Slamsex in The Netherlands among men who have sex with men (MSM): use patterns, motives, and adverse effects.

Background: This paper describes an online survey of men who have sex with men (MSM) and use drugs before or during sex ('chemsex') via injection ('slamming' or 'practising slamsex'). Approximately 15–30% of the MSM population in The Netherlands have practiced chemsex at some point, and 0.5–3.1% of them ever had 'slamsex'. This study investigates which substances are used in The Netherlands during slamsex, the motives for slamming and the health risks involved. Method: In total, 175 MSM from The Netherlands, who had used substances before or during sex via injection completed an ad hoc online questionnaire designed for this study. Results: Mean age of respondents was 47.8 years. During chemsex, almost every substance was used; the most common substances that were injected (slammed) were 3-methylmethcathinone (3-MMC), methamphetamine, ketamine, 4-methylethcathinone (4-MEC) and mephedrone (4-MMC). Reasons for slamming were mainly to experience a more intense rush and longer sex. Virtually none of the respondents used a condom during slamsex, but needles were almost never shared or used only once. Slammers reported health problems associated with injecting drugs (skin problems, collapsed veins and infections). Of most concern were the psychological symptoms reported by about three-quarters of respondents (e.g. insomnia, sadness, depressed mood, anxiety, suicidal tendencies). About half of respondents reported some degree of loss of control or concerns about their slamming behaviour. Conclusion: Results show that slamsex is associated with consciously chosen sexual risk behaviours and risk-avoidance slam behaviours. This study may contribute to the reinforcement of accessible, non-judgmental and well informed prevention and harm reduction activities to support MSM practising slamsex. About 0.5–3.1% of men who have sex with men (MSM) self inject drugs before or during sex ('slamming'). Our survey among 175 Dutch MSM, who had practised slamsex, reported various adverse health effects associated with slamsex (skin problems, collapsed veins, infections, and psychological symptoms, like insomnia, sadness, depressed mood, anxiety, suicidal tendencies and loss of control). The current information of slamsex by MSM may contribute to the reinforcement of accessible, non-judgmental and well informed prevention and harm reduction activities. [ABSTRACT FROM AUTHOR]