• SEXUAL HEALTH
• Homosexuality, Male
• DRUG MISUSE
• Sexual Behavior

Drückler et al suggest that chemsex engagement among men who have sex with men (MSM) is significantly associated with reporting non-consensual sex.1 Inspired by clinical stories gathered in a sexual healthcare service, we investigated a possible relationship between childhood sexual abuse (CSA), that is, having been a victim of forced genital contact by an adult before age 13, and current chemsex engagement. To our knowledge, only one recent study reports a ‘higher frequency’ of early sexual abuse—but without specification of type and age of sexual abuse—among adult chemsex-users MSM.2

These data were collected during youth festivals using a computerised, anonymous, self-administered survey of a non-selected population of 225 MSM (median age=23, aged 16–39) living mainly in the Paris area.

After adjustment for potential confounding factors, those who had experienced CSA were more likely than the other MSM to report not having a regular partner (adjusted OR=3.06 (95% CI 1.16 to 8.08, p<0.05)), less likely to protect themselves with a new partner of unknown risk (aOR=0.2 (0.06 to 0. 62), p<0.01), were more likely to be chronic users of both illicit psychoactive substances (aOR=4.91 (2.18 to 11.0), p<0.01) and psychotropic drugs (aOR=3.89 (1.78 to 8.50), p<0.01) and were more likely to be chemsex-users (aOR=5.62 (1.83 to 17.2), p<0.01).

This exploratory study suggests that CSA may be a strong vulnerability factor (nearly six times more likely) predisposing MSM to chemsex engagement. If confirmed by larger studies, these findings should encourage clinicians to systematically ask for a history of CSA in cases of chemsex engagement among MSM and, if deemed necessary, to integrate this major trauma into the overall clinical management of chemsex in a broad risk-harm reduction perspective.