Chemsex-Related Risk: Profiling and Mapping Psychological Vulnerability Over Time

Two studies mapped psychological vulnerability to chemsex engagement and related risks over time among men who have sex with men. Study 1 (N = 503) used latent profile analysis to map psychological traits and identity process associated with chemsex engagement and mental and sexual health risks. Study 2 (N = 176) examined 12-month transitions in profile memberships and associations with the same outcomes. Study 1 identified four profiles, labelled as Impulsive, Insecure, Self-Centered, and Withdrawn, ranging from the low-risk Self-Centered, characterized by high wellbeing and recreational chemsex, to the high-risk Impulsive, marked by disinhibition and risky engagement. Profiles differed in mental health, substance abuse, and sexual risk, with the Impulsive reporting the most problematic outcomes. Profile membership was generally stable over time, except for the Insecure and the Withdrawn, who significantly transitioned to the Impulsive and the Self-Centered, respectively. The Withdrawn who transitioned to the Self-Centered showed improved sleep quality. These findings are novel and improve our understanding of who engages in chemsex, when vulnerability is greatest, and why certain individuals experience greater mental health difficulties and poorer sexual health outcomes. Trajectories for tailored harm reduction are discussed, including intervention that accounts for psychological vulnerability and identity process.