BACKGROUND: The use of psychoactive drugs in a sexual context, also known as chemsex, has gained mediatic attention in recent months, especially in France where quantitative data is lacking. What types of drugs are involved and whether the phenomenon is truly increasing in popularity depends largely on the country studied. We sought to investigate predictors of a sexualized use of uncommon drugs by comparing three groups, in a sample of men who have sex with men (MSM) and trans people. METHODS: Data was collected through an online questionnaire completed by 10,853 French participants (Net Gay Barometer, 2018). Amongst 3,563 drug users (32.8%), 1,796 (50.4%) were users of common drugs (cannabis, poppers, or Viagra) exclusively [Group 1]. The remainder of drug users, thus having used at least one uncommon drug (cocaine, amphetamines, MDMA, methamphetamines, cathinones, GHB, opioids, etc.) in the past year, were separated in two groups: those that used drugs in a sexual context at least once (N=880) [Group 3] and those that did not (N=887) [Group 2]. Group 1 was the reference group in univariate and multivariate logistic regressions. RESULTS: Our multivariate regression model explained 50,9% (Cox and Snell's pseudo-R2) of the variance between groups. After controlling for a number of sociodemographic variables, such as gender which was unbalanced with more non-binary people (aOR=2.21) in Group 2 and more trans women (aOR=4.54) in Group 3, similarities were noted between the two groups: poly-drug use on one occasion (aOR=2.54'4.14), substantial concerns with their drug use (aOR=4.86'6.78), number of STIs (aOR=1.15'1.16), and hepatitis C infection (aOR=3.40'3.21). Some predictor variables were more specific to Group 3: injecting drugs (aOR=10.21), barebacking while using drugs (aOR=3.64), sex working on a regular basis (aOR=4.02), knowing more HIV risk-reduction strategies (aOR=1.10), and PrEP use (aOR=1.71). CONCLUSIONS: While there is a gradient of risk-taking behaviors between users of less common drugs, those who use them in a sexual context tend to be more aware and concerned by those same behaviors. This in turn can lead to safer-sex practices, which must be promoted amongst other drug users that also engage in risk-taking behaviors nonetheless. https://programme.aids2022.org/Abstract/Abstract/?abstractid=3746

BACKGROUND: The use of psychoactive drugs in a sexual context, also known as chemsex, has gained mediatic attention in recent months, especially in France where quantitative data is lacking. What types of drugs are involved and whether the phenomenon is truly increasing in popularity depends largely on the country studied. We sought to investigate predictors of a sexualized use of uncommon drugs by comparing three groups, in a sample of men who have sex with men (MSM) and trans people. METHODS: Data was collected through an online questionnaire completed by 10,853 French participants (Net Gay Barometer, 2018). Amongst 3,563 drug users (32.8%), 1,796 (50.4%) were users of common drugs (cannabis, poppers, or Viagra) exclusively [Group 1]. The remainder of drug users, thus having used at least one uncommon drug (cocaine, amphetamines, MDMA, methamphetamines, cathinones, GHB, opioids, etc.) in the past year, were separated in two groups: those that used drugs in a sexual context at least once (N=880) [Group 3] and those that did not (N=887) [Group 2]. Group 1 was the reference group in univariate and multivariate logistic regressions. RESULTS: Our multivariate regression model explained 50,9% (Cox and Snell's pseudo-R2) of the variance between groups. After controlling for a number of sociodemographic variables, such as gender which was unbalanced with more non-binary people (aOR=2.21) in Group 2 and more trans women (aOR=4.54) in Group 3, similarities were noted between the two groups: poly-drug use on one occasion (aOR=2.54'4.14), substantial concerns with their drug use (aOR=4.86'6.78), number of STIs (aOR=1.15'1.16), and hepatitis C infection (aOR=3.40'3.21). Some predictor variables were more specific to Group 3: injecting drugs (aOR=10.21), barebacking while using drugs (aOR=3.64), sex working on a regular basis (aOR=4.02), knowing more HIV risk-reduction strategies (aOR=1.10), and PrEP use (aOR=1.71). CONCLUSIONS: While there is a gradient of risk-taking behaviors between users of less common drugs, those who use them in a sexual context tend to be more aware and concerned by those same behaviors. This in turn can lead to safer-sex practices, which must be promoted amongst other drug users that also engage in risk-taking behaviors nonetheless. https://programme.aids2022.org/Abstract/Abstract/?abstractid=3746