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Title
Consumption of recreational drugs and their sexualized use in gay men, bisexual and other men-who-have-sex-with-men from Latin America: Preliminary results of the Latin America MSM Internet Survey (LAMIS)
Presenter
Michael Reyes-Díaz
Authors
P. Fernández Dávila1, J. Casabona2, U. Marcus3, M. Veras4, D. Barros4, V. Stuardo5, D. Ramírez6, K. Jonas7, C.F. Cáceres8, M. Reyes-Díaz8, H. Barros9, P. Meireles9, A.J. Schmidt10, Red Ibero-Americana de Estudios en Hombres Gay, otros HSH y Personas Trans
Institutions
1Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Badalona, Spain, 2Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Institut de Recerca Biomèdica Germans Trias i Pujol (IGTP), Badalona, Spain, 3Robert Koch Institute, Berlin, Germany, 4Facultad de Ciencias Médicas de la Santa Casa de Sao Paulo, Sao Paulo, Brazil, 5Universidad de Chile, Escuela de Salud Pública, Facultad de Medicina,, Santiago de Chile, Chile, 6Universidad de San Carlos de Guatemala, Ciudad de Guatemala, Guatemala, 7Maastricht University, Faculty of Psychology and Neuroscience, Maastrich, Netherlands, 8Universidad Peruana Cayetano Heredia, Centro de Investigación Interdisciplinaria en Sexualidad Sida y Sociedad, Lima, Peru, 9Universidade do Porto, Instituto De Saúde Pública, Porto, Portugal, 10Sigma Research, London School of Hygiene and Tropical Medicine, London, United Kingdom

Background: The increasing prevalence of sexualized drug use among gay, bisexual and other men-who-have-sex-with-men (GBMSM) is causing concern globally, as it poses multiple risks for their psycho-social-sexual health. This study aimed to describe the sexualized use of recreational drugs, and to characterize users among Latin American GBMSM.
Methods: The Latin American MSM Internet Survey was an online questionnaire, available in three languages across 18 Latin American countries. From January-May 2018, it collected information on sexual behavior, drug use, psychosocial health, HIV/STI testing, self-reported HIV/STI diagnosis, and preventive strategies. Participants were mainly recruited through gay apps/web-pages. The Chi-square test was used to compare proportions.
Results: Of the 64,655 participants, 45.8% had used drugs (excluding alcohol, tobacco, and sedatives) in the last 12 months (Brazil and Southern Cone countries had the highest proportions). Cannabis (29%), poppers (18%), erection-enhancing medications (15%), cocaine (9.5%) and ecstasy (7.3%) were the most commonly used substances. Injection drug use was reported by 0.3%. Among those who had sex with a man in the last 12 months (n=60,985), 49% had sex under the influence of alcohol or other drugs, 9.9% never had sober sex, and 24% used some recreational drug before/during sex with their last non-steady partner(s). Overall, 8,690 men (13.6%) reported using drugs to enhance or prolong sex during the last 12 months and 6.6% used drugs in a group sex setting. The using drugs to enhance their sexual experience was significantly more likely among men who reported the following characteristics: living in a Southern Cone country, residence in a city of more than one million inhabitants, aged 25-40, born abroad, higher education, employment, gay identity, engaging in transactional sex, and diagnosed with HIV. Also among these men, 72% reported condomless anal sex with non-steady partners in the last 12 months, 53% had been diagnosed with a previous STI; and, among those with no prior HIV-diagnosis, 2.6% were taking PrEP.
Conclusions: The sexualized use of drugs among Latin-American GBMSM is noticeable, particularly in big cities and Southern Cone countries. This pattern should be taken into account in public health programs and harm-reduction interventions included as part of the combined prevention approach.