title: When "Chems" Meet Sex: A Rising Phenomenon Called "ChemSex".
abstract: BACKGROUND
  The term "chemsex" was coined to indicate the voluntary intake of psychoactive and non psychoactive drugs in the context of recreational settings to facilitate and/or to enhance sexual intercourses mostly among men who have sex with other men (MSM).
  
  
  OBJECTIVE
  The authors aimed to review the mechanisms of action, the toxicity and the pattern of use and abuse of substances involved in "chemsex" practice together with the sociocultural background underlying it and the health-related consequences that they may have.
  
  
  RESULTS
  Gamma-hydroxybutyrate, gamma-butyrolactone,1,4-butanediol, mephedrone, methamphetamine, sildenafil, tadalafil, vardenafil and alkyl nitrites have been described in their role of "chemsex drugs" including pharmacological action and in their implication to impair capacities to chose sexual partners and consensual sex. Moreover, it has been demonstrated that sexual activity over protracted length of time under the influence of chemsex drugs can result in rectal trauma or penile abrasions and a significant increase of the risk of transmission of sexual transmitted diseases, especially in case of condomless intercourses, which are frequent in this context, representing therefore a serious health threat.
  
  
  CONCLUSIONS
  One of the major problems to establish health policy priority interventions for chemsex is the lack of available epidemiological data on the issue. Finally, social actions should be taken in order to break down the barriers that currently exist among chemsex drug users in accessing services, including the shame and stigma often associated with drug use. In conclusion, more specific resources to face high risks of infections and HIV transmission are required in bisexual and homosexual individuals having SUID: sex under the influence of drugs.
authors.affiliation: Section of Legal Medicine, Universita Politecnica delle Marche, Ancona. Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Giorgetti
authors.affiliation: Section of Legal Medicine, Universita Politecnica delle Marche, Ancona. Italy.
authors.forename: Adriano
authors.initials: A
authors.lastname: Tagliabracci
authors.affiliation: Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, College Lane Campus, University of Hertfordshire, Hatfield, Herts, AL10 9AB. United Kingdom.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Schifano
authors.affiliation: Unit of Forensic Toxicology (UoFT), Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome. Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Zaami
authors.affiliation: Unit of Forensic Toxicology (UoFT), Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome. Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Marinelli
authors.affiliation: Unit of Forensic Toxicology (UoFT), Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome. 0.
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Busardò
mesh_terms: D000818:Animals; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D011619:Psychotropic Drugs / Q000737:chemistry / Q000494:pharmacology*; D012725:Sexual Behavior / Q000187:drug effects*; D012747:Sexual Partners / Q000523:psychology*
chemical_list: D011619:Psychotropic Drugs
keywords: Chemsex; GHB; crystal meth; erectile dysfunction agents; mephedrone; poppers; viagra