Sex, drugs and smart phone applications: findings from semistructured interviews with men who have sex with men diagnosed with Shigella flexneri 3a in England and Wales: Table 1
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OBJECTIVES: To inform control strategies undertaken as part of an outbreak of Shigella flexneri 3a among men who have sex with men (MSM). METHODS: All men aged ≥18 years diagnosed with S flexneri 3a between October 2012 and May 2013 were invited to participate. Semistructured in-depth quantitative interviews were conducted to explore lifestyle and sexual behaviour factors. RESULTS: Of 53 men diagnosed, 42 were interviewed of whom 34 were sexually active MSM. High numbers of sexual partners were reported (median=22) within the previous year; most were casual encounters met through social media networking sites (21/34). 63% (20/32) were HIV-positive and actively sought positive partners for condomless sex. 62% (21/34) of men had used chemsex drugs (mephedrone, crystal methamphetamine and γ-butyrolactone/γ-hydroxybutrate), which facilitate sexually disinhibiting behaviour during sexual encounters. 38% (8/21) reported injecting chemsex drugs. Where reported almost half (12/23) had attended or hosted sex parties. All reported oral-anal contact and fisting was common (16/34). Many had had gonorrhoea (23/34) and chlamydia (17/34). HIV-positive serostatus was associated with both insertive anal intercourse with a casual partner and receptive fisting (adjusted OR=15.0, p=0.01; adjusted OR=18.3, p=0.03) as was the use of web applications that promote and facilitate unprotected sex (adjusted OR=19.8, p=0.02). CONCLUSIONS: HIV-positive MSM infected with S flexneri 3a used social media to meet sexual partners for unprotected sex mainly at sex parties. The potential for the transmission of S flexneri, HIV and other infections is clear. MSM need to be aware of the effect that chemsex drugs have on their health.
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Global increases in the incidence of shigellosis among adult MSM have been more recently observed.
“Global increases in the incidence of shigellosis among adult MSM have been more recently observed (252–256).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [253]
The Introduction (page not provided) reports MSM-associated shigellosis outbreaks in five countries and a rise in male Shigella flexneri 3a diagnoses in England and Wales from 18 in 2008 to 83 in 2011; it says most of those diagnosed were MSM aged 30–50. These passages support a recent increase in one setting and outbreaks across several countries, but not a global increase in incidence among adult MSM. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSpecific behaviors associated with sexually transmitted enteric infections among MSM involve attendance at sex parties and recreational drug use including chem sex, which might facilitate condomless sex, group sex, fisting, use of sex toys, and scat play.
“Specific behaviors associated with sexually transmitted enteric infections among MSM involve attendance at sex parties and recreational drug use including chem sex (i.e., using crystal methamphetamine, gamma-butyrolactone, or mephedrone before or during sex), which might facilitate condomless sex, group sex, fisting, use of sex toys, and scat play (253,271).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [253]
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Self-citationAntimicrobial-Resistant Shigella spp. in San Diego, California, USA, 2017–2020
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Self-citationUsing demographics of patients to inform treatment of shigellosis in England
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Self-citationChessell, C., Rabuszko, L., Richardson, D., & Llewellyn, C. D. (2023) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.19664 · Cited by 19 · see citing works
Peters, J. R., Cresswell, F. V., Amor, L., Cole, K., Dean, G. L., Didelot, X., Silva, D. D., Eyre, D. W., & Paul, J. (2017) · Sexually Transmitted Infections · doi:10.1136/sextrans-2017-053198 · Cited by 19 · see citing works
Gourlay, A. J., Fox, J., Gafos, M., Fidler, S. J., Nwokolo, N. C., Clarke, A. E., Gilson, R. J. C., Orkin, C. M., Collins, S., Porter, K., et al. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-016494 · Cited by 19 · see citing works
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Potential for Phages in the Treatment of Bacterial Sexually Transmitted Infections
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Silva, P. M. D., Stenhouse, G. E., Blackwell, G. A., Bengtsson, R. J., Jenkins, C., Hall, J. P. J., & Baker, K. S. (2022) · Proceedings of the Royal Society B Biological Sciences · doi:10.1098/rspb.2022.0581 · Cited by 17 · see citing works
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Men who have sex with men: A group of travellers with special needs
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Mason, L. C. E., Charles, H., Thorley, K., Chong, C. E., Silva, P. M. D., Jenkins, C., & Baker, K. S. (2024) · npj Antimicrobials and Resistance · doi:10.1038/s44259-024-00038-3 · Cited by 15 · see citing works
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Surveillance of sexualised drug use – the challenges and the opportunities
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Factors associated with C ryptosporidium in men who have sex with men: A systematic review
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Virulence plasmid pINV as a genetic signature for Shigella flexneri phylogeny
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Accessory Genome Dynamics and Structural Variation of Shigella from Persistent Infections
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- Authors
- Gilbart, V. L., Simms, I., Jenkins, C., Furegato, M., Gobin, M., Oliver, I., Hart, G., Gill, O. N., & Hughes, G.
- Affiliations
- Public Health England (GB)
- University College London (GB)
- Corresponding author
- Simms, I
- Venue
- Sexually Transmitted Infections
- Publisher
- BMJ
- Published
- 2015-04-28
- Volume
- 91
- Issue
- 8
- Pages
- 598-602
- ISSN
- 0007-134X (ISSN-L)
- 1368-4973
- 1472-3263
- OpenAlex
- W2050192744
- Cited by
- 170
- References
- 24
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 13 · 2023: 7 · 2022: 16 · 2021: 16 · 2020: 35 · 2019: 11 · 2018: 21 · 2017: 15 · 2016: 19 · 2015: 5
- FWCI
- 15.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Sexually Transmitted Infections (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (NF-SI-0611-10255)
- Public Health England
- Topics
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
- Keywords
- men who have sex with men, chemsex, HIV-positive men, social media, unprotected sex, sexual behavior, fisting, gonorrhea, chlamydia, mobile application, epidemic control, mephedrone, gamma-hydroxybutyric acid
- MeSH terms
- Smartphone, Adult, Dysentery, Bacillary, England, HIV Seropositivity, Humans, Interviews as Topic, Male, Risk-Taking, Sexual Behavior, Sexual Partners, Shigella flexneri, Wales, Homosexuality, Male, Unsafe Sex, Social Media
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