Uso sexualizado de drogas entre homosexuales, bisexuales y otros hombres que tienen sexo con hombres y su asociación con síntomas de salud mental

  1. Manuel Gámez-Guadix
  2. Daniel Incera-Fernández
  3. Francisco J. Román
  4. Estíbaliz Mateos-Pérez
  5. Erika Borrajo
  6. Kenia Martínez
Revista:
Revista española de drogodependencias

ISSN: 0213-7615

Año de publicación: 2023

Número: 48

Páginas: 77-94

Tipo: Artículo

Otras publicaciones en: Revista española de drogodependencias

Resumen

El uso sexualizado de drogas (USD) se refiere al uso intencional de sustancias psicoactivas antes o durante un encuentro sexual con el objetivo de mejorar la experiencia sexual. Los objetivos de este estudio fueron: (a) analizar la relación entre el USD y un amplio rango de síntomas de salud mental entre hombres que tienen sexo con hombres (HSH) (p. ej., ansiedad, síntomas somáticos, trastorno bipolar, depresión persistente, dependencia del alcohol); y (b) examinar la relación entre el USD y diversas adicciones conductuales, controlando un conjunto de variables demográficas, incluido el estado serológico. La muestra estuvo compuesta por 493 HSH entre los 18 y 78 años (M edad = 32,58, DE = 11,05). Los participantes completaron medidas de autoinforme sobre USD, síntomas de salud mental y adicciones conductuales. Los participantes que se implicaron en el USD presentaron un significativamente mayor abuso de drogas y alcohol y tasas más altas de comportamiento sexual compulsivo (tamaños de efecto grandes) en comparación con los participantes que no habían practicado USD. Además, el USD también se relacionó significativamente con los síntomas psicóticos y el gasto compulsivo (tamaños del efecto medios). Los resultados sugieren un patrón de síntomas de salud mental específicos asociados al USD problemático, en lugar de un patrón generalizado de disfunción psicológica. Las estrategias de reducción de riesgos deben evaluar, proporcionar información e intervenir sobre los síntomas de salud mental específicos asociados al USD.

Referencias bibliográficas

  • Algarin, A. B., Sheehan, D. M., Varas-Diaz, N., Fennie, K. P., Zhou, Z., Spencer, E. C., Cook, R. L., Morano, J. P., y Ibanez, G. E. (2020). Health Care-Specific Enacted HIV-Related Stigma’s Association with Antiretroviral Therapy Adherence and Viral Suppression Among PeopleLiving with HIV in Florida. AIDS Patient Care and STDs, 34(7), 316–326. https:// doi.org/10.1089/apc.2020.0031
  • Batisse, A., Peyrière, H., Cazanave, C., y Donnadieu-Rigole, H. (2018). « ChemSex », consommation en contexte sexuel: Quelles substances ? Quelle prévention ? Données du réseau français d’addictovigilance. Therapies, 73(6), 559. https://doi.org/10.1016/j.therap.2018.09.068
  • Blomquist, P. B., Mohammed, H., Mikhail, A., Weatherburn, P., Reid, D., Wayal, S., Hughes, G., y Mercer, C. H. (2020). Characteristics and sexual health service use of MSM engaging in chemsex: Results from a large online survey in England. Sexually Transmitted Infections, 96(8), 590–595. https://doi. org/10.1136/sextrans-2019-054345
  • Bohn, A., Sander, D., Köhler, T., Hees, N., Oswald, F., Scherbaum, N., Deimel, D., y Schecke, H. (2020). Chemsex and Mental Health of Men Who Have Sex With Men in Germany. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.542301
  • Bőthe, B., Potenza, M. N., Griffiths, M. D., Kraus, S. W., Klein, V., Fuss, J., y Demetrovics, Z. (2020). The development of the Compulsive Sexual Behavior Disorder Scale (CSBD-19): An ICD-11 based screening measure across three languages. Journal of Behavioral Addictions, 9(2), 247-258.
  • Bourne, A., Reid, D., Hickson, F., Torres Rueda, S., y Weatherburn, P. (2014). The Chemsex study: Drug use in sexual settings among gay and bisexual men in Lambeth, Southwark and Lewisham [Monograph]. Sigma Research, London School of Hygiene & Tropical Medicine. https://researchonline.lshtm.ac.uk/id/ eprint/2197245/
  • Brogan, N., Paquette, D. M., Lachowsky, N. J., Blais, M., Brennan, D. J., Hart, T. A., y Adam, B. (2019). Canadian results from the European Men-who-have-sexwith-men Internet survey (EMIS-2017). Canada Communicable Disease Report = Releve Des Maladies Transmissibles Au Canada, 45(11), 271–282. https://doi. org/10.14745/ccdr.v45i11a01
  • Card, K. G., Armstrong, H. L., Wang, L., Bacani, N., Moore, D. M., Roth, E. A., Hogg, R. S., y Lachowsky, N. J. (2019). Escape expectancies and sexualized substance use among gay, bisexual, and other men who have sex with men. AIDS Care, 1–9. https://doi.org/10.10 80/09540121.2019.1705961
  • Cardenal, V., Sánchez, M. a P., y Ortiz-Tallo, M. (2007). Los trastornos de personalidad según el modelo de Millon: Una propuesta integradora. Clínica y Salud, 18(3), 305–324.
  • Demant, D., y Oviedo-Trespalacios, O. (2019). Harmless? A hierarchical analysis of poppers use correlates among young gay and bisexual men. Drug and Alcohol Review, 38(5), 465–472. https:// doi.org/10.1111/dar.12958
  • Dolengevich-Segal, H., Gonzalez-Baeza, A., Valencia, J., Valencia-Ortega, E., Cabello, A., Tellez-Molina, M. J., Perez-Elias, M. J., Serrano, R., Perez-Latorre, L., Martin-Carbonero, L., Arponen, S., Sanz-Moreno, J., Fuente, S. D. la, Bisbal, O., Santos, I., Casado, J. L., Troya, J., Cervero-Jimenez, M., Nistal, S., … Study, on B. of the U.-S. G. 9416. (2019). Drug-related and psychopatho-logical symptoms in HIV-positive men who have sex with men who inject drugs during sex (slamsex): Data from the U-SEX GESIDA 9416 Study. PLOS ONE, 14(12), e0220272. https://doi. org/10.1371/journal.pone.0220272
  • Donnadieu-Rigole, H., Peyrière, H., Benyamina, A., y Karila, L. (2020). Complications Related to Sexualized Drug Use: What Can We Learn From Literature? Frontiers in Neuroscience, 14, 548704. https://doi.org/10.3389/ fnins.2020.548704
  • Edmundson, C., Heinsbroek, E., Glass, R., Hope, V., Mohammed, H., White, M., y Desai, M. (2018). Sexualised drug use in the United Kingdom (UK): A review of the literature. The International Journal on Drug Policy, 55, 131–148. https:// doi.org/10.1016/j.drugpo.2018.02.002
  • Evers, Y. J., Hoebe, C. J. P. A., Dukers-Muijrers, N. H. T. M., Kampman, C. J. G., Kuizenga-Wessel, S., Shilue, D., Bakker, N. C. M., Schamp, S. M. a. A., Van Buel, H., Van Der Meijden, W. C. J. P. M., y Van Liere, G. a. F. S. (2020a). Sexual, addiction and mental health care needs among men who have sex with men practicing chemsex—A cross-sectional study in the Netherlands. Preventive Medicine Reports, 18, 101074. https://doi. org/10.1016/j.pmedr.2020.101074
  • Evers, Y. J., Hoebe, C. J. P. A., Dukers-Muijrers, N. H. T. M., Kampman, C. J. G., Kuizenga-Wessel, S., Shilue, D., Bakker, N. C. M., Schamp, S. M. A. A., Van Buel, H., Van Der Meijden, W. C. J. P. M., y Van Liere, G. A. F. S. (2020b). Sexual, addiction and mental health care needs among men who have sex with men practicing chemsex – a cross-sectional study in the Netherlands. Preventive Medicine Reports, 18, 101074. https://doi. org/10.1016/j.pmedr.2020.101074
  • Gámez-Guadix, M., Calvete, E., Orue, I., y Las Hayas, C. (2015). Problematic Internet use and problematic alcohol use from the cognitive–behavioral model: A longitudinal study among adolescents. Addictive behaviors, 40, 109-114. https://doi.org/10.1016/j. addbeh.2014.09.009
  • Gámez-Guadix, M., y Incera, D. (2021). Homophobia is online: Sexual victimization and risks on the internet and mental health among bisexual, homosexual, pansexual, asexual, and queer adolescents. Computers in Human Behavior, 119, 106728. https://doi. org/10.1016/j.chb.2021.106728
  • García-Laredo, E., Castellanos, M. Á., Badaya, E., Paúl, N., Yubero, R., Maestú, F., Molina, J. D., y Chacón, J. (2021). Executive Functions Influence on Memory Process in Patients with Paranoid Schizophrenia and Bipolar Disorders with and without Psychotic Symptoms. A Pilot Study. The Spanish Journal of Psychology, 24, e40. https://doi.org/10.1017/ SJP.2021.38
  • Gavín, P., Arbelo, N., Monràs, M., Nuño, L., Bruguera, P., de la Mora, L., MartínezRebollar, M., Laguno, M., Blanch, J., y Miquel, L. (2021). [Methamphetamine use in chemsex and its consequences on mental health: A descriptive study.]. Revista Espanola De Salud Publica, 95, e202108108.
  • Gertzen, M., Strasburger, M., Geiger, J., Rosenberger, C., Gernun, S., Schwarz, J., Rabenstein, A., y Rüther, T. (2021). [Chemsex: A new challenge in addiction medicine and infectious diseases]. Der Nervenarzt. https://doi.org/10.1007/ s00115-021-01116-x
  • Giorgetti, R., Tagliabracci, A., Schifano, F., Zaami, S., Marinelli, E., y Busardò, F. P. (2017). When “Chems” Meet Sex: A Rising Phenomenon Called “ChemSex”. Current Neuropharmacology, 15(5), 762– 770. https://doi.org/10.2174/157015 9X15666161117151148
  • Goslar, M., Leibetseder, M., Muench, H. M., Hofmann, S. G., y Laireiter, A.-R. (2020). Treatments for internet addiction, sex addiction and compulsive buying: A meta-analysis. Journal of Behavioral Addictions, 9(1), 14–43. https://doi. org/10.1556/2006.2020.00005
  • Greenblatt, y Davis. (2013). The Millon Clinical Multiaxial Inventory: A Clinical Research Information Synthesis. Routledge.
  • Guerras, J.-M., Hoyos Miller, J., Agustí, C., Chanos, S., Pichon, F., Kuske, M., Cigan, B., Fuertes, R., Stefanescu, R., Ooms, L., Casabona, J., de la Fuente, L., Belza, M.- J., y Euro HIV EDAT Working Group. (2021). Association of Sexualized Drug Use Patterns with HIV/STI Transmission Risk in an Internet Sample of Men Who Have Sex with Men from Seven European Countries. Archives of Sexual Behavior, 50(2), 461–477. https://doi.org/10.1007/s10508-020-01801-z
  • Hammoud, M. A., Bourne, A., Maher, L., Jin, F., Haire, B., Lea, T., Degenhardt, L., Grierson, J., y Prestage, G. (2017). 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. Sexual Health, 15(2), 123– 134. https://doi.org/10.1071/SH17146
  • Hoare, J., Sevenoaks, T., Mtukushe, B., Williams, T., Heany, S., y Phillips, N. (2021). Global Systematic Review of Common Mental Health Disorders in Adults Living with HIV. Current HIV/AIDS Reports. https://doi.org/10.1007/s11904-021- 00583-w
  • Íncera-Fernández, D., Gámez-Guadix, M., y Moreno-Guillén, S. (2021). Mental Health Symptoms Associated with Sexualized Drug Use (Chemsex) among Men Who Have Sex with Men: A Systematic Review. International Journal of Environmental Research and Public Health, 18(24), 13299. https://doi. org/10.3390/ijerph182413299
  • Íncera-Fernández, D., Román, F. J., Moreno-Guillén, S., & Gámez-Guadix, M. (2023a). Understanding Sexualized Drug Use: Substances, Reasons, Consequences, and Self-Perceptions among Men Who Have Sex with Other Men in Spain. International Journal of Environmental Research and Public Health, 20(3), 2751. http://dx.doi.org/10.3390/ijerph20032751
  • Íncera-Fernández, D., Román-González, F. J., Moreno-Guillén, S., & Gámez-Guadix, M. (2023b). Sexualized drug use, risky sexual behaviors, and prevention strategies among gay, bisexual, and other men who have sex with men. Drugs: Education, Prevention and Policy, 1-13. https://doi.org/1 0.1080/09687637.2023.2225245
  • Karim, R., y Chaudhri, P. (2012). Behavioral Addictions: An Overview. Journal of Psychoactive Drugs, 44(1), 5–17. https://doi.org/10.1080/02791072.20 12.662859
  • Lafortune, D., Blais, M., Miller, G., Dion, L., Lalonde, F., y Dargis, L. (2021). Psycho-logical and Interpersonal Factors Associated with Sexualized Drug Use Among Men Who Have Sex with Men: A MixedMethods Systematic Review. Archives of Sexual Behavior, 50(2), 427–460. https:// doi.org/10.1007/s10508-020-01741-8
  • Li, C.-W., Ku, S. W.-W., Huang, P., Chen, L.-Y., Wei, H.-T., Strong, C., y Bourne, A. (2021). Factors associated with methamphetamine dependency among men who have sex with men engaging in chemsex: Findings from the COMeT study in Taiwan. International Journal of Drug Policy, 103119. https://doi. org/10.1016/j.drugpo.2021.103119
  • Li, L., Lin, C., Feng, N., Nguyen, D. B., Cao, W., Le, A. T., y Nguyen, A. T. (2020). Stigma Related to HIV and Drug Use: Layers, Types, and Relations to Mental Health. AIDS and Behavior, 24(8), 2347–2354. https://doi.org/10.1007/ s10461-020-02794-5
  • Lucet, C., y Olié, J. P. (2020). Addictive behaviors: Clinical facts. Bulletin De l’Academie Nationale De Medecine. https://doi. org/10.1016/j.banm.2020.04.005
  • Melendez-Torres, G. J., y Bourne, A. (2016). Illicit drug use and its association with sexual risk behaviour among MSM: More questions than answers? Current Opinion in Infectious Diseases, 29(1), 58–63. https://doi.org/10.1097/ QCO.0000000000000234
  • Millon, T. (1997). Millon Clinical Multiaxial Inventory-III [Manual Second Edition]. Bloomington, MN: Pearson Assessments.
  • Miltz, A. R., Rodger, A. J., Sewell, J., Gilson, R., Allan, S., Scott, C., Sadiq, T., Farazmand, P., McDonnell, J., Speakman, A., Sherr, L., Phillips, A. N., Johnson, A. M., Collins, S., y Lampe, F. C. (2021). Recreational drug use and use of drugs associated with chemsex among HIVnegative and HIV-positive heterosexual men and women attending sexual health and HIV clinics in England. International Journal of Drug Policy, 91, 103101. https://doi.org/10.1016/j. drugpo.2020.103101
  • Nimbi, F. M., Rosati, F., Esposito, R. M., Stuart, D., Simonelli, C., y Tambelli, R. (2020). Chemsex in Italy: experiences of men who have sex with men consuming illicit drugs to enhance and prolong their sexual activity. The Journal of Sexual Medicine, 17(10), 1875-1884. https:// doi.org/10.1016/j.jsxm.2020.07.001
  • Nöstlinger, C., Reyniers, T., Smekens, T., Apers, H., Laga, M., Wouters, K., y Vuylsteke, B. (2020). Drug use, depression and sexual risk behaviour: A syndemic among early pre-exposure prophylaxis (PrEP) adopters in Belgium? AIDS Care, 32(sup2), 57–64. https://doi.org/10.1 080/09540121.2020.1739218
  • Pakianathan, M., Whittaker, W., Lee, M. J., Avery, J., Green, S., Nathan, B., y Hegazi, A. (2018). Chemsex and new HIV diagnosis in gay, bisexual and other men who have sex with men attending sexual health clinics. HIV Medicine. https://doi. org/10.1111/hiv.12629
  • Palamar, J. J., Griffin-Tomas, M., Acosta, P., Ompad, D. C., y Cleland, C. M. (2018). A comparison of self-reported sexual effects of alcohol, marijuana, and ecstasy in a sample of young adult nightlife attendees. Psychology and Sexuality, 9(1), 54–68. Scopus. https://doi.org/10.1080/19419899.2018.1425220
  • Pedrero Pérez, E. J., Rodríguez Monje, M. T., Gallardo Alonso, F., Fernández Girón, M., Pérez López, M., y Chicharro Romero, J. (2007). Validación de un instrumento para la detección de trastornos de control de impulsosy adicciones: El MULTICAGE CAD-4. Trastornos Adictivos, 9(4), 269–279. Robbins, T. W., y Clark, L. (2015). Behavioral addictions. Current Opinion in Neurobiology, 30, 66–72. https://doi.org/10.1016/j.conb.2014.09.005
  • Platteau, T., Pebody, R., Dunbar, N., Lebacq, T., y Collins, B. (2019). The problematic chemsex journey: a resource for prevention and harm reduction. Drugs and Alcohol Today. https://doi. org/10.1108/DAT-11-2018-0066
  • Ruiz-Robledillo, N., Ferrer-Cascales, R., Portilla-Tamarit, I., Alcocer-Bruno, C., Clement-Carbonell, V., y Portilla, J. (2021). Chemsex Practices and HealthRelated Quality of Life in Spanish Men with HIV Who Have Sex with Men. Journal of Clinical Medicine, 10(8). https:// doi.org/10.3390/jcm10081662
  • Schecke, H., Lea, T., Bohn, A., Köhler, T., Sander, D., Scherbaum, N., y Deimel, D. (2019). Crystal Methamphetamine Use in Sexual Settings Among German Men Who Have Sex With Men. Frontiers in Psychiatry, 10, 886. https://doi. org/10.3389/fpsyt.2019.00886
  • Sewell, J., Miltz, A., Lampe, F. C., Cambiano, V., Speakman, A., Phillips, A. N., Stuart, D., Gilson, R., Asboe, D., Nwokolo, N., Clarke, A., Collins, S., Hart, G., Elford, J., y Rodger, A. J. (2017). 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. International Journal of Drug Policy, 43, 33–43. https://doi. org/10.1016/j.drugpo.2017.01.001
  • Soriano Ocón, R. (2022). El fenómeno del chemsex: claves para mejorar la respuesta institucional. Revista Española de Drogodependencias, 47(3), 5-13. Tomkins, A., George, R., y Kliner, M. (2019). Sexualised drug taking among men who have sex with men: A systematic review. Perspectives in Public Health, 139(1), 23–33. https://doi.org/10.1177/1757913918778872
  • Torres, T. S., Bastos, L. S., Kamel, L., Bezerra, D. R. B., Fernandes, N. M., Moreira, R. I., Garner, A., Veloso, V. G., Grinsztejn, B., y De Boni, R. B. (2020). Do men who have sex with men who report alcohol and illicit drug use before/during sex (chemsex) present moderate/high risk for substance use disorders? Drug and Alcohol Dependence, 209, 107908. https://doi.org/10.1016/j.drugalcdep.2020.107908
  • Vaccher, S. J., Hammoud, M. A., Bourne, A., Lea, T., Haire, B. G., Holt, M., Saxton, P., Mackie, B., Badge, J., Jin, F., Maher, L., y Prestage, G. (2020). Prevalence, frequency, and motivations for alkyl nitrite use among gay, bisexual and other men who have sex with men in Australia. International Journal of Drug Policy, 76, 102659. https://doi.org/10.1016/j. drugpo.2019.102659