sodium-oxybate and Dysentery--Bacillary

Outbreaks of shigellosis among men who have sex with men (MSM) have been reported since the late 1990s. HIV infection is an important risk factor. Since 2014, the global shigellosis epidemic has intensified. Whether chemsex (the use of crystal methamphetamine, γ-hydroxybutyrate or mephedrone to enhance sex) is a new risk factor has not been previously examined.. Seventy-five shigellosis cases were compared with 225 controls. High pVL (>100 000 copies/mL; adjusted OR (aOR): 4.9, 95% CI 1.4 to 16.9), gonorrhoea (aOR: 29.4, 95% CI 2.3 to 340.2) and syphilis (aOR: 4.3, 95% CI 1.6 to 11.6) were independent risk factors of shigellosis. Twenty shigellosis cases and 59 controls completed the questionnaire. Oral-to-anal sex (aOR: 15.5, 95% CI 3.6 to 66.7), chemsex (aOR: 5.6, 95% CI 1.4 to 22.7) and poppers use (aOR: 10.9, 95% CI 1.9 to 64.2) within 12 months were independent behavioural risk factors of shigellosis.. Chemsex is a new risk factor for shigellosis among MSM living with HIV, as identified in the 2015-2016 outbreak. Additional risk factors include poppers use, sexual risk behaviours and high pVL. Further studies on chemsex among MSM, which is a rising public health concern, are urgently required.

Topics: Adult; Case-Control Studies; Coinfection; Disease Outbreaks; Dysentery, Bacillary; Gonorrhea; HIV Infections; Humans; Logistic Models; Male; Methamphetamine; Multivariate Analysis; Odds Ratio; Risk Factors; Sexual and Gender Minorities; Sexual Behavior; Sodium Oxybate; Substance-Related Disorders; Syphilis; Taiwan; Viral Load