BACKGROUND: The health and well-being of those
sexual-minority men who are often behaviourally defined
as men who have sex with men (MSM) is affected by a
system of interlinked factors that interact on the structural,
interpersonal, and individual levels. Recently, two of the
most common MSM health issues have been (a) the risks
of acquiring sexually transmitted infections (STIs), mostly
HIV, and (b) the sexualized use of addictive substances,
known as chemsex. AIMS: On the basis of the first
comprehensive Czech dataset to integrate several mutually
interlinked factors on the behavioural, as well as the
psychological and structural domains, we attempt to shed
light on the barriers to HIV testing and adherence to safer
sex practices, including the most thorough description
of the chemsex phenomenon that is available. We aim to
go beyond the behavioural perspective and draw links
to the well-being and satisfaction of this sexual minority
and their sex lives. METHODS: A series of descriptive
statistical analyses was conducted on a sample of 547
respondents obtained within a self-administered online
survey. RESULTS: More than half of our respondents
(55%) and three-quarters (72%) of the men younger
than 25 years have never been tested for HIV. One-third
of the respondents considered testing services to be
insufficiently friendly to gay, bisexual, or other men, and
they also reported stigmatization and discrimination by
healthcare workers as a problem that exists. 84% of the
MSM have experience with anal sex; 43% of them always
use condoms. Of all the respondents, nearly 6% have had
at least one chemsex experience during their life. Only
46% of the MSM reported being satisfied with their sex
lives; 52% of those who were dissatisfied attributed this
to “not having a steady partner” and 49% to “not having
any sex”. CONCLUSION: The sexual behaviour of MSM
and their experience with HIV testing, chemsex, perceived
stigma, and satisfaction with their sex lives are among the
phenomena that deserve to be more regularly covered
by relevant epidemiological examinations. Although our
current analysis was more exploratory than in-depth, it
may contribute to a better understanding of the syndemic
and multifactorial conditions that influence the sexual
behaviour of MSM, including the minority stress that
may be rooted in deficiencies in our understanding of
these populations.