POVEZANOST HEMSEKSA SA SEKSUALNIM PONAŠANJEM I POLNO PRENOSIVIM INFEKCIJAMA KOD MUŠKARACA KOJI IMAJU SEKSUALNE ODNOSE SA MUŠKARCIMA U BEOGRADU
Sažetak
Uvod/Cilj: Hemseks je česta praksa među muškarcima koji imaju seksualne odnose sa muškarcima (MSM). Cilj ovog istraživanja bio je da se proceni prevalencija hemseksa među MSM populacijom u Beogradu i njegova povezanost sa njihovim ponašanjem i polno prenosivim infekcijama.
Metode: Studija preseka sprovedena je u dve zdravstvene ustanove u Beogradu i obuhvatila je 469 MSM osoba. Anonimnom anketom od svih ispitanika su prikupljeni podaci o demografskim karakteristikama, razlogu dolaska lekaru, seksualnoj anamnezi i upotrebi seksualizovanih droga u prethodnih šest meseci.
Rezultati: Od 469 ispitanika 123 (26,2%) je praktikovalo hemseks, a gama-hidroksibutirat (GHB) i gama-butirolakton (GBL) su bile najčešće korišćene seksualizovane droge (84,6%). Prema rezultatima multivarijantne logističke regresione analize učesnici koji su praktikovali hemseks značajno su se razlikovali od ostalih ispitanika u sledećim karakteristikama: češće su bili zaposleni (Unakrsni odnos – UO=2,50; 95% interval poverenja - 95%IP=1,19-5,26; p=0,015), imali su veći broj seksualnih partnera u poslednjih šest meseci (UO=1,39; 95%IP=1,14-1,72; p=0,002) i analne seksualne odnose bez upotrebe kondoma (UO=3,23; 95%IP=1,64-6,25; p=0,001), češće su praktikovali grupni seks tokom poslednjih šest meseci (UO=4,35; 95%CI=2,38-7,69; p<0,001), konzumirali su veće količine alkohola (UO=2,50; 95%CI=1,54- 4,00; p<0,001) i češće su imali bakterijsku polno prenosivu infekciju u poslednjih godinu dana (UO=2,70; 95%CI=1,61-4,54; p<0,001). Učestalost upotrebe rekreativnih droga bila je ređa kod ispitanika koji su praktikovali hemseks (UO=0,59; 95%CI = 0,41-0,88; p=0,009).
Zaključak: MSM osobe koje su imale hemseks češće su praktikovale visoko rizično seksualno ponašanje i češće su obolevale od bakterijskih polno prenosivih infekcija. Rastući fenomen hemseksa među MSM populacijom zahteva podizanje svesti o problemima hemseksa kako među pripadnicima ove vulnerabilne populacije, tako i među zdravstvenim radnicima.
Reference
Sewell J, Miltz A, Lampe FC, Cambiano V, Speakman A, Phillips AN, et al. Poly drug use, chemsex drug use, and associations with sexual risk behaviour in HIV-negative men who have sex with men attending sexual health clinics. Int J Drug Policy 2017;43: 33-43. http://doi: 10.1016/j.drugpo.2017.01.001.
Tomkins A, George R, Kliner M. Sexualised drug taking among men who have sex with men: a systematic review. Perspect Public Health 2019;139(1):23-33. http:// doi: 10.1177/1757913918778872.
Stuart D. Chemsex: origins of the world, a history of the phenomenon and a respect to the culture. Drugs Alcohol Today 2019;19(1):3-10. https://doi.org/10.1108/DAT-10-2018-0058
McCarty-Caplan D, Jantz I, Swartz J. MSM and drug use a latent class analysis of drug use and related sexual risk behaviors. Aids Behav 2014;18(7):1339-51. https:// doi: 10.1007/s10461-013-0622-x.
European monitoring centre for drugs and drug addiction (EMCDDA). European Drug Report 2018: Trends and Developments. Available at: http://www.emcdda.europa.eu/system/files/ publications/8585/20181816_TDAT18001ENN_PDF.pdf/. Accessed February 16, 2023.
Evers YJ, Van Liere GAFS, Hoebe CJPA, Dukers-Muijrers NHTM. Chemsex among men who have sex with men living outside major cities and associations with sexually transmitted infection: a cross-sectional study in the Netherlands. PLoS ONE 2019;14(5):e0216732. https://doi: 10.1371/journal.pone.0216732.
Bourne A, Reid D, Hickson F, Torres-Rueda S, Steinberg P, Weatherburn P. “Chemsex” and harm reduction need among gay men in South London. Int J Drug Policy 2015;26(12):1171-6. https:// doi: 10.1016/j.drugpo.2015.07.013.
European Monitoring Centre for Drugs and Drug Addiction. Serbia, National Drug Report 2017. Publications Office of the European Union, Luxembourg, 2017.
Kurcevič E, Lines R. New psychoactive substances in Eurasia; a qualitative study of people who use drugs and harm reduction services in six countries. Harm Reduct J 2020;17(1). 94. https:// doi: 10.1186/s12954-020-00448-2.
Babor T, Higgins-Biddle JC, Sounders JB, Monteiro MG. The alcohol use disorder identification test. Guidelines for use in primary care. Department of Mental Health and Substance Dependence, World Health Organization, 2001.
Glynn RW, Byrne N, O’Dea S, Shanley A, Codd M, Keenan E, et al. Chemsex, risk behaviours and sexually transmitted infections among men who have sex with men in Dublin, Ireland. Int J Drug Policy 2018; 52: 9-15. https:// doi: 10.1016/j.drugpo.2017.10.008.
Druckler S, van Rooijen MS, de Vries HJC. Chemsex among men who have sex with men: a sexualized drug use survey among clients of the sexually transmitted infection outpatient clinic and users of a gay dating app in Amsterdam, the Netherlands. Sex Transm Dis 2018; 45(5): 325-331. https:// doi: 10.1097/OLQ.0000000000000753.
Amundsen E, Haugstvedt A, Skogen V, Berg RC. Health characteristics associated with chemsex among men who have sex with men: results from a cross-sectional clinic survey in Norway. PLoS One 2022; 17(10): e0275618. https:// doi: 10.1371/journal.pone.0275618.
Hegazi A, Lee MJ, Whittaker W, Green S, Simms R, Cutts R, et al. 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): 362-366. https:// doi: 10.1177/0956462416651229.
Hammoud MA, Bourne A, Maher L, Jin F, Haire B, Lea T, et al. Intensive sex partying with gamma-hydroxybutyrate: factors associated with using gamma-hydroxybutyrate for chemsex among Australian gay and bisexual men – results from the Flux Study. Sex Health 2018;15(2): 123-134. https:// doi: 10.1071/SH17146.
Maxwell S, Shahmanesh M, Gafos M. Chemsex behaviours among men who have sex with men: a systematic review of the literature. IntJ Drug Policy 2019; 63: 74-89. https:// doi: 10.1016/j.drugpo.2018.11.014.
Bowden-Jones O, Whitelock C, Abdulrahim D, Hemmings S, Margetts A, Crawford M. Prevalence of HIV risk-related drug use and sexual activity among men who have sex with men attending a specialist UK club drug clinic. Drugs Alcohol Today 2017; 17(1): 50-59. https:// DOI:10.1108/DAT-01-2017-0001.
Hockenhull J, Murphy KG, Paterson S. An observed rise in gamma-hydroxybuturate associated deaths in London: evidence to suggest a possible link with concomitant rise in chemsex. Forensic Sci Int 2017; 270: 93-97. https:// doi: 10.1016/j.forsciint.2016.11.039.
Daskalopoulou M, Rodger A, Phillips AN, Sherr L, Speakman A, Collins S, et al. 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. https:// doi: 10.1016/S2352-3018(14)70001-3.
Gorbach PM, Javanbakht M, Shover CL, Bolan RK, Ragsdale A, Shoptaw S. Associations between cannabis use, sexual behavior, and sexually transmitted infections/human immunodeficiency virus in a cohort of young men who have sex with men. Sex Transm Dis 2019; 46(2):105-11. https:// doi: 10.1097/OLQ.0000000000000919.
Bruce D, Kahana S, Harper GW, Fernández MI, ATN. Alcohol use predicts sexual risk behavior with HIV-negative or partners of unknown status among young HIV-positive men who have sex with men. AIDS Care 2013; 25(5): 559-65. https:// doi: 10.1080/09540121.2012.720363.
Woolf SE, Maisto SA. Alcohol use and risk of HIV infection among men who have sex with men. AIDS Behav 2009; 13(4):757-82. https:// doi: 10.1007/s10461-007-9354-0.
Bjekić M, Šipetić-Grujičić S, Begović-Vuksanović B, Rafailović N, Vlajinac H. Syphilis resurgence in Belgrade, Serbia in the new millennium: an outbreak in 2014. Cent Eur J Public Health 2017;25(4):277-81. https:// doi: 10.21101/cejph.a4525.
Bjekić M, Lečić-Toševski D,Vlajinac H. Personality dimensions of sexually transmitted disease repeaters assessed with the Millon Clinical Multiaxial Inventory. J Eur Acad Dermatol Venereol 2002:16(1):63-5. https:// doi: 10.1046/j.1468-3083.2002.00367.x.