Abstract：
Chemsex, the use of drugs during and/or prior to sex, has been found to increase the risk of HIV and sexually transmitted infections (STI) among men who have sex with men (MSM). Many studies and reviews on chemsex were focused among MSM in high-income countries (HIC), with less attention given to understanding chemsex in low- and middle-income countries (LMIC). We estimated the prevalence of chemsex and its association with sexual risk behaviors, HIV, and STI among MSM in LMIC. We searched MEDLINE, Embase, GlobalHealth, PsychINFO, and CINAHL for quantitative, qualitative, and mixed-methods studies describing chemsex and its association with sexual risk behaviors, HIV, and STI among MSM in LMIC, published January 1, 2000-October 15, 2023. We used the Mixed Methods Appraisal Tool to assess study quality. We developed a narrative review and performed meta-analysis using a random effects model and the DerSimonian and Laird approach (PROSPERO #CRD42022339663). Thirty-two studies from LMIC, particularly from Asia, Africa, Latin America, and the Middle East, were included. MSM who engaged in chemsex had higher prevalence of condomless anal intercourse, group sex, having multiple sexual partners, and of HIV and STI compared to MSM who did not. We estimated a pooled prevalence for recent chemsex (≤ 12 months) of 16% (95% CI 11%-22%, τ = 0.01, I2 = 99.07%, p < 0.01). Chemsex and its associated behaviors are associated with HIV and STI among MSM in LMIC. Integration of harm reduction and sexual health services and structural changes could prevent HIV and STI prevention among MSM who engage in chemsex in LMIC.
摘要：
Chemsex,在性交期间和/或之前使用药物，已发现增加与男性发生性关系（MSM）的男性中艾滋病毒和性传播感染（STI）的风险。许多关于化学的研究和评论都集中在高收入国家的MSM(HIC)中，在低收入和中等收入国家(LMIC)，对了解化学性别的关注较少。我们估计了趋化性的患病率及其与性风险行为的关系，艾滋病毒,在LMIC中的MSM和STI。我们搜索了MEDLINE,Embase,GlobalHealth,心理信息,和CINAHL用于定量，定性，以及描述化学性别及其与性风险行为关联的混合方法研究，艾滋病毒,LMIC中MSM中的STI，发表于2000年1月1日-2023年10月15日。我们使用混合方法评估工具来评估研究质量。我们使用随机效应模型和DerSimonian和Laird方法（PROSPERO#CRD42022339663）进行了叙述性综述并进行了荟萃分析。LMIC的32项研究,尤其是来自亚洲,非洲,拉丁美洲,中东,包括在内。从事化学性行为的男男性行为者无公寓肛交的患病率较高，集体性,有多个性伴侣,与没有艾滋病毒和性传播感染的MSM相比。我们估计近期化疗（≤12个月）的合并患病率为16％（95％CI11％-22％，τ=0.01，I2=99.07%，p<0.01)。LMICMSM中Chemsex及其相关行为与HIV和STI相关。减少伤害和性健康服务以及结构变化的整合可以防止在LMIC中从事化学性行为的MSM中预防艾滋病毒和性传播感染。
