Background Men who have sex with men (MSM) suffer substantial health inequalities compared to the rest of the population relating to sexual health, mental health and drug use. Increasing substance misuse in a sexualised context (chemsex) has been linked to risky sexual behaviour and STI acquisition.

Aims Determine the prevalence of chemsex in our local MSM population, and associated risks to sexual health.

Methods Men attending a GU clinic during December 2014, who identified as MSM, were invited to complete an anonymous questionnaire. 53 questionnaires were received.

Results Overall, 53% reported some form of recreational drug use. 38% reported having chemsex. Chemsex participants were more likely to use mephodrone and Viagra than ecstasy and cocaine used more frequently by other party drug users. 47% of MSM surveyed used the internet to meet partners. The number of partners (any kind of sexual contact) was similar for MSM using drugs and those not. Unprotected receptive anal sex, including with a partner of unknown HIV status, was higher for MSM reporting chemsex. Men reporting chemsex were less likely to have an up-to-date HIV test (40% untested in previous year). Overall 40% reported having an STI in the last year (most commonly Gonorrhoea). All those receiving an HIV diagnosis in the last year (n = 3) were amongst the chemsex group. 49% reported a mental health problem, with 60% of chemsex participants having a history of depression and/or anxiety.

Conclusion Tackling the sexual health inequalities of MSM is complex, with substance misuse, social media, and mental wellbeing having an increasing influence.