use among Chinese MSM. - Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Background Methods Results MSM who were born biologically male, were at least 16 years of age and had engaged in anal sex with a man at least once were recruited through a nation-wide online survey in 2014. Information regarding socio-demographics, risk behaviors, recreational drug use, HIV and other STIs testing history and gay app use were collected. Univariate and multivariate analysis were used to determine factors associated with recreational drug use among Chinese MSM. Among 1424 participating MSM, 1100 (77.3%) reported ever using recreational drugs in their lifetime. In the last 12 months, 303 (21.3%) used poppers, 34 (2.4%) used crystal meth and 15 (1.0%) used ecstasy. The mean age of respondents was 25.6±6.8 years, 72.9% identified as gay, 41.3% were students, and 83.8% had never been married. Multiple logistic regression models revealed that compared with non-popper users, popper users were more likely to have been tested for HIV (adjusted OR (aOR) = 1.50, 95% CI: 1.15±1.96) and other STIs (aOR = 1.65, 95% CI: 1.26±2.17). In addition, popper users were more likely to engage Institute of Allergy and Infectious Diseases P30 AI027763 to CWei]; National Institute of Mental Health [R00MH093201 ]; the UNC Chapel Hill, Johns Hopkins University, Morehead School of Medicine and Tulane University (UJMT) Fogarty Fellowship [FIC R25TW0093]; and the Doris Duke International Clinical Research Fellowship .This publication was also supported by Grant Number UL1TR001111 from the National Center for Advancing Translational Sciences (NCATS) at the National Institutes of Health. Competing Interests: The authors have declared that no competing interests exist. in group sex (aOR = 2.63, 95% CI:1.80±3.86), commercial sex (aOR = 1.86, 95% CI:1.13± 3.06) and used gay mobile apps to seek sexual partners (aOR = 2.10, 95% CI:1.58±2.80). Conclusion Chinese MSM has a high rate of recreational drug use, including poppers. Public health programs serving MSM may consider integrating intervention programs to decrease recreational drug use related harms. Introduction Recreational drug use is long being considered to a major global driving force for HIV transmission[ 1 ]. With the implementation of harm reduction programs, however, HIV incidence rates have decreased among people who inject drugs around the world[2±4]. Despite these achievements in HIV transmission prevention among people who inject drugs, many challenges still remain [5]. In addition, new challenges have emerged in the last decade due to increasing prevalence of recreational drug use among men who have sex with men (MSM) and transgender individuals [ 6 ]. Recreational drug use is not uncommon among MSM, and may be associated with risk of HIV and sexually transmitted infections[ 7 ]. Recreational drug use and subsequent states of intoxication may influence sexual risk behavior among MSM [ 6 ]. Recreational drug use affects HIV transmission via several mechanisms, including physiological responses, routes of administration, venues at which drugs are used, incidence of HIV infection in specific drug-using populations, and cognitive eff (...truncated)


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Peizhen Zhao, Songyuan Tang, Cheng Wang, Ye Zhang, John Best, Thitikarn May Tangthanasup, Shujie Huang, Bin Yang, Chongyi Wei, Joseph D. Tucker, Weiming Tang. Recreational Drug Use among Chinese MSM and Transgender Individuals: Results from a National Online Cross-Sectional Study, PLOS ONE, 2017, Volume 12, Issue 1, DOI: 10.1371/journal.pone.0170024