[Chemsex and sexual risk in men who have sex with men: A scoping review].

OBJECTIVE

To determine whether chemsex, by itself, constitutes a sexual risk factor among men who have sex with men (MSM), particularly concerning condomless sex and sexually transmitted infections (STIs).

DESIGN

Scoping review conducted according to PRISMA-ScR guidelines.

DATA SOURCES: PubMed®, WOS®, Scopus®, CINAHL®, CUIDEN®, and BV-SSPA were searched between December 2023 and January 2024 using terms such as «Sexual and Gender Minorities», «Chemsex», «Sexual Behavior», and «Sexually Transmitted Diseases».

STUDY SELECTION: A total of 1,168 records were identified. After removing duplicates and applying eligibility criteria, 19 studies were included. All required an explicit definition of chemsex and direct analysis of its association with condomless sex and/or STI acquisition.

DATA EXTRACTION: Three reviewers independently extracted data. Variables included study type, chemsex as independent or dependent variable, condom use, HIV/STI screening, PrEP use, and STI prevalence.

RESULTS

Chemsex was associated with increased condomless sex (up to 79%) and higher STI rates (e.g., gonorrhea: 57.4% in chemsexers vs. 39.1%). PrEP use was more common among chemsexers but not clearly linked to lower STI incidence. Confidence intervals and sensitivity analyses were inconsistently reported across studies.

CONCLUSIONS

Chemsex is a high-risk sexual practice among MSM, strongly associated with condomless sex and increased STI prevalence. Primary care should implement targeted strategies for prevention, early detection, and sexual health education in this population.