Chemsex-associated drug use amongst men and gender-diverse people having sex with men in the UK: Findings from an online community survey, 2024.

ObjectivesChemsex is the use of select psychoactive drugs to enhance sexual experiences and has been described among gay, bisexual, and other men who have sex with men (GBMSM). We aimed to characterise sexual risk, wellbeing and health-seeking behaviours among GBMSM and gender-diverse people reporting chemsex-associated drug use.MethodsWe analysed data from 'Reducing inequalities in Sexual Health' (RiiSH), an online community survey of 2758 UK-resident men and gender-diverse people having sex with men undertaken in November-December 2024. We compared those reporting chemsex-associated drug use with those who did not, assessing sociodemographic characteristics, well-being, sexual risk behaviours and sexual health service (SHS) engagement.ResultsOverall, 8% (218/2758) reported chemsex-associated drug use in the last year. A higher proportion of participants reporting chemsex-associated drug use in the last year also reported a composite measure of sexual risk based on self-reported behaviours in the previous 3-4 months (e.g. prior bacterial STI diagnosis, ≥5 male condomless anal sex partners) compared to those who did not (85% vs 61%, p < 0.001). They also more frequently reported attending a SHS in the last year (81% vs 57%, p < 0.001). Those reporting chemsex-associated drug use also more frequently reported a long-term limiting mental health condition (36% vs 24%, p < 0.001) and poorer personal wellbeing (e.g. reporting low life satisfaction 36% vs 20%, p < 0.001).ConclusionWhile a minority of participants in this national, community-based sample reported chemsex-associated drug use, this group had higher sexual risk and poorer indicators of wellbeing. Many participants also attended SHSs, reinforcing the key supporting role of SHSs for referral pathways to harm reduction support for those experiencing problematic drug use.