Chemsex and childhood trauma: evidence from a explorative matched case-control analysis

Abstract Background/aims Chemsex refers to the intentional use of illicit psychoactive substances to facilitate or enhance sexual experiences, particularly among men who have sex with men (MSM), and is associated with substantial physical and mental health risks. The relationship between chemsex use and childhood trauma remains insufficiently explored. This study examined differences between chemsex users and an control group in substance use patterns, childhood trauma, and assessed associations between trauma severity and substance use. Methods In a matched case-control design, 31 chemsex users and matched controls were assessed. Substance use patterns were investigated using a structured interview based on the checklist of the Amphetamine-Type Stimulants (ATS) Basic Drug Interview, childhood trauma was measured using the Childhood Trauma Questionnaire (CTQ). Group differences were analyzed using Fisher’s exact test and Mann–Whitney U tests with mean ranks. Associations were tested using Spearman’s rank correlation. Results Chemsex users showed significantly higher rates of substance use across multiple drug classes compared to controls (all p < .016), with odds ratios ranging from 3.9 (amphetamines) to 435.0 (methamphetamine). Childhood trauma differed significantly only for emotional abuse (U = 229.50, p = .020), while no differences were found for other CTQ subscales. No significant correlations emerged between trauma severity and the extend of substance use. Conclusion Emotional abuse may contribute to the development of chemsex-related substance use patterns. Future research should further clarify the etiological specificity of childhood trauma dimensions in chemsex contexts. Beyond minority stress frameworks, additional explanatory models may enhance understanding of chemsex and inform prevention and treatment strategies.