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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV1293

Navigating risk, stigma, and pleasure: a scoping review of chemsex subcultures and healthcare interventions in Taiwan

NAVIGATING RISK, STIGMA, AND PLEASURE: A SCOPING REVIEW OF CHEMSEX SUBCULTURES AND HEALTHCARE INTERVENTIONS IN TAIWAN

Chemsex trajectories in Taiwan are heterogeneous, and because risk is produced across structural, digital, embodied, and care-related layers, approaches beyond abstinence-based models focused solely on the frequency of substance use are recommended.

The study aims to map psychosocial, structural, subcultural, clinical, and service-related evidence on chemsex among sexual minorities in Taiwan; chemsex was defined as psychoactive substance use before or during sexual activity, while broader studies of recreational substance use were included only as contextual evidence. Two databases were searched, yielding 16 full-text Taiwanese studies published between 2011 and 2025 (8 chemsex-specific, 6 on related sexual health topics, and 2 contextual). Narrative mapping based on PRISMA-ScR was conducted, without meta-analysis; the evidence base comprised 11 observational studies, 2 qualitative studies, 1 longitudinal study, 1 implementation study, and 1 instrument development study, and estimates were not pooled. Key findings included that 46.0% of participants met the SDS dependence threshold (N=517), 69.1% reported intending to reduce their chemsex-related substance use (N=152), 17.1% had used a mental health clinic (10.5% had used both services), and the HÉROS service reached 1,576 clients and received 3,600 visits in its first year. Among 256 gay, bisexual, and other men who have sex with men (GBMSM), trajectory classes were distributed as follows: never or rarely, 87.4%; persistently engaged, 8.8%; and decreased then resumed, 3.8%. Trajectory class was not clearly associated with depressive symptoms, but wide confidence intervals and Bayes factors indicated uncertainty rather than evidence of no association. Regarding polysubstance-related harms, post-session social harm was reported by 85.0% of those using methamphetamine together with GHB/GBL, 69.7% of those using methamphetamine without GHB/GBL, and 37.4% of those not using methamphetamine (N=510). In terms of pleasure, enjoyment was reported by 67.1%, relaxation by 66.9%, and intensified sexual experiences by 63.1% in the sample of N=517; risk was shown to be produced across four interacting layers: structure, digital infrastructure, embodied experience, and care. On the service side, the CARE tool consists of 14 items, with a KR-20 internal consistency coefficient of 0.830 and a cutoff score of 4 or higher. The evidence synthesis found that low income, loneliness, and injection use were associated with methamphetamine dependence, while chemsex or substance use was associated with shigellosis, HCV viremia, and incident sexually transmitted infections. In conclusion, non-stigmatizing, stage-appropriate, community-linked care that incorporates pleasure into clinical formulation is recommended; generalizability is noted to be limited by heterogeneous definitions, observational designs, and predominantly clinical or HIV-focused samples, and no controlled intervention studies were identified.

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