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. 2025 Aug 25;20:33. doi: 10.1186/s13011-025-00661-x

Table 3.

GEE multinomial logistic regression: multivariate analysis of factors associated with being a MSM who engaged in chemsex (CX) and being an MSM who did not use drugs at all (non-DU) compared with MSM who used drugs but did not engage in chemsex (DU) (N = 2 493 participants, 19 375 follow-up visits)

Univariate models Multivariate model
Non-DU* (vs. DU**) CX*** (vs. DU) No-DU (vs. DU) CX (vs. DU)
OR [IC 95%] p OR [IC 95%] p aOR [IC 95%] p aOR [IC 95%] p
Agea (years) 1.04 [1.03;1.05] < 0.001 1.04 [1.03;1.05] < 0.001 1.03 [1.02;1.04] < 0.001 1.02 [1.01;1.03] < 0.001
Education level a
 Upper secondary school certificate or lower ref ref ref ref
 Tertiary education below Master’s degree 0.78 [0.61;1.00] 0.053 0.89 [0.68;1.15] 0.365 0.81 [0.64;1.02] 0.073 0.86 [0.67;1.11] 0.240
 Master’s degree or higher 0.78 [0.61;1.00] 0.046 0.72 [0.56;0.93] 0.011 0.79 [0.62;0.99] 0.042 0.70 [0.55;0.90] 0.005
Perceived financial situation a
 Comfortable
 You get by 1.09 [0.91;1.32] 0.342 1.11 [0.90;1.36] 0.351
 It’s difficult to make ends meet 0.86 [0.71;1.05] 0.144 1.19 [0.96;1.47] 0.109
Had already taken PrEP at enrolment a 0.80 [0.68;0.93] 0.003 1.27 [1.07;1.51] 0.006 0.74 [0.64;0.86] < 0.001 1.04 [0.87;1.23] 0.664
Center for Epidemiologic Studies-Depression scale score b 1.00 [0.99;1.01] 0.934 1.01 [1.00;1.02] 0.026 1.00 [1.00;1.01] 0.854 1.01 [1.00;1.02] 0.006
Rosenberg self-esteem scale b 1.01 [1.00;1.02] 0.218 0.99 [0.98;1.01] 0.453
Feeling… b
 Very supported 0.84 [0.73;0.96] 0.011 0.75 [0.62;0.91] 0.004
 Quite supported
 Quite or very alone 1.02 [0.94;1.15] 0.660 1.14 [0.98;1.32] 0.089
Lifetime care received from a professional for mental health problems b 0.88 [0.76;1.02] 0.095 0.91 [0.77;1.07] 0.237
Alcohol Use Disorders Identification Test-Consumption score 0.86 [0.84;0.88] < 0.001 0.86 [0.84;0.89] < 0.001 0.90 [0.88;0.92] < 0.001 0.91 [0.88;0.93] < 0.001
Cannabis use c
 Never
 Occasionally 0.51 [0.46;0.57] < 0.001 0.59 [0.50;0.70] < 0.001 0.62 [0.55;0.69] < 0.001 0.67 [0.57;0.78] < 0.001
 Regularly 0.31 [0.26;0.37] < 0.001 0.49 [0.39;0.60] < 0.001 0.40 [0.34;0.48] < 0.001 0.62 [0.50;0.76] < 0.001
Poppers use c
 Never
 Occasionally 0.60 [0.54;0.67] < 0.001 1.14 [0.99;1.32] 0.077 0.70 [0.63;0.78] < 0.001 1.19 [1.03;1.37] 0.021
 Regularly 0.48 [0.42;0.55] < 0.001 1.16 [0.97;1.38] 0.102 0.61 [0.53;0.70] < 0.001 1.14 [0.96;1.37] 0.141
Having a main partner 1.04 [0.95;1.14] 0.406 0.75 [0.66;0.86] < 0.001 0.93 [0.85;1.02] 0.104 0.74 [0.65;0.84] < 0.001
Number of casual sex partners c
 < 5
 Between 5 and 9 0.70 [0.63;0.77] < 0.001 0.93 [0.81;1.08] < 0.329 0.73 [0.66;0.81] < 0.001 0.91 [0.78;1.06] 0.241
 Between 10 and 19 0.61 [0.55;0.68] < 0.001 0.96 [0.83;1.11] 0.577 0.64 [0.57;0.71] < 0.001 0.90 [0.77;1.06] 0.206
 ≥ 20 0.55 [0.49;0.63] < 0.001 1.14 [0.96;1.34] 0.131 0.61 [0.54;0.69] < 0.001 1.08 [0.91;1.27] 0.390
Systematic use of condoms c 0.97 [0.97;1.07] 0.529 0.73 [0.63;0.85] < 0.001 0.97 [0.87;1.09] 0.642 0.76 [0.64;0.81] 0.002
PrEP adherence
 Optimal
 Sub-optimal 0.81 [0.73;0.89] < 0.001 0.65 [0.57;0.74] < 0.001 0.91 [0.83;1.00] 0.058 0.70 [0.61;0.80] < 0.001
 No PrEP use (at or after baseline) 0.89 [0.82;0.98] 0.013 0.53 [0.47;0.60] < 0.001 0.94 [0.86;1.03] 0.192 0.65 [0.57;0.75] < 0.001
Fisting or BDSM sexual practices d 1.87 [1.49;2.34] < 0.001 5.60 [4.26;7.36] < 0.001 1.64 [1.34;2.01] < 0.001 4.73 [3.69;6.05] < 0.001
Satisfaction with current sex life b
 Not at all satisfied or not really satisfied
 Quite satisfied 0.80 [0.71;0.89] < 0.001 0.87 [0.76;1.01] 0.063 0.87 [0.78;0.98] 0.024 0.92 [0.79;1.07] 0.291
 Very satisfied 0.76 [0.64;0.89] < 0.001 0.85 [0.68;1.05] 0.138 0.88 [0.75;1.03] 0.112 0.95 [0.77;1.16] 0.602
Having a risky sex life b
 Not at all or not really
 Yes, quite risky 0.86 [0.78;0.95] 0.003 1.07 [0.94;1.22] 0.304 0.89 [0.81;0.98] 0.017 1.07 [0.94;1.22] 0.329
 Yes, definitely risky 0.86 [0.73;1.00] 0.055 1.29 [1.06;1.57] 0.011 0.92 [0.79;1.07] 0.277 1.23 [1.01;1.49] 0.038

aBaseline data; bAnnual imputed data; c Previous 3 months. dDuring the most recent sexual intercourse

* MSM who used drugs but did not engage in chemsex

** MSM who did not use drugs

*** MSM who engaged in chemsex