Motivations for Sexualised Drug Use among Sexual and Gender Minorities: A Scoping Review

Abstract Introduction Research on sexualised drug use (SDU) among sexual and gender minorities (SGM) has primarily focused on risks, associated harms, and predisposing factors, with less attention given to the underlying motivations. This scoping review maps and synthesises qualitative and mixed-methods evidence on SDU motivations among SGM, providing a comprehensive overview of the available literature. Methods Following PRISMA-ScR guidelines, we searched PubMed and the Biblioteca Virtual de Salud (BVS). The initial search, conducted in October 2023, was limited to studies published in English or Spanish within the past five years and yielded 9,261 publications, of which 24 met the inclusion criteria. To ensure currency, an updated search was carried out in September 2025, applying the same strategy and identifying 10 additional records. Results Thematic analysis identified six key motivations for engaging in SDU: enhancing sexual performance, facilitating experimentation, building social capital, fostering intimacy, coping and self-transformation, and as a tool for sex work. Conclusions This review highlight that SDU are multifaceted and context-dependent, reflecting both individual and socio-cultural dimensions. Unlike most earlier reviews focused on gay and bisexual men who have sex with men (GBMSM), this study also incorporates evidence from broader sexual and gender minority populations. Policy implications Findings underscore the need for public health frameworks that move beyond risk-centres approaches and recognise the social, cultural, and relational dimensions of SDU among SGM.