Chemsex Among Men Who Have Sex With Men: A Systematic Scoping Review of Research Methods

J Homosex. 2024 May 11;71(6):1392-1418. doi: 10.1080/00918369.2023.2170757. Epub 2023 Mar 20.

Abstract

Chemsex refers to the use of psychoactive substances with sex. We carried out a systematic scoping review of methodological characteristics of chemsex research among men who have sex with men (MSM), published between 2010 and 2020. For inclusion, chemsex had to be the main focus, and studies had to specify GHB/GBL, stimulant (amphetamine, crystal meth, ecstasy/MDMA, cathinones, cocaine) and/or ketamine use with sex as a variable. From 7055 titles/abstracts, 108 studies were included, mostly cross-sectional, and from Western countries. About one-third of studies recruited exclusively from clinical settings. A majority of these recruited from sexually transmitted infection (STI) clinics. The included quantitative studies analyzed possible associations between chemsex and STI health (40%), mental health (15%), drug health (12%), sexological health (10%), and post-diagnostic HIV health (7%). Most studies included GHB/GBL and crystal meth in their operationalization of chemsex. Definitions and operationalizations of chemsex vary greatly in the literature, and researchers of chemsex among MSM should consider ways in which this variation impacts the validity of their results. More studies are needed among MSM in non-high income and non-Western countries, and examination of possible links between chemsex and post-diagnostic HIV health, sexological health, and mental health.

Keywords: GHB/GBL; HIV; Health; LGBT health; MSM (men who have sex with men); chemsex; crystal meth; internalized homophobia; intersectionality; minority stress; psychology; sexual behavior; sexual health; sexualized drug use; stigma; substance use.

Publication types

  • Systematic Review

MeSH terms

  • Cross-Sectional Studies
  • HIV Infections*
  • Homosexuality, Male / psychology
  • Humans
  • Male
  • Methamphetamine*
  • N-Methyl-3,4-methylenedioxyamphetamine*
  • Sexual Behavior
  • Sexual and Gender Minorities*
  • Sexually Transmitted Diseases*
  • Sodium Oxybate*
  • Substance-Related Disorders* / epidemiology
  • Substance-Related Disorders* / psychology

Substances

  • Sodium Oxybate
  • Methamphetamine
  • N-Methyl-3,4-methylenedioxyamphetamine