Chemsex

Chemsex" refers to the targeted consumption of psychoactive substances in connection with sex, usually to prolong the sexual experience, lower inhibitions or increase intensity. Chemsex encounters usually take place in private homes, clubs or at parties, often over several hours or days. The term is particularly discussed in the context of men who have sex with men (MSM), but in principle occurs in various scenes.

Motivation:

• Longer erections, increased desire, disinhibition or group dynamics.

Risks

• Physical: Overdose (especially with GHB/GBL), cardiovascular stress, dehydration, lack of sleep.
• Psychological: addiction, depression, psychosis.
• Sexual: Increased risk of sexually transmitted infections (STIs) due to prolonged, often unprotected contact.

Meta-analytical studies show that methamphetamine is the substance most frequently associated with chemsex among MSM in Asia (prevalence = 0.16, 95% CI: 0.09-0.22), followed by GHB/GBL = γ-hydroxybutyrate (GHB) and γ-butyrolactone (GBL) (prevalence = 0.15, 95 % CI: 0.03-0.27) and ketamine (prevalence = 0.08, 95 % CI: 0.04-0.12)(Wang H et al. 2023).

Cocaine (prevalence = 0.01, 95 % CI: 0.00-0.03).

Compared to the general MSM population (prevalence = 0.19, 95 % CI: 0.15-0.23), MSM practicing transactional sex had a higher prevalence of chemsex (MSM sex work clients [prevalence = 0.28, 95 % CI: 0.11-0.45];

MSM sex workers [prevalence = 0.28, 95% CI: 0.17-0.26]). MSM living with HIV were also more likely to engage in chemsex activity (OR = 3.35, 95% CI: 1.57-7.10) compared to MSM living without HIV.

1. Kamal RM et al. (2017) Pharmacological Treatment in γ-Hydroxybutyrate (GHB) and γ-Butyrolactone (GBL) Dependence: Detoxification and Relapse Prevention. CNS Drugs 31:51-64.

2. Wang H et al. (2023) Chemsex and chemsex associated substance use among men who have sex with men in Asia: A systematic review and meta-analysis. Drug Alcohol Depend 243:109741.