Mr Steven Maxwell

Chemsex behaviours among men who have sex with men: A systematic review of the literature


Background: ‘Chemsex’ is the use of drugs before or during planned sexual events to facilitate, enhance, prolong and sustain the experience. Drugs associated with chemsex are methamphetamine, GHB/GBL, mephedrone, cocaine and ketamine. In this review we aim to synthesis published research on the antecedents, behaviours and consequences associated to chemsex related behaviour among men who have sex with men (MSM).

Methods: Papers published between January 2000 and December 2017 reporting the use of chemsex related drugs before or during sex were identified through Medline, Web of Science, CINAHL and Central. Results were synthesised using a narrative approach and conceptualised using a behavioural framework.

Results: The search identified 2492 publications, of which 27 were included in the final synthesis.  There are wide varying prevalence estimates for individual drugs.  Chemsex users have expectations that the drugs will positively affect sex and HIV+ MSM are more likely to engage in the behaviour than negative MSM. There are wide ranging prevalence estimates on injecting drugs for sexual purposes and sharing of injecting equipment. Participants are more likely to engage in condomless anal intercourse than men who do not engage in chemsex.

Conclusion: A minority of MSM engage in chemsex behaviours but they are at risk of this negatively impacting on their health.  The lack of reliable measures of chemsex limit comparison across studies. Further research is required to examine high risk chemsex behaviours.  To improve service provision, it would be beneficial for sexual health service providers to universally adopt standardised screening and care pathways for chemsex.


Dr MaryamShahmanesh, Senior Clinical Lecturer, University College London Dr Mitzy Gafos, Associate Professor, London School of Hygiene and Tropical Medicine

Conflicts of interest:

No conflict of interests