Trouiller P, Velter A, Saboni L, Sommen C, Sauvage C, Vaux S, Barin F, Chevaliez S, Lot F, Jauffret-Roustide M. Int. J. Drug Policy 2020; 79: 102703.
Affiliation
Cermes 3 (Inserm U988/UMR CNRS 8211/EHESS/Paris Descartes University), 45 rue des Saint Pères, Paris, France; Santé publique france, French national public health agency, Saint-Maurice Cedex, France, 12 rue du Val d'Osne, 94415, Saint-Maurice, France. Electronic address: Marie.JAUFFRETROUSTIDE@gmail.com.
BACKGROUND: In the last decade, European cities saw the development of "slamming," a practice related to chemsex that combines three elements: a sexual context, psychostimulant drug use, and injection practices. Epidemiological data on this practice is still sparse and media attention might have unintentionally distorted the size of this phenomenon. Therefore, we aimed to estimate the prevalence of men practicing slam and to identify factors associated with this practice.
METHODS: We used data from the Prevagay 2015 bio-behavioral survey to estimate the prevalence of slamming practices. A time-location sampling was performed among gay-labeled venues in five French cites. Behavioral information was recorded using a self-administered questionnaire. The HIV and HCV serostatus were investigated using ELISA tests on dried blood spots. The factors associated with slamming were assessed using a multiple logistic regression. We applied a weighting mechanism to enhance the generalizability of the estimates.
RESULTS: Among the 2646 men who have sex with men (MSM) included in our study, 3.1% reported slamming at least once during their lifetime (95% confidence interval (CI) = 2.2-4.3) and 1.6% (95% CI = 1-2.3) said they participated in a slamming session in the last 12 months. In the multivariate analysis, both HCV and HIV biological status were strongly associated with practicing "slam" in the last 12 months (OR = 13.37 (95% CI = 3.26-54.81) and 4.73 (95% CI = 1.58-14.44), respectively). Furthermore, a ten-point decrease in mental health scores was linked with the practice with an OR of 1.37 (95% CI = 1.08-1.73), indicating poorer mental health.
CONCLUSION: Even though slamming seems to involve a relatively small proportion of MSM, the vulnerability of this sub-group is high enough to justify setting up harm reduction measures and specific care. Training health professionals and creating services combining sexual health and drug dependence could be an effective response.