Substance use and sexual risk behaviour among HIV-infected men who have sex with men

This article discusses the problems of substance use and sexual risk behaviour among HIV-infected men who have sex with men (MSM). Chemsex is defined as using drugs immediately before or during sexual contact to enable, enhance and/or prolong sexual experience. This practice is of concern because it is associated with increased risk of having multiple sexual partners, whose serostatus is unknown. Furthermore, intercourse combined with use of drugs is usually condomless and with higher rates of depression, anxiety, suicide and drug addiction. The rates of marijuana and recreational drugs use and alcohol consumption among HIV-infected individuals are also high and negatively impact each step of the HIV care continuum. People living with stigmatized identities may use substances during sexual intercourse to decrease painful emotions, relieve psychological suffering, and maintain emotional stability and control. Improved understanding of these practices is needed in order to reduce health harms. This literature review helps to highlight that an interdisciplinary concept is obligatory to enable the attainment of a healthy approach to sexual life and there is a need for mental health support which should be among the interventions offered to MSM engaging in chemsex.