Sexualised drug taking is increasingly reported on national and international levels. We aim to review existing evidence of the relationship between recreational drug use (RDU) and sexual intercourse among men who have sex with men (MSM).
Methods:
We reviewed published abstracts and full articles identified from Cochrane, MEDLINE and Embase databases from November 2010 to 2017. We included any existing studies investigating RDU in MSM and at least one of the following: high-risk sexual practices, sexually transmitted infections (STIs) or barriers to accessing specialist support.
Results:
In total, 112 studies were included. Of them, 38 studies specifically reported the prevalence of chemsex-related drug use. Links with sexualised drug taking and high-risk sexual practices including condomless sex and group sex were reported by several studies. Recreational drug use in the sexual setting appears linked to the acquisition of STIs, including hepatitis C, syphilis and gonorrhoea. Reports of adverse mental health outcomes are increasingly described, with several studies documenting chemsex-related inpatient admission. A paucity of research addressing barriers to those accessing specialist drug support services was identified.
Conclusion:
This review demonstrates the complex interplay between recreational drug use, high-risk sexual practices and STIs. It identifies the description of adverse mental health outcomes in the chemsex setting, thus highlighting the need for a multidisciplinary approach across specialties in the management of those adversely affected. Finally, it illuminates the need for future research into perceived barriers of those who require access to support services to ensure timely and comprehensive support provision.
BourneAReidDHicksonFet al. Illicit drug use in sexual settings (‘chemsex’) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study. Sex Transm Infect2015; 91(8): 564–8.
2.
HegaziALeeMJWhittakerWet 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 AIDS2017; 28(4): 362–6.
3.
PHE action plan 2015–16. Promoting the health and wellbeing of gay, bisexual and other men who have sex with men. London: Public Health England; 2015.
4.
StoicescuC. Global state of harm reduction. London: Harm Reduction International; 2012, pp. 147–55.
5.
TomkinsAVivancosRWardCet al. How can those engaging in chemsex best be supported? An online survey to gain intelligence in Greater Manchester. Int J STD AIDS2018; 29: 128–34.
6.
HarrisRJRamsayMHopeVDet al. Hepatitis C prevalence in England remains low and varies by ethnicity: an updated evidence synthesis. Eur J Public Health2012; 22(2): 187–92.
7.
Action plan for the prevention, management and control of Hepatitis C in Northern Ireland. London: Department of Health Social Services and Public Safety; 2007.
8.
Hepatitis C in the UK. London: Public Health England;2014.
9.
HIV in the UK – situation report 2015. Incidence, prevalence and prevention. London: Public Health England; 2015.
10.
LimSHCheungDHGuadamuzTEet al. Latent class analysis of substance use among men who have sex with men in Malaysia: findings from the Asian Internet MSM Sex Survey. Drug Alcohol Depend2015; 151: 31–7.
11.
FreemanPWalkerBCHarrisDRet al. Methamphetamine use and risk for HIV among young men who have sex with men in 8 US cities. Arch Pediatr Adolesc Med2011; 165(8): 736–40.
12.
EatonLADriffinDDSmithHet al. Psychosocial factors related to willingness to use pre-exposure prophylaxis for HIV prevention among Black men who have sex with men attending a community event. Sex Health2014; 11(3): 244–51.
13.
LeaTMaoLHopwoodMet al. Methamphetamine use among gay and bisexual men in Australia: trends in recent and regular use from the Gay Community Periodic Surveys. Int J Drug Policy2016; 29: 66–72.
14.
ChenXLiXZhengJet al. Club drugs and HIV/STD infection: an exploratory analysis among men who have sex with men in Changsha, China. PLoS ONE2015; 10(5): e0126320.
15.
PitpitanEVGoodman-MezaDBurgosJLet al. Prevalence and correlates of HIV among men who have sex with men in Tijuana, Mexico. J Int AIDS Soc2015; 18(1): doi:10.7448/IAS.18.1.19304
16.
BeymerMRBolanRKFlynnRPet al. Uptake and repeat use of postexposure prophylaxis in a community-based clinic in Los Angeles, California. AIDS Res Hum Retroviruses2014; 30(9): 848–55.
17.
RichelODeHJCDijkgraafMGWet al. Risk factors for the presence of anal intraepithelial neoplasia in HIV+ men who have sex with men. PLoS ONE2013; 8(12): e84030.
18.
MacdonaldNSullivanAKFrenchPet al. Risk factors for rectal lymphogranuloma venereum in gay men: results of a multicentre case-control study in the UK. Sex Transm Infect2014; 90(4): 262–8.
19.
NishijimaTShimboTKomatsuHet al. Incidence and risk factors for incident hepatitis C infection among men who have sex with men with HIV-1 infection in a large urban HIV clinic in Tokyo. J Acquir Immune Defic Syndr2014; 65(2): 213–7.
20.
DaskalopoulouMRodgerAThorntonAet al. Sexual behaviour, recreational drug use and hepatitis C co-infection in HIV-diagnosed men who have sex with men in the United Kingdom: results from the ASTRA study. J Int AIDS Soc2014; 17(4 Suppl. 3): 19630.
21.
WardCLeeV. Experience of acute hepatitis C and HIV co-infection in an inner city clinic in the UK. J Int AIDS Soc2014; 17: 19639.
22.
NewmanLMDowellDBernsteinKet al. A tale of two gonorrhea epidemics: results from the STD surveillance network. Public Health Rep2012; 127(3): 282–92.
23.
ChewRASamuelMCLoTet al. Sex, drugs (methamphetamines), and the Internet: increasing syphilis among men who have sex with men in California, 2004–2008. Am J Public Health2013; 103(8): 1450–6.
24.
XuJJQianHZChuZXet al. Recreational drug use among Chinese men who have sex with men: a risky combination with unprotected sex for acquiring HIV infection. Biomed Res Int2014; 2014: 725361.
25.
WuEEl-BasselNMcVinneyLDet al. Feasibility and promise of a couple-based HIV/STI preventive intervention for methamphetamine-using, black men who have sex with men. AIDS Behav2011; 15(8): 1745–54.
26.
LandovitzRJFletcherJBInzhakovaGet al. A novel combination HIV prevention strategy: post-exposure prophylaxis with contingency management for substance abuse treatment among methamphetamine-using men who have sex with men. AIDS Patient Care STDS2012; 26(6): 320–8.
27.
LandovitzRJFletcherJBShoptawSet al. Contingency management facilitates the use of postexposure prophylaxis among stimulant-using men who have sex with men. Open Forum Infect Dis2015; 2(1):ofu114.
28.
HunterLJDarganPIBenzieAet al. Recreational drug use in men who have sex with men (MSM) attending UK sexual health services is significantly higher than in non-MSM. Postgrad Med J2014; 90(1061): 133–8.
29.
RaymondHFChenYHIckTet al. A new trend in the HIV epidemic among men who have sex with men, San Francisco, 2004–2011. J Acquir Immune Defic Syndr2013; 62(5): 584–9.
30.
ShoverCShoptawSJavanbakhtMet al. Engagement in the HIV pre-exposure prophylaxis care cascade for MSM with high-risk non-injection substance use: results from a sexual health clinic in Los Angeles, California. J Neuroimmune Pharma2017; 12(2 Suppl. 1): S110.
31.
NguyenTVVan KhuuNNguyenPDet al. Sociodemographic factors, sexual behaviors, and alcohol and recreational drug use associated with HIV among men who have sex with men in Southern Vietnam. AIDS Behav2016; 20(10): 2357–71.
32.
GrewalRAllenVGGardnerSet al. Serosorting and recreational drug use are risk factors for diagnosis of genital infection with chlamydia and gonorrhoea among HIV-positive men who have sex with men: results from a clinical cohort in Ontario, Canada. Sex Transm Infect2017; 93(1): 71–5.
33.
VuNTHoltMPhanHTet al. Amphetamine-type stimulant use among men who have sex with men (MSM) in Vietnam: results from a socio-ecological, community-based study. Drug Alcohol Depend2016; 158: 110–7.
34.
PinesHAGorbachPMWeissREet al. Individual-level, partnership-level, and sexual event-level predictors of condom use during receptive anal intercourse among HIV-negative men who have sex with men in Los Angeles. AIDS Behav2016; 20(6): 1315–26.
35.
BrownRETurnerCHernJet al. Partner-level substance use associated with increased sexual risk behaviors among men who have sex with men in San Francisco, CA. Drug Alcohol Depend2017; 176: 176–80.
36.
SapsirisavatVPhanuphakNKeadpudsaSet al. Psychosocial and behavioral characteristics of high-risk men who have sex with men (MSM) of unknown HIV positive serostatus in Bangkok, Thailand. AIDS Behav2016; 20(Suppl. 3): 386–97.
37.
BeymerMRWeissRESugarCAet al. Are centers for disease control and prevention guidelines for preexposure prophylaxis specific enough? Formulation of a personalized HIV risk score for pre-exposure prophylaxis initiation. Sex Transm Dis2017; 44(1): 49–57.
38.
HoeniglMChaillonAMorrisSRet al. HIV infection rates and risk behavior among young men undergoing community-based testing in San Diego. Sci Rep2016; 6: 25927.
39.
SewellJMiltzALampeFCet 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 Policy2017; 43: 33–43.
40.
VuNTTHoltMPhanHTTet al. The relationship between methamphetamine use, sexual sensation seeking and condomless anal intercourse among men who have sex with men in Vietnam: results of a community-based, cross-sectional study. AIDS Behav2017; 21(4): 1105–16.
41.
ZuleWAOramasionwuCEvonDet al. Event-level analyses of sex-risk and injection-risk behaviors among nonmedical prescription opioid users. Am J Drug Alcohol Abuse2016; 42(6): 689–97.
42.
RusowJAFletcherJBRebackCJ. Sexual venue choice and sexual risk-taking among substance-using men who have sex with men. AIDS Behav2017; 21(4): 1149–62.
43.
WilkersonJMNoorSWBreckenridgeEDet al. Substance-use and sexual harm reduction strategies of methamphetamine-using men who have sex with men and inject drugs. AIDS Care2015; 27(8): 1047–54.
44.
MitchellJWPanYFeasterD. Actor-partner effects of male couples substance use with sex and engagement in condomless anal sex. AIDS Behav2016; 20(12):2904–13.
45.
LovettCYamamotoTHunterLet al. Problematic recreational drug use: is there a role for outpatient sexual health clinics in identifying those not already engaged with treatment services?Sex Health2015; 12(6): 501–5.
46.
OttawayZFinnertyFAmlaniAet al. Men who have sex with men diagnosed with a sexually transmitted infection are significantly more likely to engage in sexualised drug use. Int J STD AIDS2015; 28(1):91–3.
47.
HoeniglMChaillonAMooreDJet al. Clear links between starting methamphetamine and increasing sexual risk behavior: a cohort study among men who have sex with men. J Acquir Immune Defic Syndr2016; 71(5): 551–7.
48.
LachowskyNJTannerZCuiZet al. An event-level analysis of condom use during anal intercourse among self-reported human immunodeficiency virus-negative gay and bisexual men in a treatment as prevention environment. Sex Transm Dis2016; 43(12): 765–70.
49.
IrelandGHigginsSGoorneyBet al. Evaluation of hepatitis C testing in men who have sex with men, and associated risk behaviours, in Manchester, UK. Sex Transm Infect2017; 93(6): 404–9.
50.
ChenYCWibergKJHsiehYHet al. Favorable socioeconomic status and recreational polydrug use are linked with sexual hepatitis C virus transmission among human immunodeficiency virus-infected men who have sex with men. Open Forum Infect Dis2016; 3(3): ofw137.
51.
JainJPSantosGMScheerSet al. Rates and correlates of syphilis reinfection among men who have sex with men in San Francisco. Drug Alcohol Depend2017; 171: e94.
52.
BazanJAMaierhoferCTurnerANet al. Prevalence of high-risk behaviors and anti-retroviral therapy non-adherence among HIV-positive men who have sex with men who are linked to care. Sex Transm Dis2016; 43(10 Suppl. 2): S175.
53.
HalkitisPNLevyMDSolomonTM. Temporal relations between methamphetamine use and HIV seroconversion in gay, bisexual, and other men who have sex with men. J Health Psychol2016; 21(1): 93–9.
54.
HaganHJordanAENeurerJet al. Incidence of sexually transmitted hepatitis C virus infection in HIV-positive men who have sex with men. AIDS2015; 29(17): 2335–45.
55.
DirksHEsserSBorgmannRet al. Substance use and sexual risk behaviour among HIV-positive men who have sex with men in specialized out-patient clinics. HIV Med2012; 13(9): 533–40.
56.
LarsenCChaixMLStratYet al. Gaining greater insight into HCV emergence in HIV-infected men who have sex with men: the HEPAIG study. PLoS ONE2011; 6(12): e29322.
57.
ChangYHLiuWCChangSYet al. Associated factors with syphilis among human immunodeficiency virus-infected men who have sex with men in Taiwan in the era of combination antiretroviral therapy. J Microbiol Immunol2014; 47(6): 533–41.
58.
SinghSHunterLDarganPet al. High levels of recreational drug use (RDU) in HIV clinics – concerns for onward HIV transmission and adherence with treatment. HIV Med2014; 15: 14–5.
59.
AckersMLGreenbergAELinCYet al. High and persistent HIV seroincidence in men who have sex with men across 47 U.S. cities. PLoS ONE2012; 7(4):e34972.
60.
BowingALDoyleJSIserDMet al. High-risk behaviour in a cohort of HIV/hepatitis C coinfected gay and bisexual men commencing hepatitis C treatment. J Hepatol2017; 66(1 Suppl. 1): S269–70.
61.
DuanCWeiLCaiYet al. Recreational drug use and risk of HIV infection among men who have sex with men: a cross-sectional study in Shenzhen, China. Drug Alcohol Depend2017; 181: 30–6.
62.
Ayerdi-AguirrebengoaOVera-GarciaMPuerta-LopezTet al. To whom is HIV pre-exposure prophylaxis proposed?Enferm Infecc Microbiol Clin2017; 35(5): 299–302.
63.
DeimelDGebhardtVStoverHet al. Drug use and health behaviour among German men who have sex with men: results of a qualitative, multi-centre study. Harm Reduct J2016; 13(1): 36.
64.
BeymerMRWeissREHalkitisPNet al. Disparities within the disparity – determining HIV risk factors among Latino gay and bisexual men attending a community-based clinic in Los Angeles, CA. J Acquir Immune Defic Syndr2016; 73(2): 237–44.
65.
PriceJCMcKinneyJECrouchPCet al. Sexually-acquired HCV infections emerging among HIV-uninfected men who have sex with men on pre-exposure prophylaxis against HIV. Hepatology2017; 66(Suppl. 1): 535A.
66.
DaskalopoulouMRodgerAJPhillipsANet al. Condomless sex in HIV-diagnosed men who have sex with men in the UK: prevalence, correlates, and implications for HIV transmission. Sex Transm Infect2017; 93(8): 590–8.
67.
Dolengevich-SegalHRodríguez-SalgadoBGómez-ArnauJet al. Severe psychosis, drug dependence, and hepatitis C related to slamming mephedrone. Case Rep Psychiat2016; 2016: 8379562.
68.
ZhaoPTangSWangCet al. Recreational drug use among Chinese MSM and transgender individuals: results from a national online cross-sectional study. PLoS ONE2017; 12(1): e0170024.
69.
HoltMLeaTAsselinJet al. The prevalence and correlates of undiagnosed HIV among Australian gay and bisexual men: results of a national, community-based, bio-behavioural survey. J Int AIDS Soc2015; 18: 20526.
70.
SchmidtAJBourneAWeatherburnPet al. Illicit drug use among gay and bisexual men in 44 cities: findings from the European MSM Internet Survey (EMIS). Int J Drug Policy2016; 38: 4–12.
71.
WirtzALZelayaCELatkinCet al. Alcohol use and associated sexual and substance use behaviors among men who have sex with men in Moscow, Russia. AIDS Behav2016; 20(3): 523–36.
72.
Fernandez-DavilaPFolchCFerrerLet al. Hepatitis C virus infection and its relationship to certain sexual practices in men-who-have-sex-with-men in Spain: results from the European MSM internet survey (EMIS). Enferm Infecc Microbiol Clin2015; 33(5): 303–10.
73.
GilbartVLSimmsIJenkinsCet al. Sex, drugs and smart phone applications: findings from semistructured interviews with men who have sex with men diagnosed with Shigella flexneri 3a in England and Wales. Sex Transm Infect2015; 91(8): 598–602.
74.
TaylorLEDelongAKMaynardMAet al. Acute hepatitis C virus in an HIV clinic: a screening strategy, risk factors, and perception of risk. AIDS Patient Care STDS2011; 25(10): 571–7.
75.
ElliotERSinghSTyeballySet al. Recreational drug use and chemsex among HIV-infected in-patients: a unique screening opportunity. HIV Med2017; 18(7): 525–31.
76.
WardCThomasDAndersonTet al. Chemsex related admissions to a city centre hospital. Sex Transm Infect2016; 92.
77.
TomkinsAAhmadSCannonLet al. Prevalence of recreational drug use reported by men who have sex with men attending sexual health clinics in Manchester, UK. Int J STD AIDS2018; 29: 350–6.
78.
TurnerKClarkeBPriestleyCet al. ‘The grand slam’: surveying the local landscape of ‘chemsex’ drug use amongst MSMS in a community outreach sexual health clinic. Sex Transm Infect2015; 91: A85.
79.
SullivanAKElliotESinghSet al. High rates of recreational drug use (RDU) and sexually transmitted infections (STIs) in HIV-positive men who have sex with men (MSM) attending clinics across London. HIV Med2016; 17(Suppl. 1): 32.
80.
WardCThomasDAndersonTet al. Manchester chemsex – injecting straight up the M6. Sex Transm Infect2016; 92.
81.
OttawayZFinnertyFBuckinghamTet al. Increasing rates of reported chemsex/sexualised recreational drug use in men who have sex with men attending for postexposure prophylaxis for sexual exposure. Sex Transm Infect2017; 93(1): 31.
82.
DrücklerSvan RooijenMSde VriesHJC. 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 Dis2018; 45: 325–31.
83.
BriggsRFinnertyFSanderNPet al. Men who have sex with men (MSM) presenting with repeat bacterial sexually transmitted infections (STI) report high use of alcohol and party drugs. Sex Transm Infect2016; 92(Suppl. 1): A36–7.
84.
PufallELWardHKallMet al. Chemsex and high-risk sexual behaviours in HIV-positive men who have sex with men. Top Antiviral Medi2016; 24: 388.
85.
MargolisADJosephHHirshfieldSet al. Anal intercourse without condoms among HIV-positive men who have sex with men recruited from a sexual networking web site, United States. Sex Transm Dis2014; 41(12): 749–55.
86.
RajasinghamRMimiagaMJWhiteJMet al. A systematic review of behavioral and treatment outcome studies among HIV-infected men who have sex with men who abuse crystal methamphetamine. AIDS Patient Care STDS2011; 26(1): 36–52.
87.
JimenezEPedrazuelaMGPerezMMet al. Prevalence of pharyngeal infection by Neisseria gonorrhoeae among human immunodeficiency virus-positive men who have sex with men in downtown Madrid, 2011. Int J STD AIDS2013; 24(11): 875–8.
88.
MimiagaMJReisnerSLPantaloneDWet al. A pilot trial of integrated behavioral activation and sexual risk reduction counseling for HIV-uninfected men who have sex with men abusing crystal methamphetamine. AIDS Patient Care STDS2012; 26(11): 681–93.
89.
VaccherSJGrulichAEHaireBGet al. Validation of participant eligibility for pre-exposure prophylaxis: baseline data from the PRELUDE demonstration project. PLoS ONE2017; 12(9): e0185398.
90.
OldenburgCEMittyJABielloKBet al. Differences in attitudes about HIV pre-exposure prophylaxis use among stimulant versus alcohol using men who have sex with men. AIDS Behav2016; 20(7): 1451–60.
91.
StarksTJMillarBMLassiterJMet al. Preintervention profiles of information, motivational, and behavioral self-efficacy for methamphetamine use and HIV medication adherence among gay and bisexual men. AIDS Patient Care STDS2017; 31(2): 78–86.
92.
WeiHT. Methamphetamine Chemsex with subsequent repeated oral gonorrhea infection and HIV postexposure prophylactic treatments: a case report. J Neuroimmune Pharma2017; 12(2): S112.
93.
DearingNFlewS. MSM the cost of having a good time? A survey about sex, drugs and losing control. Sex Transm Infect2015; 91.
94.
ZouHXuJHuQet al. Decreasing age at first anal intercourse among men who have sex with men in China: a multicentre cross-sectional survey. J Int AIDS Soc2016; 19(1): 20792.
95.
TruongHHMKelloggTAMcFarlandWet al. Sentinel surveillance of HIV-1 transmitted drug resistance, acute infection and recent infection. PLoS ONE2011; 6(10): e25281.
96.
MercerCHPrahPFieldNet al. The health and well-being of men who have sex with men (MSM) in Britain: evidence from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). BMC Public Health2016; 16: 525.
97.
LeaTLeeEMaoLet al. HIV and hepatitis C virus co-infection among men who have sex with men in Sydney, and associations with sexual and drug use practices. Sex Health2013; 10(5): 448–51.
98.
SchmidtAJRockstrohJKVogelMet al. Trouble with bleeding: risk factors for acute hepatitis C among HIV-positive gay men from Germany – a case-control study. PLoS ONE2011; 6(3): e17781.
99.
BullLDimitrijevicPScarboroughAet al. O014 Investigating attitudes towards HIV pre-exposure prophylaxis (PREP). A questionnaire study in men who have sex with men attending sexual health clinics. Sex Transm Infect2016; 92: A5.3-A6.
100.
NathanBSimmsRGreenSet al. Introduction and trial of a ‘chemsex’ support service in a South West London GU clinic. Sex Transm Infect2015; 91: A63-A64.
101.
ChungEFernsRBHeMet al. Ultra-deep sequencing provides insights into the virology of hepatitis C super-infections in a case of three sequential infections with different genotypes. J Clin Virol2015; 70: 63–6.
102.
SacksRNwokoloNMcOwanAet al. Characteristics of those with newly diagnosed HIV at a central London clinic. HIV Med2017; 18: 50.
103.
GhanemALittleSJDrumrightLet al. High-risk behaviors associated with injection drug use among recently HIV-infected men who have sex with men in San Diego, CA. AIDS Behav2011; 15(7): 1561–9.
104.
BeymerMRWeissREBolanRKet al. Sex on demand: geosocial networking phone apps and risk of sexually transmitted infections among a cross-sectional sample of men who have sex with men in Los Angeles county. Sex Transm Infect2014; 90(7): 567–72.
105.
PayneLLawrenceDSoniSet al. Investigating factors for increased gonorrhoea re-infection in men who have sex with men attending a genitourinary clinic: a qualitative study. Int J STD AIDS2017; 28(9): 858–63.
106.
MayerKHSkeerMRO’CleirighCet al. Factors associated with amplified HIV transmission behavior among American men who have sex with men engaged in care: implications for clinical providers. Ann Behav Med2014; 47(2): 165–71.
107.
ZuleWAPoultonWECoomesCMet al. Results of a pilot study to reduce methamphetamine use and sexual risk behaviors among methamphetamine-using men who have sex with men (MSM) not currently in treatment. J Psychoactive Drugs2012; 44(5): 351–8.
108.
BrookGBaconLEvansCet al. 2013 UK national guideline for consultations requiring sexual history taking. Clinical Effectiveness Group British Association for Sexual Health and HIV. Int J STD AIDS2014; 25(6): 391–404.
109.
EvansARHartGJMoleRet al. Central and East European migrant men who have sex with men: an exploration of sexual risk in the UK. Sex Transm Infect2011; 87(4): 325–30.
110.
ForrestDWMetschLRLaLotaMet al. Crystal methamphetamine use and sexual risk behaviors among HIV-positive and HIV-negative men who have sex with men in South Florida. J Urban Health2010; 87(3): 480–5.
111.
MayerKO’CleirighCSkeerMet al. Which HIV-infected men who have sex with men in care are engaging in risky sex and acquiring sexually transmitted infections: findings from a Boston community health centre. Sex Transm Infect2009; 86: 66–70.
112.
ManserghGShouseRLMarksGet al. Methamphetamine and sildenafil (Viagra) use are linked to unprotected receptive and insertive anal sex, respectively, in a sample of men who have sex with men. Sex Transm Infect2006; 82(2): 131.
113.
BousmanCChernerMAkeCet al. Negative mood and sexual behavior among non-monogamous men who have sex with men in the context of methamphetamine and HIV. J Affect Disord2009; 119: 84–91.
114.
CheungDHLimSHGuadamuzTEet al. The potential role of circuit parties in the spread of HIV among men who have sex with men in Asia: a call for targeted prevention. Arch Sex Behav2015; 44(2): 389–97.
115.
KellySMalekRTippleCet al. The impact of recreational drug use on inpatient admissions. HIV Med2015; 16: 24.
116.
Melendez-TorresGJBourneA. Illicit drug use and its association with sexual risk behaviour among MSM: more questions than answers?Curr Opin Infect Dis2016; 29(1): 58–63.
117.
PakianathanMRLeeMJKellyBet al. How to assess gay, bisexual and other men who have sex with men for chemsex. Sex Transm Infect2016; 92(8): 568–70.
118.
RaceKLeaTMurphyDet al. The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men. Sex Health2017; 14(1): 42–50.
119.
TangWXuJZouHet al. Worsen epidemic of early HIV infection among men who have sex with men in china: implication for real time action. Sex Transm Infect2015; 91(Suppl. 2): A215.
120.
WhitlockGNwokoloNMcOwanA. Is PEP prescribed appropriately?HIV Med2015; 16(8): 519–20.
121.
WigginsHMebrahtuHSullivanAet al. ‘Chemsex’ within men who have sex with men (MSM): how big is the problem outside major conurbations?Sex Transm Infect2016; 92(Suppl. 1): A42–3.
122.
XuJJTangWMZouHCet al. High HIV incidence epidemic among men who have sex with men in china: results from a multi-site cross-sectional study. Infect Dis Poverty2016; 5(1): 82.
123.
XuJJZhangCHuQHet al. Recreational drug use and risks of HIV and sexually transmitted infections among Chinese men who have sex with men: mediation through multiple sexual partnerships. BMC Infect Dis2014; 14(1): 642.
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