Links between chemsex and reduced mental health among Norwegian MSM and other men: results from a cross-sectional clinic survey

Abstract

Background The use of specific drugs to facilitate, enhance or prolong sexual sessions is referred to as ‘chemsex’. The popularity of the behavior seems to be growing, but there is a paucity of information on the mental health aspects associated with chemsex and no data on chemsex from Nordic countries. We investigated the link between chemsex and mental health among men who have sex with men (MSM) and other men in Norway. Methods We recruited participants from a walk-in sexually transmitted infections (STI) clinic. Participants completed a piloted, anonymous self-administered survey. It consisted of questions about men’s sociodemographic characteristics, mental health, sexual behaviors, substance use, and chemsex. The outcome we investigated was reduced mental health, measured with the validated Hopkins Symptom Check List. We obtained descriptive statistics and performed univariate and multivariate logistic regression analyses. Results 1013 (96%) of the surveys were complete and could be analysed. The mean age of the sample was 33, 51% were MSM, and 21.7% had reduced mental health. More MSM than other men engaged in chemsex in the past year (17% vs 12%). The most frequently reported chemsex drugs were cocaine and gamma hydroxybutyrate/gamma butyrolactone (GHB/GBL). Men engaged in chemsex primarily to enhance sexual pleasure and excitement, and about half reported almost never or never using condoms for chemsex. In univariate analyses, significant predictors of reduced mental health was chemsex (Odds Ratio [OR] = 1.82), being unemployed (OR = 3.54), and having sex with only women (OR = 0.58). In multivariate analyses, two variables remained significantly associated with reduced mental health: chemsex (adjusted OR = 2.18, 95%CI = 1.25–3.78) and being unemployed (adjusted OR = 4.10, 95%CI = 2.13–7.87). Conclusions In our sample of men from an STI clinic in Norway, about 14% self-reported engaging in chemsex in the past year and about a fifth of the men had reduced mental health. Men who engaged in chemsex, which more MSM engaged in than other men, had two times greater odds of reduced mental health. These findings suggest that mental health assistance should be among the interventions offered to men engaging in chemsex.

Increasing emergency department admissions for chemsex-related intoxications in Barcelona, Spain, among people living with HIV: an observational study from 2018 to 2020

“…In this sense, the severity of acute drug intoxications observed in patients with mental health disorders in this study could be explained by other drug-drug interactions between chemsex drugs and psychiatric drugs used for the treatment of mental health disorders [ 40 ]. Nevertheless, the association of mental disorders with the severity of intoxications highlights the importance of checking and addressing routinely the use of drugs in PLHIV, particularly in whose with mental health disorders [ 41 ].…”

Health characteristics associated with chemsex among men who have sex with men: Results from a cross-sectional clinic survey in Norway

“…The present study includes a subset of a larger survey study of MSM and men who have sex with women [ 50 , 51 ]. The objective of the original study was to assess occurrence and characteristics of chemsex among male STI clinic attendees and variables associated with chemsex.…”

Effects of Appearance- and Performance-Enhancing Drugs on Personality Traits

“…In reference to the array of drugs used to boost sexual performance, the term "chemsex" has been specifically coined to define the conscious or unconscious intake of psychoactive and non-psychoactive drugs to favor and/or stimulate sexual encounters mostly among men who have sex with other men (MSM) (11).…”

“…• "Chemsex" drugs, namely substances consumed immediately before or during sexual intercourses to facilitate, prolong, and/or intensify sexual experience such as methamphetamine, cocaine, mephedrone, gamma hydroxybutyric acid, gammabutyrolactone, ketamine, and poppers together with sildenafil and congeners (9)(10)(11).…”