“Sex and Drugs” in Substance-using Men Who Have Sex with Men (SUMSM)

Abstract

Introduction

Sex under the influence of drugs is widely known to be associated with high-risk of sexually transmitted disease. However, the impact of psychoactive substances (PAS) on the sexuality of MSM is rarely considered.

Objectives

To describe the pattern of drug use among SUMSM and its association with sexual practice.

Methods

A self-report anonymous form was remitted to SUMSM within addictology department or online from January to July 2014. The questionnaire includes a list of PAS, characteristics of their consumption and the effects sought especially on the sexual level (pleasure, facilitate sexual encounters, atypical sexual behavior…).

Results

228 MSM answered (49 through addictology department and 179 via Internet), with mean age of 39±13 years, socially integrated (74%), and having sex with multiple partner in 35% of cases. Most of them (45%) reported HIV positive status. The mostly used substances in sexual context are poppers (72%), cocaine (60%) and ecstasy (48%), with alcohol association in 58% and sildenafil in 43% of cases. Most of the respondents are polydrug users (82%). First time drug use was linked to sexual pleasure (51%).

Conclusion

Each PAS has specific sexual behaviour profile. In 54% of cases, respondents report substance-related disorder. Despite negative effect of cocaine on erection, respondents continue to use it with sildenafil to counterbalance and reach sexual pleasure. SUMSM need substance abuse education, prevention services support, and/or drug treatment. Patients should benefit from interventions targeting both sexual behavior and substance use to take into account link between sex and drug use.