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Two reviews also discussed the difficulty of defining chemsex (1, 9), with one review noting that definitions can vary based on participant preferences, availability of specific drugs, and diverse subcultures (1). Authors also found that studies recruited participants from sexual health or drug treatment services, which likely produced inaccurate estimates of prevalence (1). The use of heterogeneous sampling techniques produced prevalence estimates that varied considerably (1, 2, 9). This review concluded that prevalence estimates varied greatly, and that sexualized drug use and chemsex are poorly understood in the UK (9).Īll three reviews found similar challenges when synthesizing evidence on sexualized drug use. Authors also noted that while the use of specific drugs associated with chemsex is not limited to sexual contexts, “chemsex drug use” can be used as a direct proxy for chemsex (9). data specific to drug use prior to or during sexual activity). Studies in this category provided data on chemsex-specific drugs, but lacked event-level data (i.e. However, a third category was also included: the use of chemsex drugs in an undefined context, which authors titled “chemsex drug use”. distinguished between different forms of substance use: sexualized drug use and chemsex (9). Similarly, the scoping review by Edmundson et al. The phenomenon of chemsex is discussed in more detail in the next section. systematic review on chemsex had similar results, in addition to finding that HIV-positive men who have sex with men are more likely to engage in chemsex behaviours (1). The prevalence of chemsex was reported in 38 of the 112 studies (34%), and was associated with condomless sex, group sex, transactional sex, and negative health outcomes such as sexually transmitted infections and mental health issues (2). Crystal methamphetamine specifically was reported in 38 studies (34%). Of the 112 studies included in the review, methamphetamines were the most commonly reported drug (44 studies, or 39%). explored recreational drug use in men who have sex with men and high-risk sexual practices, sexually transmitted infections, and barriers to accessing specialist support (2). (2018) also investigated the prevalence of sexualized drug use in the UK (9). examined chemsex in high-income countries (1). broadly examined the issue of sexualized drug use on a global scale (2), while Maxwell et al. Two systematic reviews, published in 2019, examined sexualized drug use among men who have sex with men (1, 2). What we found Sexualized drug use among men who have sex with men
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This review: explores the impact of sexualized drug use among men who have sex with men, with a particular focus on chemsex (a behaviour) and methamphetamine (a substance associated with chemsex) describes effective interventions to address individual harms associated with each and discusses sex-based sociality, a concept that describes how social life among men who have sex with men may be sexually constructed (7). Use of methamphetamine is of particular concern, as its use is consistently associated with sexual risk behaviours among men who have sex with men (3, 13). Chemsex (also known as ‘party and play’) (10) is a specific subset of sexualized drug use, and has been associated with increased sexual risk behaviours and negative health outcomes (1). ‘Club drugs’, such as cocaine and ecstasy, appear to be less popular than drugs associated with ‘chemsex’, which include methamphetamine, mephedrone, gamma-hydroxybutyrate (GHB), and gamma-butyrolactone (GBL) (9, 12). In the past decade, drug use trends among men who have sex with men have shifted (9-11). Among men who have sex with men, aggregate research has identified a relationship between substance use and sexual risk behaviours (8). Sexualized drug use is when recreational drugs are taken in order to facilitate sexual activity (2).
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Chemsex (1, 2) and methamphetamine use (3, 4) are associated with sexual health-related harms among men who have sex with men.What are effective interventions and/or services that address chemsex and methamphetamine use among men who have sex with men (including prevention, harm reduction, engagement in care and treatment)?.What is the impact of sexualized drug use (specifically of chemsex and methamphetamine) on the health of men who have sex with men?.