Platteau Tom, Herrijgers C, Barvaux V, Vanden Berghe W, Apers L, Vanbaelen T
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
HIV Med. 2025 Feb;26(2):295-301. doi: 10.1111/hiv.13717. Epub 2024 Oct 3.
The study aimed to estimate the prevalence of sexualized drug use, or chemsex, in a wide group of gay, bisexual and other men who have sex with men (gbMSM) in Belgium. It examined which drugs gbMSM used before and during sex, the frequency with which they used it, whether they experienced non-consensual sex, and evaluated the impact of chemsex on the health and professional and social lives of respondents.
We conducted an online survey among Belgian gbMSM. Five specific questions on chemsex were included in the survey. These questions assessed whether gbMSM engaged in chemsex. If they did, they were asked to provide information on which drugs they had used and how often. We asked whether their and their partners' boundaries had been respected and whether and how engaging in chemsex had affected a range of life domains.
Of 836 respondents, 258 (30.9%) self-reported having had sex under the influence of substances ("chemsex") in the previous 6 months. Of these, 227 (88%) were considered chemsex users according to the definition used for the analysis. Poppers (73%), gamma-hydroxybutyrate/gamma-butyrolactone (GHB/GBL; 69%) and cathinones (68%) were the most commonly reported substances. Almost half of respondents (45%) engaging in chemsex were high on drugs during at least half of their sexual encounters. Nearly 1 in 10 (9%) reported that boundaries had not been respected, suggesting non-consensual sexual activities. The 82 respondents experiencing negative impacts from their chemsex use reported that mental health (65%), physical health (40%) and sexual health (38%) were most impacted.
Our findings provide a snapshot of the current chemsex situation in Belgium. The frequency of chemsex is concerning because several health, professional and social aspects are impacted. Almost 1 in 10 respondents using chemsex reported that chemsex impacted consent around sex, requiring additional efforts to eradicate these non-consensual sexual experiences. Therefore, larger scale research focusing on respected boundaries and consent during chemsex and the frequency of drug use for sex seems required. Additionally, sensitisation, as well as care and support programmes are critical.
本研究旨在估计比利时广大男同性恋者、双性恋者及其他与男性发生性关系的男性（gbMSM）中性化吸毒（即化学性行为）的流行率。研究考察了gbMSM在性行为前及性行为过程中使用哪些毒品、使用频率、是否经历过非自愿性行为，并评估了化学性行为对受访者健康、职业及社会生活的影响。
我们对比利时的gbMSM开展了一项在线调查。调查中包含五个关于化学性行为的具体问题。这些问题评估gbMSM是否参与化学性行为。如果参与了，会要求他们提供所使用毒品及使用频率的信息。我们询问他们及其伴侣的界限是否得到尊重，以及参与化学性行为是否以及如何影响了一系列生活领域。
在836名受访者中，258人（30.9%）自我报告在过去6个月内曾在物质影响下发生性行为（“化学性行为”）。其中，根据分析所用定义，227人（88%）被视为化学性行为使用者。亚硝酸异戊酯（73%）、γ-羟基丁酸/γ-丁内酯（GHB/GBL；69%）和卡西酮（68%）是最常被报告使用的物质。参与化学性行为的受访者中，近一半（45%）在至少一半的性接触中处于吸毒后的兴奋状态。近十分之一（9%）的受访者报告界限未得到尊重，这表明存在非自愿性活动。82名因化学性行为使用而受到负面影响的受访者报告称，心理健康（65%）、身体健康（40%）和性健康（38%）受到的影响最大。
我们的研究结果呈现了比利时当前化学性行为的状况。化学性行为的频率令人担忧，因为它对健康、职业和社会等多个方面都有影响。近十分之一参与化学性行为的受访者报告称，化学性行为影响了性行为中的同意情况，因此需要做出更多努力来消除这些非自愿性经历。因此，似乎需要开展更大规模的研究，关注化学性行为过程中被尊重的界限和同意情况以及性行为中吸毒的频率。此外，提高认识以及关怀和支持项目至关重要。
