A study by the London School of Hygiene and Tropical Medicine shows many gay and bisexual men use drugs during sex in order to mask self-esteem or self-confidence issues.

It is the first qualitative research in the UK into “chemsex”, or sex under the influence of drugs such as crystal meth, GHB/GBL and mephedrone.

Lead author Dr Adam Bourne said: “A vulnerable section of society is using new drugs in new ways that is putting them at serious risk.

“Although our study shows that chemsex is uncommon overall, there is a need for specialist support for men who have sex under the influence of these drugs.

“Gay and bisexual men need better information and advice as well as access to gay-friendly drug and sexual health services that are able to address the psychosocial aspects of chemsex.”

Researchers analysed survey data from 1,142 gay and bisexual men living in Lambeth, Southwark and Lewisham and conducted in-depth interviews with 30 gay men from the area.

They found that although chemsex was reported to increase sexual arousal and facilitate more adventurous sex, many men were using drugs to mask self-esteem or self-confidence issues. The majority of men were not happy with their sex lives and wanted a long-term partner for more intimate and emotionally connected sex.

Experts from Public Health England have previously raised concerns that chemsex could be behind rising rates of HIV and sexually transmitted infections in gay men, which have been increasing nationally for several years. The report makes a number of recommendations for local authorities, the NHS, the voluntary sector, gay businesses and the wider community.

Around a third of men interviewed found it difficult to maintain control of their behaviour or negotiate safe sex while under the influence of drugs and had unprotected sex with high risk of HIV/STI transmission, which they regretted. Overdosing, panic attacks, convulsions and sexual assault were all associated with chemsex. Many men also felt that the large amount of time they spent engaging in chemsex was detrimental to their social relationships and career progression.

The authors note that the visibility of drug use on social and sexual networking apps may be normalising the injection of drugs such as crystal methamphetamine in a sexual setting, also known as “slamming”. Chemsex was most commonly reported to occur in private homes, as well as in saunas or other sex-on-premises venues.

The Chemsex Study’s key recommendations include the production of resources that provide drug harm reduction information, access to gay-friendly drug and sexual health services that understand the issues around chemsex, co-ordinated work with managers of commercial sex-on-premises venues to develop harm reduction policies and procedures and engagement with commercial companies and gay media / apps to provide harm reduction as part of a corporate responsibility to their users.