Analysis of the motivations associated with the practice of chemsex according to sexual orientation
Background and objective: Sexualized drug use, also known as chemsex, has been documented mostly among gay, bisexual, or men who have sex with men (gbMSM), with rare studies including heterosexual men. Furthermore, motivations associated with chemsex are under-documented, regardless of reported primary sexual orientation. The aims of this study were to describe the motivations associated with chemsex among men and explore possible differences by primary sexual orientation. Methods: Semi-structured interviews were conducted with 11 cis men ( 18years) reporting sexual drug used of at least one substance related to chemsex (methamphetamine, cocaine, ketamine, MDMA, or GHB). A thematic analysis was conducted using self-determination theory (Ryan et Deci, 2000) to conceptualize emerging themes related to intrinsic and extrinsic motivations associated with chemsex practice. Results: Extrinsic motivations reported referred to (1) the influence of internalized socio-sexual norms or (2) sexual partners in initiating or maintaining chemsex practice. Intrinsic motivations included the desire to (1) enhance sexual performance and physical sensations, (2) reduce inhibitions during sex-related interactions, (3) foster emotional connection to partners, (4) cope with painful emotions or events, or (5) fulfill a need related to substance dependence. Discussion: Our results highlight the multiple facets of chemsex in terms of individual, relational or cultural factors influencing its practice, as well as the relevance of the self-determination model to distinguish user profiles with respect to their motivations and primary sexual orientation.