Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Medical Science (MMSc)

First Advisor

John Encandela, PhD


Chemsex, defined as the use of drugs before or during sex to enhance and facilitate the experience, is increasingly prevalent in urban populations of men who have sex with men. Chemsex is associated with higher risks of sexually transmitted infections including HIV, and it has negative effects on mental health and productivity. However, chemsex is under- or un-addressed in most primary care practices, and chemsex users rarely present to specialists in addiction medicine. We hypothesize that an integrative, multimodal training program for urban primary care providers in chemsex identification and harm reduction will increase the proportion of male patients screened for chemsex. We propose a stepped-wedge cluster randomized trial to measure baseline prevalence of screening and determine the effect of training on the relative risk of screening. Screening and appropriate safety counseling can stem the progression of the epidemic and reduce the burden of consequences associated with chemsex.

Open Access

This Article is Open Access