Introduction Chemsex in a European context is the use of any of the
following drugs to facilitate sex: crystal methamphetamine, mephedrone
and gamma-hydroxybutyrate (GHB)/gamma-butyrolactone (GBL) and, to a
lesser extent, cocaine and ketamine. This study describes the prevalence
of self-reported recreational drug use and chemsex in HIV-positive men
who have sex with men (MSM) accessing HIV services in four countries. It
also examines the problematic impacts and harms of chemsex and access to
chemsex-related services. Methods This is a cross-sectional multi-centre
questionnaire study of HIV-positive MSM accessing nine HIV services in
the UK, Spain, Greece and Italy. Results In all, 1589 HIV-positive MSM
attending HIV services in four countries completed the questionnaire.
The median age of participants was 38 years (interquartile range: 32-46
years) and 1525 (96.0%) were taking antiretroviral therapy (ART). In
the previous 12 months, 709 (44.6%) had used recreational drugs, 382
(24.0%) reported chemsex and 104 (6.5%) reported injection of
chemsex-associated drugs (’slamsex’). Of the 382 engaging in chemsex,
155 (40.6%) reported unwanted side effects as a result of chemsex and
81 (21.2%) as a result of withdrawal from chemsex. The reported
negative impacts from chemsex were on work (25.1%, 96), friends/family
(24.3%, 93) and relationships (28.3%, 108). Fifty-seven (14.9%)
accessed chemsex-related services in the past year, 38 of whom (67%)
felt the service met their needs. Discussion A quarter of participants
self-reported chemsex in the past 12 months. There were high rates of
harms from chemsex across all countries, including negative impacts on
work, friends/family and relationships. Although a minority of those
engaging in chemsex accessed support, most found this useful