The Silent Advance: Chemsex Practices and Their Implications in Türkiye

Abstract Background Chemsex, a form of sexualised substance use, is using psychoactive substances to enhance sexual activity. It is most commonly practiced by gay, bisexual and other men who have sex with men, trans and non-binary people and is increasing in prevalence across multiple regions worldwide. Yet, it remains insufficiently studied due to the stigma and criminalisation of some forms of drug use and sexual behaviour in many societies. We aimed to explore the prevalence, substance use patterns, motivations, and associated risks of chemsex in Türkiye. Methods An online survey including 18 multiple-choice questions assessing substance use, behavioural patterns, and psychosocial aspects of chemsex was distributed through Hornet and civil society contacts. Turkish people who have lived chemsex experience participated in developing the survey language to ensure its accessibility. Descriptive statistics and the Pearson Chi-Square Test were used to analyse the data. Results Overall, 290 people across 44 cities in Türkiye responded. Chemsex was reported as a growing practice by 72%. The majority of respondents (71.3%) were from metropolitan areas, where 62.3% reported ongoing chemsex practices for ˃3 years. Methamphetamine (70.5%), 3,4-Methylenedioxymethamphetamine (MDMA) (43.8%), snorted cocaine (35.1%), and γ-Hydroxybutyric acid/γ-Butyrolactone (GHB/GBL) (29.5%) were the most common substances. The main motivations for engaging in chemsex included enhanced sexual pleasure (70.7%) and relaxation (61.7%). Reported harms were psychological distress (80.7%), 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 Chemsex is a growing phenomenon in Türkiye, accompanied by significant health, social, and psychological risks. The lack of harm reduction services and open discourse underscores the gaps in healthcare and community support that require urgent 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.