Exploring the links between motivations to engage in sexualized drug use and psychosexual well-being: A cross-sectional study

Sexualized drug use (SDU) has been associated with various motivations (e.g. coping with emotional distress, enhancing sexual functioning) and factors related to sexo-relational well-being (e.g., sexual satisfaction, performance anxiety). However, there is a lack of comprehensive models exploring associations between motivations for SDU and sexo-relational correlates. This study examined motivations related to SDU and their associations with sexo-relational correlates (e.g., sexual satisfaction, compulsivity). A community sample of 1,196 adults from Quebec completed an online survey on sexual health, including a questionnaire on SDU and related motivations and validated questionnaires on sexual satisfaction, sexual performance anxiety, body shame, discomfort with sexual communication, sexual compulsivity, and a history of childhood sexual abuse (CSA). Exploratory factor analyses (EFA) were performed on the SDU motivations questionnaire, followed by path analysis to test for sexo-relational correlates motivation domains. The EFA revealed four SDU motivations: increasing satisfaction and sensations (Factor 1), increasing sexual self-esteem (Factor 2), mitigating distress (Factor 3), and increasing sexual responsiveness and functioning (Factor 4). Higher performance anxiety and sexual compulsivity were associated with higher scores on all four motivation factors. Greater body shame was positively linked to Factors 2 and 3 and negatively to Factor 4. Sexual satisfaction, discomfort with sexual communication, and CSA were, respectively, uniquely associated with Factors 1, 3, and 4. The results provide insight into the heterogeneity of motivations for SDU and into the relationship between these motivations and sexo-relational well-being.