(PS6-11) Chemsex and Compulsive Sexual Behavior Among Sexual Minority Men

Abstract Text: Chemsex, referring to the use of psychoactive substances to enhance or extend sexual encounters, is increasingly observed among sexual minority men and is associated with various health risk. This presentation examines the co-occurence of chemsex and compulsive sexual behavior disorder (CSBD) and whether this co-occurrence is associated with mental and sexual health outcomes.
A sample of 289 sexual minority men (223 gay, 66 bisexual), primarily recruited through the dating/hookup app Grindr, completed measures of chemsex participation, CSBD, substance use disorder symptoms, and health outcomes. CSBD was assessed using the Compulsive Sexual Behavior Disorder Scale-7 (CSBD-7), which includes a validated cut-off for identifying individuals at high risk for CSBD.
Chemsex participation (15.2%) and falling above the CSBD-7 cut-off (34.3%) were both prevalent, with 9.3% of participants endorsing both. Compared to alcohol and marijuana use during sex, chemsex was more strongly linked to sexual and mental health outcomes. Additionally, individuals engaging in chemsex and/or scoring above the CSBD-7 cut-off reported higher depression and anxiety levels. However, only those experiencing both chemsex and CSBD showed greater sexual health risks, such as condomless anal sex and HIV infection. Due to low frequency, analyses did not include participants who reported chemsex alone.
Findings indicate that chemsex and CSBD frequently co-occur and are associated with adverse health outcomes, including depression and increased sexual risk behaviors. Notably, sexual health concerns (e.g., condomless anal sex, HIV infection, and the use of poppers and erectile dysfunction medications) emerged only when participants endorsing chemsex were included in analyses, suggesting that CSBD’s link to sexual risk may arise from a subset of individuals struggling with chemsex. Additionally, chemsex, popper use, and erectile dysfunction medication use during sex showed stronger connections to CSBD than marijuana or alcohol use during sex. Future research should employ larger samples, longitudinal designs, and more refined measures of chemsex.