ABSTRACT

This chapter will explore the sexualised use of psychoactive substances within the men who have sex with men (MSM) population, referred to as ‘chemsex’. The social and psychological underpinnings of chemsex among MSM and the relationship between this practice and HIV risk are explored. Recent data on the prevalence of chemsex are provided and then case studies of MSM who engage in chemsex are presented to illustrate the risk factors, the lived experience and potential mental and sexual health outcomes associated with the practice. Identity process theory from social psychology is suggested as an approach to understand the relationship between psychological adversity and engagement in chemsex behaviour. Empirical research exploring issues associated with chemsex is considered through the lens of identity process theory, case study discussions and reflective exercises. A model for supporting MSM who engage in, or who are at risk of engaging in, chemsex is outlined and thoughts given to how healthcare practitioners can offer interdisciplinary support in partnership with community services.