Childhood sexual abuse, risk behaviours and chemsex engagement among men who have sex with men in Paris, France

Drückler et al suggest that chemsex engagement among men who have sex with men (MSM) is significantly associated with reporting non-consensual sex.1 Inspired by clinical stories gathered in a sexual healthcare service, we investigated a possible relationship between childhood sexual abuse (CSA), that is, having been a victim of forced genital contact by an adult before age 13, and current chemsex engagement. To our knowledge, only one recent study reports a ‘higher frequency’ of early sexual abuse—but without specification of type and age of sexual abuse—among adult chemsex-users MSM.2

These data were collected during youth festivals using a computerised, anonymous, self-administered survey of a non-selected population of 225 MSM (median age=23, aged 16–39) living mainly in the Paris area.

After adjustment for potential confounding factors, those who had experienced CSA were more likely than the other MSM to report not having a regular partner (adjusted OR=3.06 (95% CI 1.16 to 8.08, p<0.05)), less likely to protect themselves with a new partner of unknown risk (aOR=0.2 (0.06 to 0. 62), p<0.01), were more likely to be chronic users of both illicit psychoactive substances (aOR=4.91 (2.18 to 11.0), p<0.01) and psychotropic drugs (aOR=3.89 (1.78 to 8.50), p<0.01) and were more likely to be chemsex-users (aOR=5.62 (1.83 to 17.2), p<0.01).

This exploratory study suggests that CSA may be a strong vulnerability factor (nearly six times more likely) predisposing MSM to chemsex engagement. If confirmed by larger studies, these findings should encourage clinicians to systematically ask for a history of CSA in cases of chemsex engagement among MSM and, if deemed necessary, to integrate this major trauma into the overall clinical management of chemsex in a broad risk-harm reduction perspective.

Ethics statementsPatient consent for publicationEthics approval

Data were obtained from computerised self-administered questionnaires and were completely anonymous, with the authorisation from the French National Data Protection Authority (CNIL approval n° 00 13 47). Participants gave informed consent to participate in the study before taking part.

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