{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:22:03Z","timestamp":1791901323420,"version":"4.3.4"},"reference-count":37,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T00:00:00Z","timestamp":1671840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K01 DA051346"],"award-info":[{"award-number":["K01 DA051346"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R21TW011665"],"award-info":[{"award-number":["R21TW011665"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["K01 DA051346"],"award-info":[{"award-number":["K01 DA051346"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["R21TW011665"],"award-info":[{"award-number":["R21TW011665"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Chemsex is the use of illicit drugs\u2014particularly methamphetamine, gamma hydroxybutyrate (GHB), and gamma-butyrolactone (GBL)\u2014to enhance sexual activity. Chemsex, which occurs primarily among communities of men who have sex with men (MSM), is associated with greater HIV risk behaviors, including multiple sex partners, group sex, condomless sex, and injection drug use. Despite evidence showing chemsex engagement among Malaysian MSM, there is a paucity of research on chemsex among MSM in Malaysia. Methods: This cross-sectional study was conducted through an online survey (August to September 2021) among 870 Malaysian MSM. Participants were recruited through targeted advertisements on social networks. We collected information regarding participants\u2019 recent (&lt;6 months) engagement in chemsex, demographic characteristics, psychosocial factors, pre-exposure prophylaxis (PrEP) knowledge and history, and recent sexual- and drug-related behavior. Multivariable logistic regression was used to identify factors associated with recent (&lt;6 months) chemsex engagement. Results: Just under 1 in 10 (9.0%) of participants reported having engaged in chemsex in the previous six months. More than two-thirds of participants (69.1%) had not disclosed their sexual orientation to anyone in their family and 35.2% reported moderate to severe depressive symptoms. Multivariable analysis found that recent injection drug use (adjusted odds ratio: aOR = 6.61; 95% confidence interval: CI, 2.30\u201319.03), having shared pre-exposure prophylaxis (PrEP) with someone else (aOR = 5.60; 95% CI, 1.76\u201317.77), higher perceived HIV risk (aOR = 3.15; 95% CI, 1.25\u20137.93), knowing someone using PrEP (aOR = 2.93; 95% CI, 1.62\u20135.31), recent engagement in transactional sex (aOR = 2.38; 95% CI, 1.06\u20135.39), having a recent STI diagnosis (aOR = 2.36; 95% CI, 1.25\u20134.44), recent engagement in anal sex (aOR = 2.21; 95% CI, 1.07\u20134.57), and recent sexual intercourse with an HIV-positive partner (aOR = 2.09; 95% CI, 1.07\u20134.08) were associated with recent engagement in chemsex. Conclusions: Malaysian MSM who practice chemsex are vulnerable to several HIV risk factors, such as transactional sex, HIV-positive sexual partners, and injection drug use. There is an urgent need for programs that integrate drug, sexual health, and mental health services, with a focus on harm reduction (e.g., condoms, access to and utilization of HIV testing and PrEP services, drug knowledge, and safer drug use) tailored for MSM who practice chemsex.<\/jats:p>","DOI":"10.3390\/ijerph20010294","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T04:35:43Z","timestamp":1672115743000},"page":"294","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Engagement in Chemsex among Men Who Have Sex with Men (MSM) in Malaysia: Prevalence and Associated Factors from an Online National Survey"],"prefix":"10.3390","volume":"20","author":[{"given":"Francesca","family":"Maviglia","sequence":"first","affiliation":[{"name":"Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, 135 College St., Suite 323, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7701-9162","authenticated-orcid":false,"given":"Jeffrey A.","family":"Wickersham","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, 135 College St., Suite 323, New Haven, CT 06510, USA"},{"name":"Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iskandar","family":"Azwa","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, Malaysia"},{"name":"Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Copenhaver","sequence":"additional","affiliation":[{"name":"Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"Kern","sequence":"additional","affiliation":[{"name":"Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Khati","sequence":"additional","affiliation":[{"name":"Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sin How","family":"Lim","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, Malaysia"},{"name":"Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7121-7421","authenticated-orcid":false,"given":"Kamal","family":"Gautam","sequence":"additional","affiliation":[{"name":"Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4340-3101","authenticated-orcid":false,"given":"Roman","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, 135 College St., Suite 323, New Haven, CT 06510, USA"},{"name":"Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur 59100, Malaysia"},{"name":"Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/j.jsxm.2019.02.018","article-title":"Substance-Linked Sex in Heterosexual, Homosexual, and Bisexual Men and Women: An Online, Cross-Sectional \u201cGlobal Drug Survey\u201d Report","volume":"16","author":"Lawn","year":"2019","journal-title":"J. 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