Community perceptions of chemsex practices in Türkiye: a cross-sectional online survey

BACKGROUND: Chemsex, a form of sexualised substance use, is using psychoactive substances to enhance sexual pleasure. It is most commonly practised by gay, bisexual and other men who have sex with men, transgender and non-binary people. Although chemsex has been increasingly discussed globally, it remains insufficiently studied in many societies due to the stigma and criminalisation of some forms of drug use and sexual behaviour. We aimed to describe community perceptions of chemsex in Türkiye, including perceived substance use patterns, associated benefits and harms and barriers to discussion and support. METHODS: An anonymous online cross-sectional survey including 18 multiple-choice questions was distributed via Hornet, a social networking/dating application, and through community-based networks. The survey was designed to capture community-level perceptions and was not restricted to respondents with confirmed personal chemsex experience. Only limited participant-level sociodemographic data were collected. Turkish people with lived experience of chemsex contributed to the adaptation of the survey language. Descriptive statistics were used to analyse the data. RESULTS: Overall, 290 respondents from 44 cities in Türkiye participated. Most respondents (72%) perceived chemsex as a practice that has been increasingly visible in their local/community context. The majority of respondents (71.3%) were from metropolitan areas; 62.3% perceived that chemsex practices had been present in their local context for more than 3 years. Participants most frequently reported methamphetamine (70.5%), 3,4-Methylenedioxymethamphetamine (MDMA) (43.8%), snorted cocaine (35.1%), and gamma-Hydroxybutyric acid/gamma-Butyrolactone (GHB/GBL) (29.5%) use in chemsex context. The most commonly reported perceived benefits associated with chemsex included enhanced sexual pleasure (70.7%) and relaxation (61.7%). Respondents most frequently associated chemsex with psychological distress (80.7%), physical health harms (69.3%), social and relational issues (60.0%) and legal or financial consequences (59.0%). Overall, 54.1% stated that chemsex could not be discussed openly. CONCLUSIONS: In this survey, participants perceived chemsex as an increasingly visible phenomenon in their local/community context and associated it with multiple potential health, social and psychological harms. Respondents also described barriers to open discussion and limited visibility of relevant support services. These findings provide preliminary, context-specific insight into community perceptions of chemsex in Türkiye and support the need for further research and timely action, such as targeted, culturally sensitive, sex- and pleasure-positive harm reduction strategies that address stigma, improve mental health support and expand access to HIV/STI prevention and treatment.