Chemsex among women: specifities, risks, and expectations in general practice.

Abstract

Chemsex refers to the intentional use of psychoactive substances to initiate, intensify, or prolong sexual experiences. While mainly described among men who have sex with men (MSM), recent data suggests its emergence in other groups, including women. This study explores the characteristics of Chemsex among women and determines their needs and expectations in general practice. We conducted semi-structured interviews with seven women engaging in Chemsex and living in Brussels. We then analysed our findings by using Interpretative Phenomenology Analysis (IPA) and running our data through Atlas.ti software. Participants, who were socially integrated and of diverse sexual orientations, engaged in Chemsex as part of a broader pattern of recreational substance use. They consumed various substances and relied on self-directed risk management. Motivations included seeking disinhibition, emotional connection, intensified sexual experiences, or coping with pre-existing sexual difficulties. Reported effects included somatic issues (for example, cystitis and genital pain), psychological consequences, substance use disorders, and altered relationships with sexuality. Consent was a central concern, particularly during group sex encounters. Participants also expressed a need to identify with the practice and expected non-stigmatising, informed, and harm-reduction-oriented attitudes from primary care providers. Chemsex among women encompasses diverse practices involving specific physical, psychological, and sexual health-related risks. The participants in our study experienced a threefold invisibilisation; as women, as socially integrated users, and as Chemsex users. The study underscores the need to broaden representations of Chemsex to include women's experiences and to strengthen the role and training of GPs.