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In Brazil, however, evidence on healthcare access among individuals who engage in SDU\/chemsex remains limited and fragmented. This scoping review aimed to map and analyze the available literature on healthcare access in this population, identifying barriers, facilitators, and gaps in care. Methods: The review followed the Arksey and O\u2019Malley framework and Joanna Briggs Institute recommendations, with searches conducted in six databases (MEDLINE\/PubMed, Embase, Scopus, SciELO, LILACS, and PsycINFO) for studies published between 2014 and 2025. Results: Eleven studies met the inclusion criteria, predominantly quantitative and concentrated in large urban centers. Findings indicate that healthcare access is shaped by persistent structural and symbolic barriers, including stigma, discrimination, fear of disclosure, and limited professional preparedness. Care remains largely centered on human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) services, with insufficient integration of primary care, mental health, and substance use services, contributing to fragmented care. Significant gaps were identified, including the underrepresentation of women, transgender, and non-binary populations, and the absence of studies focusing on healthcare professionals. Conclusions: Substance use patterns reflect both global trends and local specificities, particularly the prominence of alcohol and cocaine in Brazil. This review provides the first synthesis of Brazilian evidence on chemsex from a healthcare access perspective. The findings highlight critical inequities and support the need for integrated, stigma-free, and context-sensitive care within the Brazilian Unified Health System. Based on these findings, the VIP-SDU\/Chemsex Model is proposed as a multilevel framework to explain how structural, symbolic, and programmatic factors shape access and health outcomes.<\/jats:p>","DOI":"10.3390\/nursrep16070238","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T14:17:51Z","timestamp":1783606671000},"page":"238","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Healthcare Access in Chemsex Contexts in Brazil: A Scoping Review and the VIP-Chemsex Model"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6800-971X","authenticated-orcid":false,"given":"Isadora Silva de","family":"Carvalho","sequence":"first","affiliation":[{"name":"Department of General and Specialized Nursing, Ribeir\u00e3o Preto School of Nursing, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14040-902, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5374-2293","authenticated-orcid":false,"given":"Lariane Angel","family":"Cepas","sequence":"additional","affiliation":[{"name":"Department of General and Specialized Nursing, Ribeir\u00e3o Preto School of Nursing, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14040-902, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2710-2122","authenticated-orcid":false,"given":"\u00c1lvaro Francisco Lopes de","family":"Sousa","sequence":"additional","affiliation":[{"name":"Campus Tr\u00eas Lagoas, Federal University of Mato Grosso do Sul (UFMS), Tr\u00eas Lagoas 79070-900, Brazil"},{"name":"Public Health Research Centre, Comprehensive Health Research Center (CHRC), NOVA University Lisbon, 1099-085 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1916-6348","authenticated-orcid":false,"given":"Talita Morais","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Sport Sciences, Higher Institute of Lisbon and Tagus Valley, 2620-379 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1849-2095","authenticated-orcid":false,"given":"Talia Gomes","family":"Luz","sequence":"additional","affiliation":[{"name":"Department of General and Specialized Nursing, Ribeir\u00e3o Preto School of Nursing, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14040-902, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5534-3313","authenticated-orcid":false,"given":"Ruan Nilton Rodrigues","family":"Melo","sequence":"additional","affiliation":[{"name":"Department of General and Specialized Nursing, Ribeir\u00e3o Preto School of Nursing, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14040-902, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9161-2220","authenticated-orcid":false,"given":"Mayara Souza","family":"Gomes","sequence":"additional","affiliation":[{"name":"Department of General and Specialized Nursing, Ribeir\u00e3o Preto School of Nursing, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14040-902, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9767-3938","authenticated-orcid":false,"given":"Ca\u00edque Jordan Nunes","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Graduate Program of Nursing, Federal University of Sergipe, S\u00e3o Crist\u00f3v\u00e3o 49107-230, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8534-1960","authenticated-orcid":false,"given":"Anderson Reis de","family":"Sousa","sequence":"additional","affiliation":[{"name":"School of Nursing, Federal University of Bahia, Salvador 40170-110, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00eas","family":"Fronteira","sequence":"additional","affiliation":[{"name":"Public Health Research Centre, Comprehensive Health Research Center (CHRC), NOVA University Lisbon, 1099-085 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0372-259X","authenticated-orcid":false,"given":"F\u00e1tima","family":"Morales","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, School of Medicine, University of Seville, 41009 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5490-1355","authenticated-orcid":false,"given":"Ricardo","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Computer Engineering and Digital Systems, Polytechnic School, University of S\u00e3o Paulo, S\u00e3o Paulo 05508-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6916-4025","authenticated-orcid":false,"given":"Ana Paula Morais","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of General and Specialized Nursing, Ribeir\u00e3o Preto School of Nursing, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14040-902, Brazil"},{"name":"Public Health Research Centre, Comprehensive Health Research Center (CHRC), NOVA University Lisbon, 1099-085 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.drugpo.2018.11.014","article-title":"Chemsex behaviours among men who have sex with men","volume":"63","author":"Maxwell","year":"2019","journal-title":"Int. J. Drug Policy"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"de Carvalho, I.S., Cepas, L.A., de Sousa, \u00c1.F.L., Fernandes, T.M., Luz, T.G., da Silva, J.C.S., da Silva Marques, A., Ribeiro, C.J.N., Lima, S.V.M.A., and de Sousa, A.R. (2025). Healthcare Access Among Individuals Who Practice Chemsex in Brazil: A Scoping Review Protocol. Nurs. Rep., 15.","DOI":"10.3390\/nursrep15100353"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Coronado-Mu\u00f1oz, M., Garc\u00eda-Cabrera, E., Quintero-Fl\u00f3rez, A., Rom\u00e1n, E., and Vilches-Arenas, \u00c1. (2024). Sexualized drug use and chemsex among men who have sex with men in Europe: A systematic review and meta-analysis. J. Clin. Med., 13.","DOI":"10.3390\/jcm13061812"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.35919\/rbsh.v34.1136","article-title":"Chemsex entre HSH: Revis\u00e3o integrativa","volume":"34","author":"Souza","year":"2023","journal-title":"Rev. Bras. Sex. Hum."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1080\/13691058.2023.2192256","article-title":"Pampalibog: Chemsex, desire and pleasure in the Philippines","volume":"26","author":"Lasco","year":"2024","journal-title":"Cult. Health Sex."},{"key":"ref_6","doi-asserted-by":"crossref","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":"ref_7","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1177\/1757913918778872","article-title":"Sexualised drug taking among men who have sex with men: A systematic review","volume":"139","author":"Tomkins","year":"2019","journal-title":"Perspect. Public Health"},{"key":"ref_8","doi-asserted-by":"crossref","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":"ref_9","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1177\/13634607211026223","article-title":"Critical chemsex studies: Interrogating cultures of sexualized drug use beyond the risk paradigm","volume":"26","author":"Hakim","year":"2023","journal-title":"Sexualities"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1177\/1363460720986922","article-title":"chemsex cultures: Subcultural reproduction and queer survival","volume":"26","year":"2023","journal-title":"Sexualities"},{"key":"ref_11","doi-asserted-by":"crossref","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":"ref_12","doi-asserted-by":"crossref","first-page":"e00202420","DOI":"10.1590\/0102-311x00202420","article-title":"Pr\u00e1tica de chemsex entre homens que fazem sexo com homens (HSH) durante per\u00edodo de isolamento social por COVID-19: Pesquisa online multic\u00eantrica","volume":"36","author":"Sousa","year":"2020","journal-title":"Cad. Sa\u00fade P\u00fablica"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e84068","DOI":"10.2196\/84068","article-title":"Development of a Line of Care for the Health of People Who Engage in Chemsex: Protocol for a Multimethod Study","volume":"15","author":"Cepas","year":"2026","journal-title":"JMIR Res. Protoc."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Jalil, E.M., Torres, T.S., de A Pereira, C.C., Farias, A., Brito, J.D.U., Lacerda, M., da Silva, D.A.R., Wallys, N., Ribeiro, G., and Gomes, J. (2022). High Rates of Sexualized Drug Use or Chemsex among Brazilian Transgender Women and Young Sexual and Gender Minorities. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031704"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e3474","DOI":"10.1590\/1518-8345.4975.3474","article-title":"Fatores associados \u00e0 pr\u00e1tica de chemsex em Portugal durante a pandemia da COVID-19","volume":"29","author":"Chone","year":"2021","journal-title":"Rev. Lat.-Am. Enferm."},{"key":"ref_16","first-page":"e20230004","article-title":"Chemsex and its repercussions on the health of men who have sex with men (MSM): A global health perspective","volume":"76","author":"Sousa","year":"2023","journal-title":"Rev. Bras. Enferm."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Lisboa, C., Stuardo, V., and Folch, C. (2023). Sexualized drug use among gay men and other men who have sex with men in Latin America: A description of the phenomenon based on the results of LAMIS-2018. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0287683"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: Towards a methodological framework","volume":"8","author":"Arksey","year":"2005","journal-title":"Int. J. Soc. Res. Methodol."},{"key":"ref_19","unstructured":"Aromataris, E., and Munn, Z. (2020). Cap\u00edtulo 11: Revis\u00f5es do escopo (vers\u00e3o 2020). JBI Manual for Evidence Synthesis, Joanna Briggs Institute."},{"key":"ref_20","unstructured":"Joanna Briggs Institute (JBI) (2014). The Joanna Briggs Institute Reviewers\u2019 Manual 2014, The Joanna Briggs Institute."},{"key":"ref_21","unstructured":"Lacerda, M.R., and Costenaro, R.G.S. (2015). Systematic literature review: Development and contribution to evidence-based nursing practice. Research Methodology for Nursing and Health: From Theory to Practice, Mori\u00e1. [1st ed.]."},{"key":"ref_22","unstructured":"Peters, M., Godfrey, C., Mcinerney, P., Baldini Soares, C., Khalil, H., and Parker, D. (2017). Scoping reviews. Joanna Briggs Institute Reviewer\u2019s Manual, Joanna Briggs Institute. Available online: https:\/\/wiki.joannabriggs.org\/display\/MANUAL\/Chapter+11%3A+Scoping+reviews."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1590\/S0034-8910.2014048004992","article-title":"HIV risk practices by female sex workers according to workplace","volume":"48","author":"Damacena","year":"2014","journal-title":"Rev. Sa\u00fade P\u00fablica"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1590\/0104-1169.0077.2597","article-title":"Risk behaviors for sexually transmitted diseases among crack users","volume":"23","author":"Carneiro","year":"2015","journal-title":"Rev. Lat.-Am. Enferm."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"340","DOI":"10.7883\/yoken.JJID.2015.490","article-title":"HIV testing in non-injection drug users: Prevalence and associated factors","volume":"70","author":"Lucchese","year":"2017","journal-title":"Jpn. J. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"214","DOI":"10.17058\/barbaroi.v0i49.8943","article-title":"Viv\u00eancias sexuais de mulheres jovens usu\u00e1rias de crack","volume":"49","author":"Aguiar","year":"2017","journal-title":"Barbar\u00f3i"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Oliveira-Filho, A.B., Santos, F.J.A., Silva, F.Q., Raiol, N.C., Costa, C.C.S., Piauiense, J.N.F., Martins, L.C., Cardoso, Y.M.N., Di Miceli, J.F.F., and Resque, R.L. (2019). Hepatitis C virus infection status and associated factors among a multi-site sample of people who used illicit drugs in the Amazon region. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-4270-2"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1007\/s10900-021-01010-2","article-title":"Risky sexual behavior among street children","volume":"46","author":"Hartmann","year":"2021","journal-title":"J. Community Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"23259582241283196","DOI":"10.1177\/23259582241283196","article-title":"Sexual practices and HIV risk perception among men who have sex with men in Brazil","volume":"23","author":"Chaves","year":"2024","journal-title":"J. Int. Assoc. Provid. AIDS Care"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Pedrosa, N.L., Pinheiro, P.M., Filho, F.W.B.H., and de Araujo, W.N. (2024). Incidence and risk factors associated with acquired syphilis. PLoS ONE, 19.","DOI":"10.1101\/2024.04.25.24306355"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1111\/phn.13308","article-title":"Chemsex among men who have sex with men during the Mpox health crisis","volume":"41","author":"Santos","year":"2024","journal-title":"Public Health Nurs."},{"key":"ref_33","first-page":"100419","article-title":"Impact of HIV pre-exposure prophylaxis on quality of life","volume":"79","author":"Takada","year":"2024","journal-title":"Clinics"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Silva, M.M.S., Santos, L.C.D., Almeida, M.M.S., and Nichiata, L.Y.I. (2025). Sexual orientation and gender identity associated with sexual practices, psychoactive substance use and sexually transmitted infections among HIV PrEP users. Healthcare, 13.","DOI":"10.3390\/healthcare13151841"},{"key":"ref_35","first-page":"196","article-title":"Vulnerabilidade, cuidado e integralidade: Reconstru\u00e7\u00f5es conceituais e desafios atuais para as pol\u00edticas e pr\u00e1ticas de cuidado em HIV\/Aids","volume":"46","author":"Ayres","year":"2022","journal-title":"Sa\u00fade Debate"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/1475-9276-12-18","article-title":"Acesso \u00e0 assist\u00eancia \u00e0 sa\u00fade centrado no paciente: Conceitualizando o acesso na interface entre sistemas de sa\u00fade e popula\u00e7\u00f5es","volume":"12","author":"Levesque","year":"2013","journal-title":"Int. J. Equity Health"},{"key":"ref_37","first-page":"71","article-title":"G\u00eanero: Uma categoria \u00fatil de an\u00e1lise hist\u00f3rica","volume":"20","author":"Scott","year":"1995","journal-title":"Educ. Real."},{"key":"ref_38","unstructured":"Butler, J. (2018). Problemas de G\u00eanero: Feminismo e Subvers\u00e3o da Identidade, Civiliza\u00e7\u00e3o Brasileira. Available online: https:\/\/cursosextensao.usp.br\/pluginfile.php\/869762\/mod_resource\/content\/0\/Judith%20Butler-Problemas%20de-g\u00eanero.Feminismo%20e%20subvers\u00e3o-da%20identidade-Civiliza\u00e7\u00e3o%20Brasileira-%202018.pdf."},{"key":"ref_39","first-page":"111","article-title":"Viol\u00eancia contra as mulheres e aten\u00e7\u00e3o prim\u00e1ria \u00e0 sa\u00fade: Um olhar de g\u00eanero","volume":"4","author":"Fonseca","year":"2017","journal-title":"PROENF Aten\u00e7\u00e3o Prim\u00e1ria Sa\u00fade Fam\u00edlia"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e2743254","DOI":"10.1590\/1981-7746-ojs2743","article-title":"A invisibilidade das pessoas LGBT no acesso \u00e0 sa\u00fade","volume":"22","author":"Tesser","year":"2024","journal-title":"Trab. Educ. Sa\u00fade"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1920","DOI":"10.36489\/saudecoletiva.2019v9i51p1920-1925","article-title":"Os impactos do Chemsex na sa\u00fade p\u00fablica mundial: Um estudo sobre uma perigosa pr\u00e1tica sexual entre homens","volume":"9","author":"Silva","year":"2020","journal-title":"Sa\u00fade Coletiva"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1016\/j.jsxm.2022.03.616","article-title":"Chemsex: Um desafio contempor\u00e2neo para a sa\u00fade p\u00fablica","volume":"19","author":"Bolmont","year":"2022","journal-title":"J. Sex. Med."},{"key":"ref_43","first-page":"e200684","article-title":"Implementa\u00e7\u00e3o da Pol\u00edtica Nacional de Sa\u00fade Integral de L\u00e9sbicas, Gays, Bissexuais, Travestis e Transexuais (PNSILGBT) no Paran\u00e1: Desafios para forma\u00e7\u00e3o profissional e supera\u00e7\u00e3o do estigma","volume":"25","author":"Silva","year":"2021","journal-title":"Interface"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e240001","DOI":"10.1590\/1980-549720240001.supl.1","article-title":"Sexually transmitted infections and other health issues among transgender women and travestis in Brazil: Epidemiological profile, vulnerabilities, access to services and care","volume":"27","author":"Veras","year":"2024","journal-title":"Rev. Bras. Epidemiol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Jatob\u00e1, A., Castro-Nunes, P., and Carvalho, P.V.R. (2025). On the epistemology of resilience in public health: A novel perspective in a changing world. Front. Health Serv., 4.","DOI":"10.3389\/frhs.2024.1453006"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s00115-021-01116-x","article-title":"Sexo qu\u00edmico","volume":"93","author":"Gertzen","year":"2022","journal-title":"Der Nervenarzt"},{"key":"ref_47","first-page":"401","article-title":"Hist\u00f3ria e forma\u00e7\u00e3o do mercado das drogas","volume":"41","author":"Calvete","year":"2020","journal-title":"Rev. Econ."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e159","DOI":"10.26633\/RPSP.2018.159","article-title":"Como a aten\u00e7\u00e3o prim\u00e1ria \u00e0 sa\u00fade pode fortalecer a alimenta\u00e7\u00e3o adequada enquanto direito na Am\u00e9rica Latina","volume":"42","author":"Botelho","year":"2018","journal-title":"Rev. Panam. Salud P\u00fablica"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3861","DOI":"10.1590\/1413-812320222710.08212022","article-title":"(Des)caminhos na garantia da sa\u00fade da popula\u00e7\u00e3o negra e no enfrentamento ao racismo no Brasil","volume":"27","author":"Pereira","year":"2022","journal-title":"Ci\u00eancia Sa\u00fade Coletiva"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Jaspal, R. (2022). Chemsex, identidade e sa\u00fade sexual. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191912124"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"19190","DOI":"10.36489\/saudecoletiva.2026v17i104p19190-19203","article-title":"Entre o Sexo e as Subst\u00e2ncias: O Desafio do Chemsex na Aten\u00e7\u00e3o Prim\u00e1ria","volume":"17","author":"Cidri","year":"2026","journal-title":"Sa\u00fade Coletiva"},{"key":"ref_52","first-page":"928","article-title":"Pr\u00e1ticas de redu\u00e7\u00e3o de danos em usu\u00e1rios de \u00e1lcool e outras drogas","volume":"23","author":"Aragao","year":"2022","journal-title":"Psic. Sa\u00fade Doen\u00e7as"},{"key":"ref_53","first-page":"e41010615897","article-title":"Pr\u00e1ticas de cuidado em um CAPS-AD: Abstin\u00eancia e redu\u00e7\u00e3o de danos","volume":"10","author":"Tavares","year":"2021","journal-title":"Pesqui. Soc. Desenvolv."},{"key":"ref_54","first-page":"2313","article-title":"Explora\u00e7\u00e3o de elementos de sa\u00fade mental no comportamento de Chemsex: Interven\u00e7\u00f5es, fatores de influ\u00eancia e atitudes em rela\u00e7\u00e3o \u00e0 redu\u00e7\u00e3o de riscos e danos na Espanha","volume":"14","year":"2024","journal-title":"Enfermeira. Rep."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"9633","DOI":"10.36489\/nursing.2023v26i300p9633-9644","article-title":"A\u00e7\u00f5es de Enfermagem para Preven\u00e7\u00e3o do Hiv em Adolescentes: Uma Revis\u00e3o Integrativa","volume":"26","author":"Harmuch","year":"2023","journal-title":"Nurs. Edi\u00e7\u00e3o Bras."}],"container-title":["Nursing Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4403\/16\/7\/238\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T04:23:59Z","timestamp":1783743839000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4403\/16\/7\/238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,9]]},"references-count":55,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["nursrep16070238"],"URL":"https:\/\/doi.org\/10.3390\/nursrep16070238","relation":{},"ISSN":["2039-4403"],"issn-type":[{"value":"2039-4403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,9]]}}}