Prevalence of sexualized drug use and risk of HIV among sexually active MSM in East and South Asian countries: systematic review and meta‐analysis
Abstract Introduction Sexualized drug use (SDU), the use of psychoactive drugs in the context of sexual intercourse, has been identified as a risk factor for HIV among men who have sex with men (MSM) in Asia. Given the distinct social and cultural context of same‐sex relationships and drug‐using pra...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-01-01
|
| Series: | Journal of the International AIDS Society |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jia2.26054 |
| _version_ | 1811176436616134656 |
|---|---|
| author | Laura Nevendorff Sophia E. Schroeder Alisa Pedrana Adam Bourne Mark Stoové |
| author_facet | Laura Nevendorff Sophia E. Schroeder Alisa Pedrana Adam Bourne Mark Stoové |
| author_sort | Laura Nevendorff |
| collection | DOAJ |
| description | Abstract Introduction Sexualized drug use (SDU), the use of psychoactive drugs in the context of sexual intercourse, has been identified as a risk factor for HIV among men who have sex with men (MSM) in Asia. Given the distinct social and cultural context of same‐sex relationships and drug‐using practice in Asia, we aimed to describe the prevalence of SDU in East and South Asian countries and its associations with condomless anal sex (CAI) and HIV status. Synthesizing SDU research in this region, including SDU definitions, prevalence and outcomes, provides insights to inform future research and improved programme planning, resourcing and advocacy. Methods We systematically searched OVID Medline, OVID EMBASE, OVID Global Health, CINAHL, PsycINFO and SCOPUS publication databases for scientific articles published from 1990 to 2022 measuring SDU among MSM in East and South Asian countries. A narrative synthesis was utilized to describe key study attributes and findings, and meta‐analyses using random pooled effect models were used to estimate SDU prevalence and its associations with CAI and HIV status. Subgroup meta‐analyses, sensitivity analysis and assessment of publication bias examined potential sources of heterogeneity for the pooled SDU prevalence estimates. Results and discussion Of the 1788 publications screened, 49 publications met the selection criteria and 18 were suitable for meta‐analyses. Findings highlight SDU definitions distinct from other regions but inconsistencies in the definition of SDU between studies that have been highlighted in research elsewhere. The pooled prevalence of recent SDU (past 12 months) was 13% (95% CI = 10–16%; I2 = 97.6) but higher when studies utilized self‐administered surveys (15%; 95% CI = 12–19%; p<0.05). SDU was associated with greater odds of CAI (pooled odds ratio [OR] = 3.21; 95% CI = 1.82–5.66) and living with diagnosed HIV (OR = 4.73; 95% CI = 2.27–8.21). Conclusions SDU is common among MSM in East and South Asian countries, but varying SDU definitions limit between‐study comparisons. Responses to SDU‐related harms should consider local contexts, including specific drug types used and their relative risks. |
| first_indexed | 2024-04-10T19:51:25Z |
| format | Article |
| id | doaj.art-2a8fdc7f7466484fae6d97ccd8e89d71 |
| institution | Directory Open Access Journal |
| issn | 1758-2652 |
| language | English |
| last_indexed | 2024-04-10T19:51:25Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the International AIDS Society |
| spelling | doaj.art-2a8fdc7f7466484fae6d97ccd8e89d712023-01-28T02:15:31ZengWileyJournal of the International AIDS Society1758-26522023-01-01261n/an/a10.1002/jia2.26054Prevalence of sexualized drug use and risk of HIV among sexually active MSM in East and South Asian countries: systematic review and meta‐analysisLaura Nevendorff0Sophia E. Schroeder1Alisa Pedrana2Adam Bourne3Mark Stoové4Disease Elimination Program Burnet Institute Melbourne Victoria AustraliaDisease Elimination Program Burnet Institute Melbourne Victoria AustraliaDisease Elimination Program Burnet Institute Melbourne Victoria AustraliaAustralian Research Centre in Sex, Health and Society La Trobe University Melbourne Victoria AustraliaDisease Elimination Program Burnet Institute Melbourne Victoria AustraliaAbstract Introduction Sexualized drug use (SDU), the use of psychoactive drugs in the context of sexual intercourse, has been identified as a risk factor for HIV among men who have sex with men (MSM) in Asia. Given the distinct social and cultural context of same‐sex relationships and drug‐using practice in Asia, we aimed to describe the prevalence of SDU in East and South Asian countries and its associations with condomless anal sex (CAI) and HIV status. Synthesizing SDU research in this region, including SDU definitions, prevalence and outcomes, provides insights to inform future research and improved programme planning, resourcing and advocacy. Methods We systematically searched OVID Medline, OVID EMBASE, OVID Global Health, CINAHL, PsycINFO and SCOPUS publication databases for scientific articles published from 1990 to 2022 measuring SDU among MSM in East and South Asian countries. A narrative synthesis was utilized to describe key study attributes and findings, and meta‐analyses using random pooled effect models were used to estimate SDU prevalence and its associations with CAI and HIV status. Subgroup meta‐analyses, sensitivity analysis and assessment of publication bias examined potential sources of heterogeneity for the pooled SDU prevalence estimates. Results and discussion Of the 1788 publications screened, 49 publications met the selection criteria and 18 were suitable for meta‐analyses. Findings highlight SDU definitions distinct from other regions but inconsistencies in the definition of SDU between studies that have been highlighted in research elsewhere. The pooled prevalence of recent SDU (past 12 months) was 13% (95% CI = 10–16%; I2 = 97.6) but higher when studies utilized self‐administered surveys (15%; 95% CI = 12–19%; p<0.05). SDU was associated with greater odds of CAI (pooled odds ratio [OR] = 3.21; 95% CI = 1.82–5.66) and living with diagnosed HIV (OR = 4.73; 95% CI = 2.27–8.21). Conclusions SDU is common among MSM in East and South Asian countries, but varying SDU definitions limit between‐study comparisons. Responses to SDU‐related harms should consider local contexts, including specific drug types used and their relative risks.https://doi.org/10.1002/jia2.26054sexualized drug usemen who have sex with menEast‐South Asiasexual risk behaviourssystematic reviewmeta‐analysis |
| spellingShingle | Laura Nevendorff Sophia E. Schroeder Alisa Pedrana Adam Bourne Mark Stoové Prevalence of sexualized drug use and risk of HIV among sexually active MSM in East and South Asian countries: systematic review and meta‐analysis Journal of the International AIDS Society sexualized drug use men who have sex with men East‐South Asia sexual risk behaviours systematic review meta‐analysis |
| title | Prevalence of sexualized drug use and risk of HIV among sexually active MSM in East and South Asian countries: systematic review and meta‐analysis |
| title_full | Prevalence of sexualized drug use and risk of HIV among sexually active MSM in East and South Asian countries: systematic review and meta‐analysis |
| title_fullStr | Prevalence of sexualized drug use and risk of HIV among sexually active MSM in East and South Asian countries: systematic review and meta‐analysis |
| title_full_unstemmed | Prevalence of sexualized drug use and risk of HIV among sexually active MSM in East and South Asian countries: systematic review and meta‐analysis |
| title_short | Prevalence of sexualized drug use and risk of HIV among sexually active MSM in East and South Asian countries: systematic review and meta‐analysis |
| title_sort | prevalence of sexualized drug use and risk of hiv among sexually active msm in east and south asian countries systematic review and meta analysis |
| topic | sexualized drug use men who have sex with men East‐South Asia sexual risk behaviours systematic review meta‐analysis |
| url | https://doi.org/10.1002/jia2.26054 |
| work_keys_str_mv | AT lauranevendorff prevalenceofsexualizeddruguseandriskofhivamongsexuallyactivemsmineastandsouthasiancountriessystematicreviewandmetaanalysis AT sophiaeschroeder prevalenceofsexualizeddruguseandriskofhivamongsexuallyactivemsmineastandsouthasiancountriessystematicreviewandmetaanalysis AT alisapedrana prevalenceofsexualizeddruguseandriskofhivamongsexuallyactivemsmineastandsouthasiancountriessystematicreviewandmetaanalysis AT adambourne prevalenceofsexualizeddruguseandriskofhivamongsexuallyactivemsmineastandsouthasiancountriessystematicreviewandmetaanalysis AT markstoove prevalenceofsexualizeddruguseandriskofhivamongsexuallyactivemsmineastandsouthasiancountriessystematicreviewandmetaanalysis |