Is there a reduction in chemsex practice in men who have sex with men during Covid-19 lockdown? Results of the CheRRLock study.

Abstract

Chemsex is a growing concern among men who have sex with men (MSM). Covid-19 lockdowns have had consequences on social and sexual interactions. We aimed to assess changes in chemsex practices during Covid-19 lockdown in France among MSM, and factors associated with maintaining or increasing chemsex practice. Repeated face-to-face questionnaires were conducted at "Le 190" Sexual Health Center, Paris, France, exploring lifestyle, sexual and chemsex practices, Covid-19 concerns and mental health before and during second lockdown in France (30/10/2020-15/12/2020). Inclusion criteria were: chemsex practices at least 3 times throughout lifetime and at least once in the 3 months prior to second lockdown. The primary endpoint was the proportion of participants who declared having stopped, decreased, maintained, or increased their chemsex practice during lockdown. Uni- and multivariable logistic regressions were used to analyze factors associated with evolutions of chemsex practice. 93 MSM were included: 66% HIV-positive, 30% taking PrEP. Drugs most used were cathinones (91%) and GHB/GBL (52%). Participants reported stopping, decreasing, maintaining and increasing chemsex drugs use in 14%, 22%, 22% and 42% of cases, respectively. Despite this overall increase in chemsex practice, MSM decreased their number of sexual partners. Factors significantly associated with maintaining or increasing chemsex drugs use were: feeling lonely (OR=3.24), craving (OR=4.51), and working during lockdown (OR=3.27), contrasting with fear of Covid-19 (OR=0.31). Restriction measures lead to changes in sexual behavior and appear to increase chemsex practice. Maintaining care for most isolated patients should be a priority in Covid-19 context.