Lethal Lust: Suicidal Behavior and Chemsex—A Narrative Review of the Literature

Abstract

Chemsex is described as the use of certain drugs—commonly methamphetamine, gamma-butyrolactone (GBL)/gammahydroxybutyrate (GHB), and mephedrone—before or during planned sexual activity primarily among men who have sex with men (MSM). Evidence shows that MSM who engage in chemsex are at increased risk of physical harm, such as sexually transmittable infections (STIs), and are more likely to experience mental health symptoms. To further assess this, we reviewed the recent literature to evaluate whether the psychological impact of chemsex behavior includes suicidal ideation and suicidal attempts. Pubmed/MEDLINE was searched for articles reporting suicidal ideation and behavior among chemsex users with the terms “chemsex”, “sexualized drug use”, “suicide”, and “mental health”. Twelve articles (three case reports and nine cross-sectional studies) were included in the final narrative review. Overall, we retrieved mixed results regarding the relationship between chemsex practice and suicidality outcomes. Considering the inhomogeneous nature of the studies, the findings indicate that suicidality could be an issue of concern among MSM in general but among chemsex users in particular. Possible risk factors for suicidality among chemsex participants may include adversities experienced due to one’s sexual orientation and an increased risk for HIV and other STI infections and the resulting negative impact on mental well-being. These aspects warrant further investigations.

Estudio descriptivo de las personas en tratamiento por adicciones que practican chemsex en la ciudad de Madrid

“…A pesar de la probable infraestimación derivada del registro, nos hemos encontrado con un alto porcentaje de personas que habían sufrido algún tipo de violencia a lo largo de sus vidas (37,2%), lo cual sería acorde con la asociación encontrada en algunas publicaciones (Strasser et al, 2023) entre antecedentes traumáticos, como los abusos sexuales o los delitos de odio, con la práctica de chemsex. No resulta sorprendente que una de cada 5 personas de la muestra sufrie-El alto porcentaje observado en nuestra muestra de personas con diagnóstico positivo de VIH (60%) resulta llamativo, aunque coherente con otras publicaciones que apuntan a una alta prevalencia de infección por VIH en usuarios de chemsex (González-Baeza et al, 2023;MacGregor et al, 2021;Nevendorff et al, 2023;Vallecillo et al, 2022;Whitlock et al, 2021).…”

“…Perfil de consumo y tratamiento Estudio descriptivo de las personas en tratamiento por adicciones que practican chemsex en la ciudad de MadridGarcía-Pérez et al, 2022). Más de la mitad de las personas tenían algún diagnóstico de salud mental, principalmente trastornos del estado de ánimo y de ansiedad, lo que coincide con otros estudios encontrados(Díez López, 2022;Leyva-Moral et al, 2023;Maviglia et al, 2023;Strasser et al, 2023), y cuya asociación con la pertenencia al colectivo LGBTI+ y su discriminación, así como con la infección por VIH, ha sido bien establecida(Cesida, 2023; European Centre for DiseasePrevention and Control. et al, 2019;Íncera et al, 2022;Soler Terrones, 2023;Somos…”

ChemsexPH: The association between chemsex, HIV status and adherence to antiretroviral therapy among men who have sex with men in the Philippines

“…Chemsex engagement involves psychotropic drug use to enhance sexual experiences [ 4 , 5 ] and the subculture of “slamsex” involves intravenous drug injection—both often influenced by sensation‐seeking behaviours [ 6 , 7 ] and pose increased risks of bloodborne virus transmission [ 8 ]. Common substances used in chemsex include crystal methamphetamine (“shabu” in the Philippines) and gamma hydroxybutyrate [ 9 , 10 , 11 ].…”

Application of the Delphi Method for Content Validity Analysis of a Questionnaire to Determine the Risk Factors of the Chemsex

“…The assessment of mood disorders and addiction linked to the practice of chemsex is of interest given the psychoactive substances used [11]. The practice of chemsex has been linked to increased suicide, sexually transmitted infections (STIs) [12][13][14][15], psychosis [16], and mental problems [9], and decreased adherence to pre-exposure prophylaxis treatment (PrEP) among others [17].…”