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ChemsexPH: The Association Between Chemsex, HIV Status and Adherence to Antiretroviral Therapy Among Men Who Have Sex with Men in the Philippines

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Journal J Int AIDS Soc
Date 2024 Jul 10
PMID 38982574
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Abstract

Introduction: Chemsex, the use of psychotropic drugs before or during sexual intercourse, is associated with various HIV risk factors, including condomless sex and reduced adherence to pre-exposure prophylaxis or antiretroviral therapy (ART). In the Philippines, there are still limited studies exploring the associations between chemsex, HIV status and ART adherence. This study aims to compare recent and lifetime chemsex engagement in association with self-reported HIV status among Filipino men who have sex with men (MSM). We further explored the association between chemsex and ART adherence among people living with HIV engaged in chemsex.

Methods: A cross-sectional online survey of 479 Filipino MSM was conducted from 3 August to 1 December 2019. Demographic profiles, sexual behaviours, drug use, history of sexually transmitted infections (STIs), chemsex engagement and HIV status were collected and analysed. Bivariable and multivariable logistic regression were employed to assess the association between self-reported HIV status and chemsex engagement.

Results: Among the 479 respondents, Filipino MSM engaged in drug use and chemsex were generally older compared to those not engaged in drug use and chemsex (average age 31-33 vs. 29 years old; p<0.05). Methamphetamine was the most common drug for people who reported using drugs. An HIV-positive status was associated with recent chemsex engagement (aOR = 5.18, p<0.05) and a history of STIs (aOR = 2.09, p<0.05). The subgroup analysis showed that 79% (166/200) of persons living with HIV were adherent to ART. There was no significant association found between chemsex and ART adherence in the logistic regression analyses.

Conclusions: Chemsex behaviour, particularly recent chemsex engagement, is significantly associated with self-reported HIV status. The emerging data on MSM engaged in chemsex require integration of a more person-centred, comprehensive and robust harm reduction programmes into the existing combination prevention strategies in the country. Health education for Filipino MSM engaged in chemsex should prioritize raising awareness about methamphetamine effects and overdose risks, alongside proper medical management.

References
1.
Evers Y, van Liere G, Hoebe C, Dukers-Muijrers N . Chemsex among men who have sex with men living outside major cities and associations with sexually transmitted infections: A cross-sectional study in the Netherlands. PLoS One. 2019; 14(5):e0216732. PMC: 6516639. DOI: 10.1371/journal.pone.0216732. View

2.
Roux P, Fressard L, Suzan-Monti M, Chas J, Sagaon-Teyssier L, Capitant C . Is on-Demand HIV Pre-exposure Prophylaxis a Suitable Tool for Men Who Have Sex With Men Who Practice Chemsex? Results From a Substudy of the ANRS-IPERGAY Trial. J Acquir Immune Defic Syndr. 2018; 79(2):e69-e75. DOI: 10.1097/QAI.0000000000001781. View

3.
O Connor C, Leyritana K, Calica K, Gill R, Doyle A, Lewis J . Risk factors affecting adherence to antiretroviral therapy among HIV patients in Manila, Philippines: a baseline cross-sectional analysis of the Philippines Connect for Life Study. Sex Health. 2021; 18(1):95-103. DOI: 10.1071/SH20028. View

4.
Morineau G, Nugrahini N, Riono P, Nurhayati , Girault P, Mustikawati D . Sexual risk taking, STI and HIV prevalence among men who have sex with men in six Indonesian cities. AIDS Behav. 2009; 15(5):1033-44. DOI: 10.1007/s10461-009-9590-6. View

5.
Ugarte A, de la Mora L, Garcia D, Martinez-Rebollar M, de Lazzari E, Torres B . Evolution of Risk Behaviors, Sexually Transmitted Infections and PrEP Care Continuum in a Hospital-Based PrEP Program in Barcelona, Spain: A Descriptive Study of the First 2 Years' Experience. Infect Dis Ther. 2022; 12(2):425-442. PMC: 9753893. DOI: 10.1007/s40121-022-00733-6. View