An online study to understand chemsex in India.

Background: While chemsex has been studied in several parts of the world, it has been an under-studied area in India. Anecdotally, use of substances in the context of sexual encounters has been increasing in India, especially in the population of men having sex with men.

Aim: In the background of limited literature in India, this online survey aimed to assess facets related to chemsex in the country.

Methods: This online survey initiated from Delhi recruited participants through social media using snowball sampling. Adult Indian citizens, who had at least one sexual experience were asked about chemsex, which was operationally defined as use of substances to experiences initiate, facilitate, improve, and prolong sexual experiences (except alcohol, tobacco, or cannabis). Relevant demographic and sexual history were also collected.

Results: Among 136 recruited participants (75.7% males, 44.1% self-identified as homosexual), chemsex was present in 46 participants (33.8% of the sample). "Meth," "Yaba" or "Ice" was the commonest substances reported to be used, followed by MDMA, poppers and cocaine. Twenty-one individuals (i.e., 45.7% of the participants having chemsex) were also involved in slamsex. About two thirds of those who had chemsex had reported that their partners also used drugs or substances. The commonest motivation was to improve sexual pleasure. Adverse experiences were also reported, with gaps in memory and feelings of fear or anxiety being the commonest. Chemsex was more common in individuals who had greater number of partners, had indulged in group sex, had tested HIV positive, had sexually transmitted infections, or have had taken Pre-Exposure Prophylaxis (PrEP).

Conclusion: The survey findings highlight the pattern of chemsex in the Indian population. With the constraints of sampling, the study suggests that risk mitigation strategies may be contemplated for individuals who indulge in use of drugs (especially injection drug use) to facilitate sexual intercourse.