Chemsex Among Men Who Have Sex With Men: A Systematic Scoping Review of Research Methods

Figures & data

Figure 1. Modified Prisma flow chart of the selection process.   

k = number of studies, s = number of samples, n = number of MSM participants.

Figure 2. Timing of study publication. Numbers within each bar denote proportion of all studies within the same study category. All numbers to the right of each bar denote proportion of all included studies.

Table 1. Number of MSM participants.

	All s = 91	Qual s = 21	Freq s = 17	MSM Chemsex Assoc s = 35	Wider Assoc s = 13	Long s = 7
Absolute no (n)	76 872	942	9 429	47 641	18 262	3 601
Relative no. (%)		1%	12%	62%	24%	5%
Median no.	326	33	30	722	516	326

Note: s = number of samples, n = number of MSM participants. Qual = Qualitative. Freq = Frequency. MSM Chemsex Assoc = MSM Chemsex Association. Wider Assoc = Wider Association. Long = Longitudinal.

Table 2. Study locations of the included studies.

Countries	k	s	n	Countries	k	s	n	Countries	k	s	n
Australia^a	8	8	3 682	India^c	1	1	1	Switzerland^a	1	1	7 107
Belgium^a	1	1	1 529	Ireland^a	2	2	496	Taiwan^a	2	2	80
Brazil^b	1	1	1 048	Italy^a	2	2	3	Thailand^b	2	2	1 412
Canada^a	3	3	780	Malaysia^b	1	1	20	the Netherlands^a	8	7	15 173
China^b	1	1	826	Norway^a	1	1	516	The UK^a	25	17	13 308
France^a	3	3	292	Russia^b	1	1	30	The US^a	31	26	16 521
Germany^a	2	2	745	Singapore^a	1	1	30	Vietnam^c	2	2	665
Hong Kong^a	1	1	3 044	Spain^a	4	3	915	several	4	4	9 192

Note: a = High Income Economy according to the World Bank. b = Upper Middle-Income Economy. c = Lower Middle-Income Economy. d = Low-Income Economy. k = number of studies. s = number of samples. n = number of MSM participants.

Figure 3. Recruitment arenas of the included studies (by number of studies). All numbers within each bar denote proportions of studies within the same study category. All numbers to the right of each bar denote proportions of all studies.

Figure 4. Recruitment arenas of the included studies (by number of MSM study participants). Numbers to the right of the bar denote proportion of all MSM participating in studies that report both recruitment arena(s) and number of MSM study participants.

Figure 5. Eligibility criteria of the included studies (by number of studies). SDU* = use of other drugs with sex than GHB/GBL, stimulants (amphetamine, crystal meth, ecstasy/MDMA, cathinones, cocaine) and/or ketamine. Drug health** = relating to symptoms, diagnoses, follow-up, prognosis/complications of drug health condition in ICD-11. Proportions: all numbers within each bar denote proportion of studies within the same category. All numbers to the right of each bar denote proportion of all studies reporting eligibility criteria.

Figure 6. Eligibility criteria of the included studies (by number MSM study participants).

*Other SDU = use of other drugs with sex than GHB/GBL, stimulants (amphetamine, crystal meth, ecstasy/MDMA, cathinones, cocaine) and/or ketamine. Numbers to the right of the bar denote proportion of all MSM participants in studies that reported both eligibility criteria and number of MSM participants.

Figure 7. Drugs included in operationalizations of chemsex. Note: Numbers within each bar denote proportion of all studies within the same category. Numbers to the right of each bar denote proportion of all studies included in the review.

Figure 8. Quantitative assessments of chemsex against other variables. Numbers within each bar denote proportion of all quantitative studies within the same category. Numbers to the right of each bar denote proportion of all quantitative studies included in the review.

*Other SDU = use of other drugs with sex than GHB/GBL, stimulants (amphetamine, crystal meth, ecstasy/MDMA, cathinones, cocaine) and/or ketamine **Health = STI, HIV, sexological, drug, mental, and/or other health. Appendix 2 provides details on the classification of variables measuring health symptoms, diagnoses, follow-up or prognosis/complications in one of these categories.

Table 3. Proposed research agenda resulting from this systematic scoping review.

Support and prioritize chemsex research among MSM in Asia, Africa, and Latin America/the Carribean, as well as non-high-income European countries. Explore profiles of sexual and non-sexual drug use among MSM. Design studies to explore whether MSM may engage in chemsex to reverse dysfunction within sexological and/or mental health. Qualitative studies examining these and other underlying drivers of chemsex are particularly appropriate designs, as will be a future systematic review of these studies. Longitudinal studies that measure sexological, drug, and mental health over time, related to chemsex engagement. Measure changes in health over time specifically among MSM with positive HIV status. Increase participant engagement in clinical trial design.