AccScience Publishing / IJPS / Online First / DOI: 10.36922/ijps.2599

Health-related challenges faced by men who had sex with other men amid the COVID-19 pandemic in the context of sexualized drug use (chemsex): A literature review

Chawapon Sarnkhaowkhom1 Kobkul Madican2* Athichai Pankam2 Martin Pieter Willemse3
Show Less
1 Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
2 Boromarajonani College of Nursing Uttaradit, Faculty of Nursing, Praboromarajchanok Institute, Thailand
3 Faculty of Information and Communication Technology, Mahidol University, Nakhon Pathom, Thailand
Submitted: 31 December 2023 | Accepted: 15 May 2024 | Published: 3 July 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( )

The COVID-19 pandemic has had widespread effects, impacting various aspects of human life, including sexual behaviors and substance use activities. This article aims to review and synthesize findings from existing published and unpublished research regarding health-related issues related to sexualized drug use (chemsex) among men who had sex with men (MSM) during the COVID-19 pandemic. The information was gathered from various databases, and 21 articles were included in this review. The results focused on the following seven health-related aspects: (i) Trends in chemsex practices among MSM during the pandemic; (ii) sexual behaviors and drug usage issues among MSM during the pandemic; (iii) mental and psychological health issues among MSM participating in chemsex during the pandemic; (iv) challenges and obstacles regarding health-care service access for MSM during the pandemic; (v) health disparity issues among MSM during the pandemic; (vi) digital health technology offering health care to MSM during the pandemic; and (vii) health-care interventions related to MSM engaging in chemsex during the pandemic. During the pandemic, targeted interventions were required that not only focused on mitigating physical health risks but also on addressing the mental health and socioeconomic challenges faced by MSM participating in chemsex. Moreover, digital health technologies and telemedicine offered promising avenues to provide necessary services remotely during the COVID-19.

Sexualized drug use
Men who have sex with men
Literature review

Alizadeh, H., Sharifi, A., Damanbagh, S., Nazarnia, H., & Nazarnia, M. (2023). Impacts of the COVID-19 pandemic on the social sphere and lessons for crisis management: A literature review. Natural Hazards, 117:1-26.


Amundsen, E., Haugstvedt, Å., Skogen, V., & Berg, R.C. (2022). Health characteristics associated with chemsex among men who have sex with men: Results from a cross-sectional clinic survey in Norway. PLoS One, 17(10):e0275618.


Brennan, D.J., Card, K.G., Collict, D., Jollimore, J., & Lachowsky, N.J. (2020). How might social distancing impact gay, bisexual, queer, trans and two-spirit men in Canada? AIDS and Behavior, 24(9):2480-2482.


Card, K., McGuire, M., Bond-Gorr, J., Nguyen, T., Wells, G.A., Fulcher, K., et al. (2021). Perceived difficulty of getting help to reduce or abstain from substances among sexual and gender minority men who have sex with men (SGMSM) and use methamphetamine during the early period of the COVID-19 pandemic. Substance Abuse Treatment, Prevention, and Policy, 16(1):88.


Charest, M. (2021). Changes in Sexual Behaviours among Gay, Bisexual and Other Men who have Sex with Men Occurring During the Covid-19 Pandemic. [Doctoral Dissertation, University of Toronrto]. Available from: https://hdl.handle. net/1807/104925 [Last accessed on 2023 Jul 12].


Chone, J.S., Lima, S.V.M.A., Fronteira, I., Mendes, I.A.C., Shaaban, A.N., Martins, M.D.R.O., et al. (2021). Factors associated with chemsex in Portugal during the COVID-19 pandemic. Revista Latino-Americana de Enfermagem, 29:e3474.


Chow, E.P.F., Hocking, J.S., Ong, J.J., Phillips, T.R., Schmidt, T., Buchanan, A., et al. (2021). Brief Report: Changes in PrEP use, sexual practice, and use of face mask during sex among MSM during the second wave of COVID-19 in Melbourne, Australia. Journal of Acquired Immune Deficiency Syndromes, 86(2):153-156.


Clemente-Suárez, V.J., Dalamitros, A.A., Beltran-Velasco, A.I., Mielgo-Ayuso, J., & Tornero-Aguilera, J.F. (2020). Social and psychophysiological consequences of the COVID-19 pandemic: An extensive literature review. Frontiers in Psychology, 11:580225.


Dai, Z., Fu, J., Qu, Y., Wu, Y., Si, M., Chen, X., et al. (2023). Depressive symptoms, perceived social support, and anticipated HIV stigma among HIVVID-19 pandemic: An extensive literature review. ic. ruring the COVID-19 pandemic: A multicenter online cross-sectional study. Brain and Behavior, 13(4):e2946.


De la Court, F., Boyd, A., Coyer, L., Van den Elshout, M., De Vries, H.J., Matser, A., et al. (2023). The impact of COVID. The impact of COVIDation AMsterdam, H-TEAM) Consortiumemic: An extensiprophylaxis use, and sexually transmitted infection incidence among men who have sex with men in Amsterdam, the Netherlands. HIV Medicine, 24(2):212-223.


Donnadieu-Rigole, H., Peyrière, H., Benyamina, A., & Karila, L. (2020). Complications related to sexualized drug use: What can we learn from literature? Frontiers in Neuroscience, 14:548704.


Dunlop, A., Lokuge, B., Masters, D., Sequeira, M., Saul, P., Dunlop, G., et al. (2020). Challenges in maintaining treatment services for people who use drugs during the COVID-19 pandemic. Harm Reduction Journal, 2020;17(1):26.


Eleuteri, S., Alessi, F., Petruccelli, F., & Saladino, V. (2022). The global impact of the COVID-19 pandemic on individuals’ and couples’ sexuality. Frontiers in Psychology, 12:798260.


Giorgetti, R., Tagliabracci, A., Schifano, F., Zaami, S., Marinelli, E., & Busardò, F.P. (2017). When “chems” meet sex: A rising phenomenon called “ChemSex”. Current Neuropharmacology, 15(5):762-770.


Gómez-Castro, J., Cerecero-García, D., Vermandere, H., & Bautista- Arredondo, S. (2022). Changes in sexual behavior, PrEP use, and COVID-19 experience among men who have sex with men in Mexico. AIDS and Behavior, 26(10):3451-3458.


Hosseinzadeh, P., Zareipour, M., Baljani, E., & Moradali, M.R. (2022). Social consequences of the COVID-19 pandemic. A systematic review. Investigacion y Educacion en Enfermeria, 40(1):e10.


Hyndman, I., Nugent, D., Whitlock, G.G., McOwan, A., & Girometti, N. (2021). COVID-19 restrictions and changing sexual behaviours in HIV-negative MSM at high risk of HIV infection in London, UK. Sexually Transmitted Infections, 97(7):521-524.


Lyu, H., Zhen, S., Feng, Y., Huang, S., Li, J., Zhou, Y., et al. (2022). Changes in sexual behavior among men who have sex with men during the spread of COVID-19 in China: Results of an online survey. Research Square.


Manchia, M., Gathier, A.W., Yapici-Eser, H., Schmidt, M.V., De Quervain, D., Van Amelsvoort, T., et al. (2022). The impact of the prolonged COVID-19 pandemic on stress resilience and mental health: A critical review across waves. European Neuropsychopharmacology, 55:22–83.


Maviglia, F., Wickersham, J.A., Azwa, I., Copenhaver, N., Kennedy, O., Kern, M., et al. (2022). Engagement in chemsex among men who have sex with men (MSM) in Malaysia: Prevalence and associated factors from an online national survey. International Journal of Environmental Research and Public Health, 20(1):294.


Maxwell, S., Shahmanesh, M., & Gafos, M. (2019). Chemsex behaviours among men who have sex with men: A systematic review of the literature. International Journal on Drug Policy, 63:74-89.


Mugglin, C., Hamusonde, K., Salazar-Vizcaya, L., Kuseijko, K., Nicca, D., Haerry, D., et al. (2023). Sexual behaviour and STI incidence in sexually active MSM living with HIV in times of COVID-19. Open Forum Infectious Diseases, 10:ofad399.


Murphy, D., Ellard, J., Maher, L., Saxton, P., Holt, M., Haire, B., et al. (2022). How to have sex in a pandemic: The development of strategies to prevent COVID-19 transmission in sexual encounters among gay and bisexual men in Australia. Culture, Health and Sexuality, 25:271-286.


Nowaskie, D.Z., & Roesler, A.C. (2022). The impact of COVID-19 on the LGBTQ+ community: Comparisons between cisgender, heterosexual people, cisgender sexual minority people, and gender minority people. Psychiatry Research, 309:114391.


Petrova, M., Miller-Perusse, M., Hirshfield, S., Carrico, A., & Horvath, K. (2022). Effect of the COVID-19 pandemic on stimulant use and antiretroviral therapy adherence among men who have sex with men living with HIV: Qualitative focus group study. JMIR Formative Research, 6(5):e30897.


Power, J., Mikołajczak, G., Bourne, A., Brown, G., Leonard, W., Lyons, A., et al. (2018). Sex, drugs and social connectedness: Wellbeing among HIV-positive gay and bisexual men who use party-and-play drugs. Sexual Health, 15(2):135-143.


Reyniers, T., Rotsaert, A., Thunissen, E., Buffel, V., Masquillier, C., Van Landeghem, E., et al. (2021). Reduced sexual contacts with non-steady partners and less PrEP use among MSM in Belgium during the first weeks of the COVID-19 lockdown: Results of an online survey. Sexually Transmitted Infections, 97(6):414-419.


Roux, P., Donadille, C., Girard, G., Spire, B., Protière, C., & Velter, A. (2022). Impact of COVID-19 pandemic on men who have sex with men that practice chemsex in France: Results from the national ERAS web survey. American Journal of Men’s Health, 16(1):15579883211073225.


Saladino, V., Algeri, D., & Auriemma, V. (2020). The psychological and social impact of Covid-19: New perspectives of well- Being. Frontiers in Psychology, 11:577684.


Sanchez, T.H., Zlotorzynska, M., Rai, M., & Baral, S.D. (2020). Characterizing the impact of COVID-19 on men who have sex with men across the United States in April, 2020. AIDS and Behavior, 24(7):2024-2032.


Shilo, G., & Mor, Z. (2020). COVID-19 and the changes in the sexual behavior of men who have sex with men: Results of an online survey. Journal of Sexual Medicine, 17(10):1827-1834.


Sousa, A.F.L., Oliveira, L.B., Schneider, G., Queiroz, A.A.F.L., Carvalho, H.E.F., Araujo, T.M.E., et al. (2021). Casual sex among men who have sex with men (msm) during the period of sheltering in place to prevent the spread of COVID-19. International Journal of Environmental Research and Public Health, 18(6):3266.


Sousa, A.F.L., Queiroz, A.A.F.L.N., Lima, S.V.M.A., Almeida, P.D., Oliveira, L.B., Chone, J.S., et al. (2020). Chemsex practice among men who have sex with men (MSM) during social isolation from COVID-19: Multicentric online survey. Cadernos de Saude Publica, 36(12):e00202420.


Starks, T.J., Jones, S.S., Sauermilch, D., Benedict, M., Adebayo, T., Cain, D., et al. (2020). Evaluating the impact of COVID-19: A cohort comparison study of drug use and risky sexual behavior among sexual minority men in the U.S.A. Drug and Alcohol Dependence, 216:108260.


Torres, T.S., Hoagland, B., Bezerra, D.R.B., Garner, A., Jalil, E.M., Coelho, L.E., et al. (2021). Impact of COVID-19 pandemic on sexual minority populations in Brazil: An analysis of social/racial disparities in maintaining social distancing and a description of sexual behavior. AIDS and Behavior, 25(1):73-84.


Uhrmacher, M., Skaletz-Rorowski, A., Nambiar, S., Schmidt, A.J., Ahaus, P., Serova, K., et al. (2022). HIV pre-exposure prophylaxis during the SARS-CoV-2 pandemic: Results from a prospective observational study in Germany. Frontiers in Public Health, 10:930208.


Xavier Hall, C.D., Javanbakht, M., Iyer, C., Costales, C., Napolitano, J.C., Johnson, T., et al. (2022). Examining the impact of social distancing and methamphetamine use on sexual risk and intimate partner violence in sexual and gender minority young adults during the COVID-19 pandemic. Drug and Alcohol Dependence, 232:109231.

Conflict of interest
The authors declare they have no competing interests.
Back to top
International Journal of Population Studies, Electronic ISSN: 2424-8606 Print ISSN: 2424-8150, Published by AccScience Publishing