Research Article: Recreational Drug Use among Chinese MSM and Transgender Individuals: Results from a National Online Cross-Sectional Study

Date Published: January 20, 2017

Publisher: Public Library of Science

Author(s): Peizhen Zhao, Songyuan Tang, Cheng Wang, Ye Zhang, John Best, Thitikarn May Tangthanasup, Shujie Huang, Bin Yang, Chongyi Wei, Joseph D. Tucker, Weiming Tang, Zhefeng Meng.


Recreational drug use has increased considerably among Chinese men who have sex with men (MSM). The phenomenon has the potentially to increase HIV transmission among Chinese MSM. The aims of this study were: 1) to investigate the prevalence of recreational drug use among Chinese MSM, and 2) to explore the correlation between gay smartphone based sex-seeking applications (gay apps), HIV/STIs testing, group sex, commercial sex, sexual roles and poppers use among Chinese MSM.

MSM who were born biologically male, were at least 16 years of age and had engaged in anal sex with a man at least once were recruited through a nation-wide online survey in 2014. Information regarding socio-demographics, risk behaviors, recreational drug use, HIV and other STIs testing history and gay app use were collected. Univariate and multivariate analysis were used to determine factors associated with recreational drug use among Chinese MSM.

Among 1424 participating MSM, 1100 (77.3%) reported ever using recreational drugs in their lifetime. In the last 12 months, 303 (21.3%) used poppers, 34 (2.4%) used crystal meth and 15 (1.0%) used ecstasy. The mean age of respondents was 25.6±6.8 years, 72.9% identified as gay, 41.3% were students, and 83.8% had never been married. Multiple logistic regression models revealed that compared with non-popper users, popper users were more likely to have been tested for HIV (adjusted OR (aOR) = 1.50, 95% CI: 1.15–1.96) and other STIs (aOR = 1.65, 95% CI: 1.26–2.17). In addition, popper users were more likely to engage in group sex (aOR = 2.63, 95% CI:1.80–3.86), commercial sex (aOR = 1.86, 95% CI:1.13–3.06) and used gay mobile apps to seek sexual partners (aOR = 2.10, 95% CI:1.58–2.80).

Chinese MSM has a high rate of recreational drug use, including poppers. Public health programs serving MSM may consider integrating intervention programs to decrease recreational drug use related harms.

Partial Text

Recreational drug use is long being considered to a major global driving force for HIV transmission[1]. With the implementation of harm reduction programs, however, HIV incidence rates have decreased among people who inject drugs around the world[2–4]. Despite these achievements in HIV transmission prevention among people who inject drugs, many challenges still remain [5]. In addition, new challenges have emerged in the last decade due to increasing prevalence of recreational drug use among men who have sex with men (MSM) and transgender individuals [6].

The increasing use of recreational drug among Chinese MSM may facilitate high-risk behaviors for HIV transmission among Chinese MSM[7]. Previous studies have shown that individuals who used recreational drug had a 2–4 times greater risk of acquiring HIV than those who did not use drugs [11,20]. Most of the literature about recreational drug use among MSM has focused on high-income contexts and its association with risk behaviors. Our study adds to the literature by recruiting participants from multiple cities throughout China, utilizing an online countrywide survery, and demonstrating the association with HIV/ STIs testing and gay apps use. Our findings indicate that individuals who use recreational drugs have a higher prevalence of risk behaviors and tend to use gay apps to find sexual partners, which has the potential to worsen the epidemic of HIV and other STIs among MSM. In addition, recreational drug users are more likely to have HIV/STI testing experience than non-users.




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