Chemsex in primary care: Qualitative study of general practitioners’ perceptions of the phenomenon and views on care pathways in Finistère (France)

Romain Verdeau

Keywords: Chemsex, general practitioner, primary care, PrEP, harm reduction, sexualized drug use

Background:

Chemsex refers to sexual activity under the influence of a psychoactive substance. Treatment in general practice is poorly described.

Research questions:

This study aimed to analyze the perceptions of General Practitioners (GPs) in Brittany regarding chemsex, its inherent problems and GPs’ views on the users’ care.

Method:

This qualitative study used semi-structured interviews with GPs in Brittany. The interview guide explored risky sexual behavior, the use of drugs during sex, chemsex, and GPs’ view of this behavior and its perception in their practice. A manual thematic analysis inspired by phenomenological interpretative analysis was conducted by two independent researchers.

Results:

Nine GPs (four women) were interviewed. Data sufficiency was considered achieved after the ninth interview. GPs often poorly understood chemsex. Pre-exposure prophylaxis prescribers had a more precise perception of chemsex. GPs considered that early awareness of sexuality at school and in primary care could help limit young people’s entry into chemsex. The changing relationship to sex, easy access to drugs and new communication modes were factors favoring this behavior.

Conclusions:

A similar study in larger cities would refine these results. A chemsex user interviewed lacked knowledge about the current healthcare offer and the role GPs could play in his care.

Points for discussion:

PrEP as a springboard for understanding chemsex / Relative consent in practice

Known barriers that are difficult to overcome despite a high-quality GP–patient relationship / GPs need to find their place in a complex healthcare system

Unblocking sexuality issues in general medical consultations

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