Engagement in Chemsex among Men Who Have Sex with Men (MSM) in Malaysia: Prevalence and Associated Factors from an Online National Survey
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Participants
2.2. Study Procedures
3. Measures
3.1. Demographic Characteristics
3.2. Psychosocial Factors
3.3. PrEP Knowledge and History
3.4. Recent Sexual and HIV-Related Behavior
4. Data Analysis
5. Results
5.1. Participant Characteristics
5.2. Correlates of Chemsex Engagement
5.3. Discussion
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Full Sample | Engagement in Chemsex | p-value d | |
---|---|---|---|---|
(n = 870) | No (n = 792) | Yes (n = 78) | ||
Demographic Characteristics | n (%) | n (%) | n (%) | |
Age | 0.059 | |||
18–29 | 377 (43.3) | 353 (44.6) | 24 (30.8) | |
30–39 | 341 (39.2) | 300 (37.9) | 41 (52.6) | |
40–49 | 105 (12.1) | 95 (12.0) | 10 (12.8) | |
50+ | 47 (5.4) | 44 (5.6) | 3 (3.8) | |
Ethnicity | 0.184 | |||
Chinese | 428 (49.2) | 396 (50.0) | 32 (41.0) | |
Indian | 53 (6.1) | 47 (5.9) | 6 (7.7) | |
Malay | 255 (29.3) | 233 (29.4) | 22 (28.2) | |
Other | 134 (15.4) | 116 (14.6) | 18 (23.1) | |
University graduate a | 0.399 | |||
No | 297 (34.1) | 267 (33.7) | 30 (38.5) | |
Yes | 573 (65.9) | 525 (66.3) | 48 (61.5) | |
Relationship status | 0.627 | |||
Single | 615 (70.7) | 558 (70.5) | 57 (73.1) | |
Partner | 255 (29.3) | 234 (29.5) | 21 (26.9) | |
Monthly Income | 0.172 | |||
RM 0–4849 | 550 (63.2) | 508 (64.1) | 42 (53.8) | |
RM 4850–10,959 | 257 (29.5) | 227 (28.7) | 30 (38.5) | |
RM 10,960+ | 62 (7.2) | 57 (7.2) | 6 (7.7) | |
Psychosocial Factors | n (%) | n (%) | n (%) | p-value d |
Depressive symptoms | 0.888 | |||
No | 564 (64.8) | 514 (64.9) | 50 (64.1) | |
Yes | 306 (35.2) | 278 (35.1) | 28 (35.9) | |
Disclosed sexual orientation to family | <0.001 | |||
No | 601 (69.1) | 562 (71.0) | 39 (50.0) | |
Yes | 269 (30.9) | 230 (29.0) | 39 (50.0) | |
Experienced discrimination by healthcare provider | <0.001 | |||
No | 758 (87.1) | 702 (88.6) | 56 (71.8) | |
Yes | 112 (12.9) | 90 (11.4) | 22 (28.2) | |
PrEP b Knowledge and History | n (%) | n (%) | n (%) | p-value |
Ever heard of PrEP b | 0.140 | |||
No | 166 (19.1) | 156 (19.7) | 10 (12.8) | |
Yes | 704 (80.9) | 636 (80.3) | 68 (87.2) | |
Ever used PrEP b | <0.001 | |||
No | 715 (82.2) | 666 (84.1) | 49 (62.8) | |
Yes | 155 (17.8) | 126 (15.9) | 29 (37.2) | |
Currently using PrEP b | (n = 155) | (n = 126) | (n = 29) | 0.660 |
No | 59 (38.1) | 49 (38.9) | 10 (34.5) | |
Yes | 96 (61.9) | 77 (61.1) | 19 (65.5) | |
Knows anyone using PrEP b | <0.001 | |||
No | 449 (51.6) | 439 (54.3) | 19 (24.4) | |
Yes | 421 (48.4) | 362 (45.7) | 59 (75.6) | |
Ever shared PrEP b | (n = 155) | (n = 126) | (n = 29) | 0.001 |
No | 138 (89.0) | 117 (92.9) | 21 (72.4) | |
Yes | 17 (11.0) | 9 (7.1) | 8 (27.6) | |
Willing to use PrEP b | 0.339 | |||
No | 82 (9.4) | 77 (9.7) | 5 (6.5) | |
Yes | 788 (90.6) | 715 (90.3) | 73 (93.6) | |
Likelihood of contracting HIV in next 6 months | <0.001 | |||
Not likely at all | 538 (61.8) | 506 (63.9) | 32 (41.0) | |
A little likely | 223 (25.6) | 199 (25.1) | 24 (30.8) | |
Somewhat likely | 68 (7.8) | 58 (7.3) | 10 (12.8) | |
Extremely likely | 41 (4.7) | 29 (3.7) | 12 (15.4) | |
Lifetime HIV testing | n (%) | n (%) | n (%) | p-value |
Ever tested for HIV | 0.022 | |||
No | 294 (33.8) | 276 (34.8) | 18 (23.1) | |
Yes | 576 (66.2) | 516 (65.2) | 60 (76.9) | |
Recent Behavior (Past 6 months) | n (%) | n (%) | n (%) | p-value |
HIV test | (n = 576) | (n = 516) | (n = 60) | 0.446 |
No | 286 (49.7) | 259 (50.2) | 27 (45.0) | |
Yes | 290 (50.3) | 257 (49.8) | 33 (55.0) | |
Injected drugs | <0.001 | |||
No | 843 (96.9) | 778 (98.2) | 65 (83.3) | |
Yes | 27 (3.1) | 14 (1.8) | 13 (16.7) | |
Engaged in anal sex | <0.001 | |||
No | 328 (37.7) | 317 (40.0) | 11 (14.1) | |
Yes | 542 (62.3) | 475 (60.0) | 67 (85.9) | |
Consistent condom use | (n = 542) | (n = 475) | (n = 67) | 0.166 |
No | 330 (60.8) | 277 (58.3) | 53 (79.1) | |
Yes | 212 (39.1) | 198 (41.7) | 14 (20.9) | |
HIV-positive sexual partner | <0.001 | |||
No | 784 (90.1) | 728 (91.9) | 56 (71.8) | |
Yes | 86 (9.9) | 64 (8.1) | 22 (28.2) | |
Engaged in transactional sex | <0.001 | |||
No | 821 (94.4) | 758 (95.7) | 63 (80.8) | |
Yes | 49 (5.6) | 34 (4.3) | 15 (19.2) | |
Diagnosed with STI c | <0.001 | |||
No | 767 (88.2) | 717 (90.5) | 50 (64.1) | |
Yes | 103 (11.8) | 75 (9.5) | 28 (35.9) |
Variable | B | SE | p | aOR | 95% CI |
---|---|---|---|---|---|
Demographic Characteristics | |||||
Age | |||||
18–29 | - | - | - | - | - |
30–39 | 0.38 | 0.31 | 0.219 | 1.46 | [0.80, 2.67] |
40–49 | 0.34 | 0.45 | 0.458 | 1.40 | [0.56, 3.41] |
50+ | −0.09 | 0.72 | 0.906 | 0.92 | [0.22, 3.79] |
Psychosocial Factors | |||||
Disclosed sexual orientation to family | 0.43 | 0.28 | 0.123 | 1.53 | [0.89, 2.64] |
Experienced discrimination by healthcare provider | 0.62 | 0.34 | 0.071 | 1.86 | [0.95, 3.63] |
Lifetime HIV testing | |||||
Ever tested for HIV | −0.22 | 0.33 | 0.504 | 0.80 | [0.42, 1.53] |
PrEP a Knowledge and History | |||||
Ever used PrEP a | 0.04 | 0.34 | 0.913 | 1.04 | [0.53, 2.02] |
Knows someone using PrEP a | 1.05 | 0.32 | 0.001 | 2.87 | [1.54, 5.33] |
Ever shared PrEP a | 1.42 | 0.65 | 0.028 | 4.14 | [1.16, 14.75] |
Likelihood of contracting HIV in next 6 months | |||||
Not likely at all (reference) | - | - | - | - | - |
A little likely | 0.46 | 0.32 | 0.150 | 1.58 | [0.85, 2.96] |
Somewhat likely | 0.20 | 0.49 | 0.690 | 1.22 | [0.47, 3.18] |
Extremely likely | 1.07 | 0.48 | 0.028 | 2.90 | [1.13, 7.48] |
Recent Behavior (Past 6 months) | |||||
Injected drugs | 1.77 | 0.56 | 0.001 | 5.88 | [1.99, 17.47] |
Engaged in anal sex | 0.72 | 0.38 | 0.054 | 2.06 | [0.99, 4.30] |
HIV-positive sexual partner | 0.70 | 0.36 | 0.049 | 2.02 | [1.00, 4.07] |
Engaged in transactional sex | 0.89 | 0.42 | 0.036 | 2.44 | [1.06, 5.60] |
Diagnosed with STI b | 0.83 | 0.34 | 0.014 | 2.29 | [1.18, 4.43] |
Variable | B | SE | p | aOR | 95% CI |
---|---|---|---|---|---|
PrEP a Knowledge and History | |||||
Knows someone using PrEP a | 1.05 | 0.32 | <0.001 | 2.93 | [1.62, 5.31] |
Ever shared PrEP a | 1.42 | 0.65 | 0.003 | 5.60 | [1.76, 17.77] |
Likelihood of contracting HIV in next 6 months | |||||
Not likely at all | - | - | - | - | - |
A little likely | 0.46 | 0.32 | 0.146 | 1.58 | [0.85, 2.92] |
Somewhat likely | 0.20 | 0.49 | 0.652 | 1.31 | [0.53, 3.23] |
Extremely likely | 1.07 | 0.48 | 0.015 | 3.15 | [1.25, 7.93] |
Recent Behavior (Past 6 months) | |||||
Injected drugs | 1.77 | 0.56 | <0.001 | 6.61 | [2.30, 19.03] |
Engaged in anal sex | 0.72 | 0.38 | 0.032 | 2.21 | [1.07, 4.57] |
HIV-positive sexual partner | 0.70 | 0.36 | 0.032 | 2.09 | [1.07, 4.08] |
Engaged in transactional sex | 0.89 | 0.42 | 0.037 | 2.38 | [1.06, 5.39] |
Diagnosed with STI b | 0.83 | 0.34 | 0.008 | 2.36 | [1.25, 4.44] |
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Share and Cite
Maviglia, F.; Wickersham, J.A.; Azwa, I.; Copenhaver, N.; Kennedy, O.; Kern, M.; Khati, A.; Lim, S.H.; Gautam, K.; Shrestha, R. Engagement in Chemsex among Men Who Have Sex with Men (MSM) in Malaysia: Prevalence and Associated Factors from an Online National Survey. Int. J. Environ. Res. Public Health 2023, 20, 294. https://doi.org/10.3390/ijerph20010294
Maviglia F, Wickersham JA, Azwa I, Copenhaver N, Kennedy O, Kern M, Khati A, Lim SH, Gautam K, Shrestha R. Engagement in Chemsex among Men Who Have Sex with Men (MSM) in Malaysia: Prevalence and Associated Factors from an Online National Survey. International Journal of Environmental Research and Public Health. 2023; 20(1):294. https://doi.org/10.3390/ijerph20010294
Chicago/Turabian StyleMaviglia, Francesca, Jeffrey A. Wickersham, Iskandar Azwa, Nicholas Copenhaver, Olivia Kennedy, Monique Kern, Antoine Khati, Sin How Lim, Kamal Gautam, and Roman Shrestha. 2023. "Engagement in Chemsex among Men Who Have Sex with Men (MSM) in Malaysia: Prevalence and Associated Factors from an Online National Survey" International Journal of Environmental Research and Public Health 20, no. 1: 294. https://doi.org/10.3390/ijerph20010294