{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:38:57Z","timestamp":1784248737275,"version":"3.55.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T00:00:00Z","timestamp":1668470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016658","name":"Plan Nacional sobre Drogas","doi-asserted-by":"publisher","award":["2019I017"],"award-info":[{"award-number":["2019I017"]}],"id":[{"id":"10.13039\/100016658","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>This original study compares the prevalences of drug use for any purpose and for sexualized drug use (SDU) among MSM. It also describes relevant characteristics of first SDU, analyzes to what extent SDU has been the first experience (the gateway) with different drugs by age and explores the correlates of SDU. Study participants included 2,919 HIV-negative MSM attending four HIV\/STI diagnosis services in Madrid and Barcelona. They answered an online, self-administered questionnaire. Poisson regression models with robust variance were used. About 81.4% had ever used any drug, and 71.9% had done so in the last-12-months, while 56% had ever engaged in SDU, and 50% had done so in the last-12-months. Participants under 25 years old had the lowest prevalences of SDU, and the 25\u201339 age group the highest, except for Viagra, which was higher among those over age 40. The most frequently used drugs for first SDU were poppers (53.6%), cannabis (19.6%) and Viagra (12.2%). These drugs were also the most ever consumed for SDU. Among sexualized users, methamphetamine (78.3%) and Mephedrone (75.4%) were used always\/most of the times for sex in the last-12-months. Around 72.2% of Mephedrone sexualized users and 69.6% of Methamphetamine vs 23.1% of ecstasy users' first consumption of these drugs involved use for sex. These drugs were provided to them free where they have sex for 66.8, 79.1, and 31.9%, respectively. On that occasion, 8.1% of Mephedrone, 6.8% of Methamphetamine and 18.4% of ecstasy users had sex only with steady partner; with 50.2, 56.2, and 26.2% respectively using a condom with any partner. SDU in the first use was associated with similar variables for recreational and chemsex drugs. The highest prevalence ratios were for having ever been penetrated by &amp;gt;20 men and having ever injected drugs. It can be concluded that the prevalence of SDU was more than half of the prevalence for any purpose. Thus SDU was the gateway to use for many drugs in an important proportion of users, who frequently consumed drugs that were free and had condomless anal sex with occasional and multiple partners. These circumstances were much more common for chemsex than for recreational drugs.<\/jats:p>","DOI":"10.3389\/fpubh.2022.997730","type":"journal-article","created":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T05:20:20Z","timestamp":1668489620000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":21,"title":["Sexualized drug use among men who have sex with men in Madrid and Barcelona: The gateway to new drug use?"],"prefix":"10.3389","volume":"10","author":[{"given":"Juan-Miguel","family":"Guerras","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Hoyos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Donat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"de la Fuente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Palma D\u00edaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar","family":"Ayerdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge N.","family":"Garc\u00eda-P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Garc\u00eda de Olalla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda-Jos\u00e9","family":"Belza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.drugpo.2018.02.002","article-title":"Sexualised drug use in the United Kingdom (UK): a review of the literature","volume":"55","author":"Edmundson","year":"2018","journal-title":"Int J Drug Policy."},{"key":"B2","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.drugpo.2018.11.014","article-title":"Chemsex behaviors among men who have sex with men: a systematic review of the literature","volume":"63","author":"Maxwell","year":"2019","journal-title":"Int J Drug Policy."},{"key":"B3","doi-asserted-by":"publisher","first-page":"103187","DOI":"10.1016\/j.drugpo.2021.103187","article-title":"A narrative systematic review of sexualised drug use and sexual health outcomes among LGBT people","volume":"93","author":"Hibbert","year":"2021","journal-title":"Int J Drug Policy"},{"key":"B4","doi-asserted-by":"publisher","first-page":"108237","DOI":"10.1016\/j.drugalcdep.2020.108237","article-title":"Review of sexualized drug use associated with sexually transmitted and blood-borne infections in gay, bisexual and other men who have sex with men","volume":"216","author":"Guerra","year":"2020","journal-title":"Drug Alcohol Depend."},{"key":"B5","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":"B6","doi-asserted-by":"publisher","first-page":"h5790","DOI":"10.1136\/bmj.h5790","article-title":"What is chemsex and why does it matter?","volume":"351","author":"McCall","year":"2015","journal-title":"BMJ."},{"key":"B7","unstructured":"Sustance Misuse Services for Men Who have Sex with Men Involved in Chemsex2015"},{"key":"B8","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1108\/DAT-10-2018-0058","article-title":"Chemsex: origins of the word, a history of the phenomenon and a respect to the culture","volume":"19","author":"Stuart","year":"2019","journal-title":"Drugs Alcohol Today."},{"key":"B9","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1186\/s12879-020-05024-4","article-title":"Uptake and willingness to use PrEP among Chinese gay, bisexual and other men who have sex with men with experience of sexualized drug use in the past year","volume":"20","author":"Wang","year":"2020","journal-title":"BMC Infect Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/s10508-020-01801-z","article-title":"Association of sexualized drug use patterns with HIV\/STI transmission risk in an internet sample of men who have sex with men from seven European countries","volume":"50","author":"Guerras","year":"2021","journal-title":"Arch Sex Behav."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e17894","DOI":"10.2196\/17894","article-title":"Influence of social media on sexualized drug use and chemsex among Chinese men who have sex with men: observational prospective cohort study","volume":"22","author":"Wang","year":"2020","journal-title":"J Med Internet Res."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1001\/jamapsychiatry.2021.2588","article-title":"Methamphetamine use, methamphetamine use disorder, and associated overdose deaths among US adults","volume":"78","author":"Han","year":"2021","journal-title":"JAMA Psychiatry."},{"key":"B13","doi-asserted-by":"publisher","first-page":"13299","DOI":"10.3390\/ijerph182413299","article-title":"Mental health symptoms associated with sexualized drug use (Chemsex) among men who have sex with men: a systematic review","volume":"18","author":"Incera-Fernandez","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B14","doi-asserted-by":"publisher","first-page":"542301","DOI":"10.3389\/fpsyt.2020.542301","article-title":"Chemsex and mental health of men who have sex with men in Germany","volume":"11","author":"Bohn","year":"2020","journal-title":"Front Psychiatry."},{"key":"B15","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":"B16","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.2174\/1389200218666171108163817","article-title":"Deaths in the lesbian, gay, bisexual and transgender United Kingdom communities associated with GHB and precursors","volume":"19","author":"Corkery","year":"2018","journal-title":"Curr Drug Metab."},{"key":"B17","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.drugpo.2019.03.021","article-title":"Changes in chemsex and sexual behavior over time, among a cohort of MSM in London and Brighton: findings from the AURAH2 study","volume":"68","author":"Sewell","year":"2019","journal-title":"Int J Drug Policy."},{"key":"B18","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1089\/apc.2017.0263","article-title":"Sexualized drug use (Chemsex) is associated with high-risk sexual behaviors and sexually transmitted infections in HIV-positive men who have sex with men: data from the U-SEX GESIDA 9416 study","volume":"32","author":"Gonzalez-Baeza","year":"2018","journal-title":"AIDS Patient Care STDS."},{"key":"B19","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1089\/apc.2020.0246","article-title":"Changing pattern of chemsex drug use among newly diagnosed HIV-positive Taiwanese from 2015 to 2020 in the era of treat-all policy","volume":"35","author":"Lee","year":"2021","journal-title":"AIDS Patient Care STDS."},{"key":"B20","doi-asserted-by":"publisher","first-page":"3183","DOI":"10.3390\/ijerph18063183","article-title":"Longitudinal event-level sexual risk and substance use among gay, bisexual, and other men who have sex with men","volume":"18","author":"Sang","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"055215","DOI":"10.1136\/sextrans-2021-055215.","article-title":"Chemsex and incidence of sexually transmitted infections among Canadian pre-exposure prophylaxis (PrEP) users in the l'Actuel PrEP cohort (2013\u20132020)","author":"Flores Anato","year":"2022","journal-title":"Sex Transm Infect."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1093\/aje\/kwh135","article-title":"Substance use and sexual risk: a participant\u2014and episode-level analysis among a cohort of men who have sex with men","volume":"159","author":"Colfax","year":"2004","journal-title":"Am J Epidemiol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.drugalcdep.2009.02.002","article-title":"Factors associated with event-level stimulant use during sex in a sample of older, low-income men who have sex with men in Los Angeles","volume":"102","author":"Ober","year":"2009","journal-title":"Drug Alcohol Depend."},{"key":"B24","doi-asserted-by":"publisher","first-page":"i18","DOI":"10.1093\/jurban\/jti020","article-title":"Longitudinal investigation of methamphetamine use among gay and bisexual men in New York City: findings from project BUMPS","volume":"82","author":"Halkitis","year":"2005","journal-title":"J Urban Health"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.1097\/01.aids.0000180794.27896.fb","article-title":"Amphetamine use is associated with increased HIV incidence among men who have sex with men in San Francisco","volume":"19","author":"Buchacz","year":"2005","journal-title":"AIDS."},{"key":"B26","doi-asserted-by":"publisher","first-page":"113","DOI":"10.2105\/AJPH.88.1.113","article-title":"Histories of substance use and risk behavior: precursors to HIV seroconversion in homosexual men","volume":"88","author":"Chesney","year":"1998","journal-title":"Am J Public Health."},{"key":"B27","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1097\/01.qai.0000230530.02212.86","article-title":"Unprotected anal intercourse and substance use among men who have sex with men with recent HIV infection","volume":"43","author":"Drumright","year":"2006","journal-title":"J Acquir Immune Defic Syndr."},{"key":"B28","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/0376-8716(88)90038-5","article-title":"A comparison of alcohol and drug use patterns of homosexual and heterosexual men: the San Francisco men's health study","volume":"22","author":"Stall","year":"1988","journal-title":"Drug Alcohol Depend."},{"key":"B29","doi-asserted-by":"publisher","first-page":"e41","DOI":"10.2196\/jmir.6.4.e41","article-title":"Crystal methamphetamine use predicts incident STD infection among men who have sex with men recruited online: a nested case-control study","volume":"6","author":"Hirshfield","year":"2004","journal-title":"J Med Internet Res."},{"key":"B30","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1097\/QAI.0b013e3180417c99","article-title":"The relationship between methamphetamine and popper use and risk of HIV seroconversion in the multicenter AIDS cohort study","volume":"45","author":"Plankey","year":"2007","journal-title":"J Acquir Immune Defic Syndr."},{"key":"B31","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1056\/NEJMra2033007","article-title":"Substance use among men who have sex with men","volume":"385","author":"Compton","year":"2021","journal-title":"N Engl J Med."},{"key":"B32","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1300\/J082v41n02_02","article-title":"A double epidemic: crystal methamphetamine drug use in relation to HIV transmission among gay men","volume":"41","author":"Halkitis","year":"2001","journal-title":"J Homosex."},{"key":"B33","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1080\/13691050600783320","article-title":"Crystal methamphetamine and sexual sociality in an urban gay subculture: an elective affinity","volume":"8","author":"Green","year":"2006","journal-title":"Cult Health Sex."},{"key":"B34","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.drugpo.2018.01.002","article-title":"Prevalence of drug use during sex amongst MSM in Europe: results from a multi-site bio-behavioral survey","volume":"55","author":"Rosinska","year":"2018","journal-title":"Int J Drug Policy."},{"key":"B35","unstructured":"EMIS-2017\u2014The European Men-Who-Have-Sex-With-Men Internet Survey2019"},{"key":"B36","doi-asserted-by":"publisher","first-page":"105","DOI":"10.20882\/adicciones.823","article-title":"Applied prevalence ratio estimation with different regression models: an example from a cross-national study on substance use research","volume":"29","author":"Espelt","year":"2016","journal-title":"Adicciones."},{"key":"B37","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1016\/j.drugalcdep.2011.12.018","article-title":"Common liability to addiction and gateway hypothesis: theoretical, empirical and evolutionary perspective","volume":"1","author":"Vanyukov","year":"2012","journal-title":"Drug Alcohol Depend."},{"key":"B38","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.drugpo.2017.10.008","article-title":"Chemsex, risk behaviors and sexually transmitted infections among men who have sex with men in Dublin, Ireland","volume":"52","author":"Glynn","year":"2018","journal-title":"Int J Drug Policy."},{"key":"B39","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1007\/s10461-007-9232-9","article-title":"Assessing representativeness of sampling methods for reaching men who have sex with men: a direct comparison of results obtained from convenience and probability samples","volume":"11","author":"Schwarcz","year":"2007","journal-title":"AIDS Behav."},{"key":"B40","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":"B41","doi-asserted-by":"publisher","first-page":"37","DOI":"10.20882\/adicciones.1371","article-title":"Substance use in sexual context among Spanish resident men who have sex with men","volume":"34","author":"Guerras","year":"2022","journal-title":"Adicciones."},{"key":"B42","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.drugpo.2018.01.007","article-title":"Typology of drug use in United Kingdom men who have sex with men and associations with socio-sexual characteristics","volume":"55","author":"Melendez-Torres","year":"2018","journal-title":"Int J Drug Policy."},{"key":"B43","doi-asserted-by":"publisher","first-page":"107526","DOI":"10.1016\/j.drugalcdep.2019.06.028","article-title":"Sex, drugs, and sexually transmitted infections: a latent class analysis among men who have sex with men in Amsterdam and surrounding urban regions, the Netherlands","volume":"206","author":"Achterbergh","year":"2020","journal-title":"Drug Alcohol Depend."},{"key":"B44","unstructured":"Documento T\u00e9cnico sobre Abordaje del Fen\u00f3meno del Chemsex2020"},{"key":"B45","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1071\/SH18023","article-title":"Sharing solutions for a reasoned and evidence-based response: chemsex\/party and play among gay and bisexual men","volume":"15","author":"Bourne","year":"2018","journal-title":"Sex Health."},{"key":"B46","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1071\/SH17145","article-title":"A community-led, harm-reduction approach to chemsex: case study from Australia's largest gay city","volume":"15","author":"Stardust","year":"2018","journal-title":"Sex Health."},{"key":"B47","unstructured":"Real Chemistry\u2014Connection, Wellbeing Chemsex Recovery2021"},{"key":"B48","doi-asserted-by":"publisher","first-page":"103163","DOI":"10.1016\/j.drugpo.2021.103163","article-title":"Priorities and practices of risk reduction among gay and bisexual men in Australia who use crystal methamphetamine for sex","volume":"93","author":"Drysdale","year":"2021","journal-title":"Int J Drug Policy."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.997730\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T05:20:28Z","timestamp":1668489628000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.997730\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,15]]},"references-count":48,"alternative-id":["10.3389\/fpubh.2022.997730"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.997730","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,15]]},"article-number":"997730"}}