Competency-based approaches to sexualized substance use: Addressing curriculum gaps in nurse practitioner education

The rise of chemsex and party-and-play (PnP) among gay, bisexual, and other men who have sex with men (MSM) presents complex challenges for nurse practitioner (NP) delivered care. Research consistently demonstrates that PnP participation contributes to increased sexually transmitted infection (STI) and HIV risk, stimulant and polysubstance dependence, trauma-associated symptoms, and mental health concerns. Despite this evidence, PnP remains largely absent within NP education in the United States. Studies across behavioral health, sexual health, addiction science, and LGBTQ+ health report elevated depressive symptoms, anxiety, emotional vulnerability, and stimulant-driven sexual behaviors among PnP participants. These findings underscore the need for NP graduates to acquire competencies in sexualized drug use, trauma-informed care, harm reduction, social determinants of health (SDOH), and culturally responsive communication. This gap leads to fragmented care, missed diagnoses, and diminished opportunities for early intervention in substance use, sexual health, and mental health. Drawing on 21 studies, this article integrates evidence on PnP-related harm with documented NP curriculum deficiencies and proposes a competency-based educational model. Recommendations include LGBTQ+ health integration, trauma-informed strategies, harm reduction approaches, ethics education, SDOH content, and population-specific competencies aligned with national nursing standards. Preparing NP students to recognize, assess, and manage PnP-related health issues is essential to improving clinical outcomes and advancing health equity for LGBTQ+ communities.