{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:14:51Z","timestamp":1787062491557,"version":"build-2736575974"},"reference-count":25,"publisher":"CSIRO Publishing","issue":"2","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":2594,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,4,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This paper establishes the prevalence of chemsex drug use among men who have sex with men (MSM), the extent to which these drugs are used in a sexual context, as well as their associated behaviours and circumstances of use. Methods: Data from a cross-sectional, online survey of 2328 MSM recruited via gay sociosexual media in Scotland, Wales, Northern Ireland and the Republic of Ireland were analysed. Results: While almost half (48.8%) of participants had ever taken illicit drugs, lifetime chemsex drug use was less common (18.0%) and far fewer reported chemsex drug use in the last year (8.2%) or last 4 weeks (3.0%). Just over one-quarter (27.1%) of men who used chemsex drugs in the last year reported no sexualised drug use, but almost three-quarters (72.9%) did. Only 6.1% of the whole sample reported sexualised chemsex drug use in the last year. The odds of reporting chemsex in the last year were significantly higher for men aged 36\u201345 years (AOR = 1.96), single men (AOR = 1.83), men who were HIV positive (AOR = 4.01), men who report high-risk sex (AOR = 4.46), being fisted (AOR = 7.77) or had sex in exchange for goods other than money (AOR = 4.7) in the last year and men who reported an HIV test in the last 3 months (AOR = 1.53). Discussion: Only a small proportion of MSM in Scotland, Wales, Northern Ireland and the Republic of Ireland reported chemsex, and, for the first time, it is demonstrated that not all chemsex drug use was sexualised. Nevertheless, MSM who engage in chemsex (MWEC) reported substantial sexual risk inequalities. These novel findings highlight several opportunities for intervention, particularly around the multiple vulnerabilities of MWEC, opportunities for early identification of those most vulnerable to chemsex-related harm and the potential to develop a specialised responsive patient pathway.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh17159","type":"journal-article","created":{"date-parts":[[2018,3,28]],"date-time":"2018-03-28T20:31:03Z","timestamp":1522269063000},"page":"144-150","source":"Crossref","is-referenced-by-count":94,"title":["Low levels of chemsex among men who have sex with men, but high levels of risk among men who engage in chemsex: analysis of a cross-sectional online survey across four countries"],"prefix":"10.1071","volume":"15","author":[{"given":"Jamie","family":"Frankis","sequence":"first","affiliation":[{"name":"ASchool of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, UK."},{"name":"DCorresponding author. Email: J.Frankis@gcu.ac.uk"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Flowers","sequence":"additional","affiliation":[{"name":"ASchool of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"McDaid","sequence":"additional","affiliation":[{"name":"BMRC\/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, G12 8QQ, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Bourne","sequence":"additional","affiliation":[{"name":"CAustralian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Vic. 3086, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2018,3,29]]},"reference":[{"issue":"1","key":"2025102419072155500_R1","first-page":"6","article-title":"Sexualised drug use by MSM: background, current status and response.","volume":"13","author":"Stuart","year":"2013","journal-title":"HIV Nursing"},{"key":"2025102419072155500_R2","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/S0140-6736(13)60032-X","article-title":"High-risk drug practices tighten grip on London gay scene.","volume":"381","author":"Kirby","year":"2013","journal-title":"Lancet"},{"key":"2025102419072155500_R3","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1016\/j.drugpo.2015.07.013","article-title":"\u201cChemsex\u201d and harm reduction need among gay men in South London.","volume":"26","author":"Bourne","year":"2015","journal-title":"Int J Drug Policy"},{"key":"2025102419072155500_R4","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.forsciint.2016.11.039","article-title":"An observed rise in gamma-hydroxybutyrate-associated deaths in London: evidence to suggest a possible link with concomitant rise in chemsex.","volume":"270","author":"Hockenhull","year":"2017","journal-title":"Forensic Sci Int"},{"key":"2025102419072155500_R5","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.drugpo.2017.01.001","article-title":"Poly drug use, chemsex drug use, and associations with sexual risk behaviour in HIV-negative men who have sex with men attending sexual health clinics.","volume":"43","author":"Sewell","year":"2017","journal-title":"Int J Drug Policy"},{"key":"2025102419072155500_R6","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1177\/0956462416666753","article-title":"Men who have sex with men diagnosed with a sexually transmitted infection are significantly more likely to engage in sexualised drug use.","volume":"28","author":"Ottaway","year":"2017","journal-title":"Int J STD AIDS"},{"key":"2025102419072155500_R7","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1136\/sextrans-2015-052052","article-title":"Illicit drug use in sexual settings (\u201cchemsex\u201d) and HIV\/STI transmission risk behaviour among gay men in South London: findings from a qualitative study.","volume":"91","author":"Bourne","year":"2015","journal-title":"Sex Transm Infect"},{"key":"2025102419072155500_R8","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1111\/j.1360-0443.2006.01571.x","article-title":"Use of crystal methamphetamine among gay men in London.","volume":"101","author":"Bolding","year":"2006","journal-title":"Addiction"},{"key":"2025102419072155500_R9","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1177\/0956462416642125","article-title":"Findings from within-subjects comparisons of drug use and sexual risk behaviour in men who have sex with men in England.","volume":"28","author":"Melendez-Torres","year":"2017","journal-title":"Int J STD AIDS"},{"key":"2025102419072155500_R10","doi-asserted-by":"publisher","first-page":"S49","DOI":"10.1097\/01.aids.0000255085.77470.bd","article-title":"Use of illicit drugs among gay men living with HIV in Sydney.","volume":"21","author":"Prestage","year":"2007","journal-title":"AIDS"},{"key":"2025102419072155500_R11","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1097\/QCO.0000000000000234","article-title":"Illicit drug use and its association with sexual risk behaviour among MSM: more questions than answers?","volume":"29","author":"Melendez-Torres","year":"2016","journal-title":"Curr Opin Infect Dis"},{"key":"2025102419072155500_R12"},{"key":"2025102419072155500_R13","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.drugpo.2016.09.007","article-title":"Illicit drug use among gay and bisexual men in 44 cities: findings from the European MSM Internet Survey (EMIS).","volume":"38","author":"Schmidt","year":"2016","journal-title":"Int J Drug Policy"},{"key":"2025102419072155500_R14","doi-asserted-by":"publisher","first-page":"e014105","DOI":"10.1136\/bmjopen-2016-014105","article-title":"Prevalence and clinical impact of recreational drug consumption in people living with HIV on treatment: a cross-sectional study.","volume":"7","author":"Garin","year":"2017","journal-title":"BMJ Open"},{"key":"2025102419072155500_R15","unstructured":"Strudwick P. Inside the dark dangerous world of chemsex [Internet]. Buzzfeed. 2016. Available online at: https:\/\/www.buzzfeed.com\/patrickstrudwick\/inside-the-dark-dangerous-world-of-chemsex?utm_term=.qsDKq7vVP#.ht77dvonW [verified 23 January 2018]."},{"key":"2025102419072155500_R16","unstructured":"Wilson C. What is chemsex and why is the UK government worried about it? [Internet] New Scientist. London: New Scientist; 2017. Available online at: https:\/\/www.newscientist.com\/article\/2140756-what-is-chemsex-and-why-is-the-uk-government-worried-about-it\/ [verified 23 January 2018]."},{"key":"2025102419072155500_R17"},{"key":"2025102419072155500_R18","doi-asserted-by":"publisher","first-page":"e22","DOI":"10.1016\/S2352-3018(14)70001-3","article-title":"Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study.","volume":"1","author":"Daskalopoulou","year":"2014","journal-title":"Lancet HIV"},{"key":"2025102419072155500_R19","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1177\/0956462416651229","article-title":"Chemsex and the city: sexualised substance use in gay bisexual and other men who have sex with men attending sexual health clinics.","volume":"28","author":"Hegazi","year":"2017","journal-title":"Int J STD AIDS"},{"key":"2025102419072155500_R20","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1111\/hiv.12373","article-title":"Frequency of HIV testing among gay and bisexual men in the UK: implications for HIV prevention.","volume":"17","author":"McDaid","year":"2016","journal-title":"HIV Med"},{"key":"2025102419072155500_R21","doi-asserted-by":"publisher","first-page":"e0151385","DOI":"10.1371\/journal.pone.0151385","article-title":"Who will use pre-exposure prophylaxis (PrEP) and why?: understanding PrEP awareness and acceptability amongst men who have sex with men in the UK \u2013 a mixed methods study.","volume":"11","author":"Frankis","year":"2016","journal-title":"PLoS One"},{"key":"2025102419072155500_R22","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1136\/sextrans-2016-052674","article-title":"Substance use among men who have sex with men: patterns, motivations, impacts and intervention development need.","volume":"93","author":"Bourne","year":"2017","journal-title":"Sex Transm Infect"},{"key":"2025102419072155500_R23","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1136\/sextrans-2015-052389","article-title":"Men who have sex with men in Great Britain: comparing methods and estimates from probability and convenience sample surveys.","volume":"92","author":"Prah","year":"2016","journal-title":"Sex Transm Infect"},{"key":"2025102419072155500_R24","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1136\/sextrans-2016-052695","article-title":"Motivations and values associated with combining sex and illicit drugs (\u2018chemsex\u2019) among gay men in South London: findings from a qualitative study.","volume":"93","author":"Weatherburn","year":"2017","journal-title":"Sex Transm Infect"},{"key":"2025102419072155500_R25","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1016\/S0140-6736(17)30003-X","article-title":"Syndemics and the biosocial conception of health.","volume":"389","author":"Singer","year":"2017","journal-title":"Lancet"}],"container-title":["Sexual Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/15\/2\/144\/147097\/sh17159.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/15\/2\/144\/147097\/sh17159.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T23:07:28Z","timestamp":1761347248000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/sh\/article\/15\/2\/144\/21317\/Low-levels-of-chemsex-among-men-who-have-sex-with"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,29]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,4,9]]}},"URL":"https:\/\/doi.org\/10.1071\/sh17159","relation":{},"ISSN":["1448-5028","1449-8987"],"issn-type":[{"value":"1448-5028","type":"print"},{"value":"1449-8987","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,29]]}}}