Unveiling the meaning behind sexualised drug use among men who have sex with men in Greece: expectations and lived experiences

Sexualised drug use (SDU) refers to the voluntary use of psychoactive substances before or during sexual activity to facilitate or enhance sexual experiences. Although qualitative research has explored how men who have sex with men experience and understand SDU, evidence from Greece and the wider Balkan region remains limited. This study explores the lived experiences and underlying motivations associated with SDU among MSM in Greece and, to our knowledge, represents the first qualitative study on this topic in the country. Fifteen semi-structured interviews were conducted with MSM residing in Greece who had engaged in SDU. Data were analysed using thematic analysis. Three key themes were identified: SDU as social practice, SDU as an escape, and the escalation of SDU. Participants’ narratives also revealed an interaction among social anticipation, emotional coping, and the pursuit of intense sexual experiences that contributed to repeated engagement in SDU over time. These findings suggest that SDU is not only a potential individual risk behaviour, but also a socially and experientially complex practice shaped by relational contexts, cognitive processes, and ways of coping with stress.