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Reports from western countries documented that MSM nitrite inhalants users were more likely to engage in risky sexual behaviors and were involved in greater likelihood of HIV acquisition.
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However, recent findings suggested nitrite inhalants (also referred to as rush poppers) had taken the place of methamphetamine or ecstasy and become the most popular recreational substance among MSM in China. Previous studies reported that methamphetamine or ecstasy was the most prevalent recreational drug among MSM. Recreational drug use was reported to be associated with risky sexual behaviors, which placed users at elevated risk of HIV and STDs. Recent studies revealed that recreational drugs were increasingly popular among MSM in China. The rapid spread of the HIV epidemic among MSM has posed great challenges to HIV/AIDS prevention in China. In 2017, 25.5% of the 134 512 newly diagnosed HIV cases were attributed to sex between men, while sexual contacts between men only accounted for 12.2% of the 50 000 new infections in 2007. Therefore, increased attention and counselling should be given to nitrite inhalants-using MSM.ĭespite the achievements obtained in human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) control and prevention in China, national updates on the AIDS/sexually transmitted diseases (STDs) epidemic indicated that men who have sex with men (MSM) were at increasing risk of HIV infection in the past decades. This study found that nitrite inhalants were the most commonly used recreational substance among MSM and nitrite inhalants use were associated with higher probability of HIV and syphilis infection. The general prevalence of HIV and syphilis infection among the enrolled MSM were 16.8% (95% CI: 14.7–19.0%) and 12.6% (95% CI: 10.7–14.4%), respectively. The proportions of participants reported engaging in group sex and practicing condomless internal ejaculation during anal sex in the past six months were 5.8% (95% CI: 4.4–7.2%) and 41.7% (95% CI: 38.7–44.7%), respectively. Of the 1151 eligible participants, 18.9% (218) reported use of at least one type of recreational drugs in the past 6 months, and nitrite inhalants were the most commonly used substance (17.7, 95% confidence interval : 15.6–20.2%). Logistic regression analysis was performed to evaluate factors correlated with nitrite inhalants use and its relationship with risky sexual behaviors and HIV/syphilis infection. Blood samples were drawn from each participant for the diagnoses of HIV and syphilis.
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Information of demographics, drug use, sexual behaviors and HIV testing was collected through an anonymous survey.
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This cross-sectional study was conducted in Chongqing between March 2019 and February 2020. The present study aimed to describe the prevalence and correlates of nitrite inhalants use and its association with risky sexual behaviors and human immunodeficiency virus (HIV)/syphilis infection among MSM in Chongqing, a city in China where MSM were burdened with the highest pooled HIV prevalence in the country. Emerging evidence indicates nitrite inhalants have become increasingly prevalent among men who have sex with men (MSM).