Sexual Victimization in Contexts of Chemsex: A Scoping Review with Harm Reduction Implications.

Chemsex, understood as a form of sexualized drug use that involves a range of psychoactive substance and sociocultural contexts, has been associated with various physical and psychological risks. Among these, sexual victimization remains a critical yet underexplored issue. This scoping review synthesizes literature on sexual victimization in chemsex to identify key patterns, risk factors, and research gaps. A systematic search was conducted in multiple databases, following the PRISMA Extension for Scoping Review guidelines. Fifteen empirical studies met the inclusion criteria and were assessed for methodological quality using the Mixed Methods Appraisal Tool. Three main themes were identified: (1) experiences of nonconsensual sex acts; (2) sexual consent, self-perception, and labeling sexual victimization; (3) risk factors for sexual victimization. Reports of sexual victimization in chemsex are significant, particularly in cases of drug-facilitated sexual assault. Moreover, the understanding of consent remains ambiguous, and there is little perception and acknowledgment of victimization experiences. Several risk factors, including specific substances such as gamma-hydroxybutyrate (GHB), younger age, and power dynamics contribute to this phenomenon. Based on the results, harm reduction strategies were proposed at three different levels to mitigate risks (public and policy, health care and support professionals, and practitioners). Future research should refine measurement tools and further investigate protective factors and intervention effectiveness.