Emergency Healthcare Utilization and Unmet Care Needs in Chemsex Users: A Cross-Sectional Survey among Sexual Minority Men.

Chemsex entails potential risks that may lead to medical emergencies. This cross-sectional study analyzed data from an anonymous, self-administered online survey on substance use among 1,203 sexual minority men (SMM) who engage in chemsex in Spain. The study aimed to determine the proportion of chemsex users that have sought emergency care following a session, identify their reasons for consultation, examine associated sociodemographic factors, and assess the proportion who felt they should have sought emergency care but did not. Frequencies of emergency consultations following chemsex sessions and episodes where participants felt they should have sought care but did not were calculated. Associations between seeking emergency care and sociodemographic and substance use factors were analyzed using Poisson regressions. Reasons for consultation were categorized based on responses to an open-ended question. 15.4% (95%CI:12.9-17.8) of chemsex users sought emergency care to request HIV post-exposure prophylaxis (PEP), and 4.0% (95%CI: 2.9-5.1) for other reasons. However, 21.8% (95%CI:19.3-24.2) did not seek care despite feeling they should have. The most common reasons for consultation were overdose symptoms, STI symptoms, and trauma. Living in smaller towns was associated with 2.4 times lower likelihood of visiting emergency services (95% CI:1.2-5.0). Injection substance use and mephedrone use were associated with 2.7 (95%CI:1.2-5.9) and 2.3 (95%CI:1.0-5.2) times higher likelihood of seeking care, respectively. Emergency visits for reasons other than requesting PEP were infrequent among chemsex users; however, a notable percentage felt they should have sought care but did not. Risk reduction strategies should prioritize addressing injection use and mephedrone consumption.