Getting inside the mind of chemsex practitioners: motivations to engage in chemsex - a systematic review

Abstract

Background: Chemsex is a neologism mixing chemical and sex. It is a subtype of Sexualized drug use (SDU), especially practised among Gay and Bisexual Men who have Sex with Men (GBMSM). SDU is associated with sex lasting hours or days with multiple sexual partners which increase prevalence of Sexual Transmitted Infections among this population. The most used chemsex drugs are grouped in three families: methamphetamines, synthetic cathinones and γ-hydroxybutyric acid/ γ-butyrolactone. Aim: This study aims to identify and discuss the motivations and reasons to engage in chemsex experiences in GBMSM population. Methods: A systematic review based on papers published between 2010 and 2022 was conducted according to PRISMA guidelines. Searched data bases were PubMed/Medline, Scopus, Google Scholar and PsycINFO. Results: Our search identified 1400 publications, of which 23 were included. Motivations to engage in chemsex were aggregated as follows: (1) Enhancing sexual sensations and performance, (2) Achieving hedonic mental and emotional states, (3) Tackle negative thoughts and feelings, and (4) Social motivations. Different sample methods and ways of asking motivations may limit internal validity of these conclusions. Conclusions: Both individual and social factors are involved in the decision to engage in chemsex. This reality should not be medicalized, however therapeutic support should provide multidisciplinary, pleasure-centred, harm reducing care interventions, specifically designed to these minority of GBMSM.