Vulnerability Conditions in a Cohort of Men Who Have Sex with Men Who Engage in Chemsex in Barcelona City: a Cross-Sectional Study

Introduction Chemsex is a dynamic phenomenon with cultural variation. There is limited information about its prevalence and specific characteristics in our geographical area. Methods In this cross-sectional study of a series of gay, bisexual, and other men who have sex with men (gbMSM) who engaged in chemsex and were attending the Hospital Clinic of Barcelona, Spain, between March 2018 and May 2019, we aimed to identify potential vulnerabilities and describe the profiles of individuals who engaged in chemsex in our site. Baseline clinical and epidemiological characteristics related to HIV, HCV, STIs, sexual practices, and drug consumption were evaluated. A sub-analysis considering vulnerability conditions was completed. Results We included 161 participants: 67% were migrants and 48% were Latin American. A total of 150 participants were people living with HIV (PLWH), and 13% had a detectable HIV viral load (VL). The prevalence of HCV infection was 37%. Slamming practice was reported by 20% of the participants. Migrants from Latin America were younger, had a lower percentage of university education, and more frequently had detectable HIV-VLs and syphilis. HCV-positive participants reported more injecting drug use, versatile fisting practices, and syphilis. Slam users consumed more methamphetamine and mephedrone, had significantly higher HIV-VLs when detectable, and reported less sober sex. Conclusion and Policy Implications We identified certain baseline characteristics of our chemsex cohort that may confer a profile of greater vulnerability, which must be addressed in a personalized way when attempting damage reduction and a global approach to the practice of chemsex at our site. Access to specialized and interdisciplinary services with cultural competence in the complexity of the phenomenon should be guaranteed to these individuals for better management.