Chemsex-Related Risk Among Men Who Have Sex with Men: Profiling and Mapping Psychological Vulnerability Over Time

The present research includes two studies mapping psychological vulnerability to chemsex and related risks over 12 months. Chemsex refers to the intentional use of psychoactive substances in sexual contexts among men who self-identify as men who have sex with men. Study 1 (N = 503) used latent profile analysis to map individual differences in personality traits, identity resilience, and homonegativity associated with chemsex and mental and sexual health risks. Study 2 examined 12-month profile transitions in the same participants using McNemar-Bowker's test and associations with mental and sexual health risks. Study 1 identified four profiles: Impulsive (high disinhibition and risky chemsex), Insecure (low identity continuity, high internalized homonegativity and internalizing distress), Self-Centered (high identity resilience, wellbeing, and predominantly recreational chemsex), and Withdrawn (emotional detachment, low externalized risk and reduced wellbeing). Profile membership was generally stationary, except for the Insecure and the Withdrawn, who significantly transitioned to the Impulsive and the Self-Centered, respectively. The Withdrawn who transitioned to the Self-Centered showed improved sleep quality. These findings are novel and improve our understanding of who engages in chemsex, when vulnerability is greatest, and why some chemsex users experience poorer mental and sexual health outcomes, suggesting the need for person-centered harm reduction strategies.