Health-Care Access and Unmet Needs Among Sexual and Gender Minorities Engaging in Chemsex: A Scoping Review

Objectives: Chemsex detrimentally affects psychological, social, and physical well-being, generating substantial health-care demands and revealing systemic service deficiencies. The aim of this scoping review is to explore three key areas in health care for gay, bisexual, and other men who have sex with men (MSM), transgender, and nonbinary populations: unmet clinical needs, patterns of service utilization, and barriers to accessing care. Methods: Comprehensive literature searches employed PubMed, PsycINFO, Embase, Web of Science, and Scopus. Retrieval scope encompassed reference lists of all eligible full-text records. Data extraction and narrative synthesis were structured along three analytical dimensions: health-care needs, service engagement patterns, and barriers to access. Results: 33 eligible articles were identified from 2,176 unique search results. Key unmet service needs encompass psychological support; sexual health and substance use interventions; human immunodeficiency virus (HIV) and sexually transmitted infection (STI), prevention particularly including pre-exposure prophylaxis provision (PrEP); emergency medical care, and urgent overdose management. Utilization rates of specialized medical services vary significantly across target populations, with a marked preference observed for chemsex support specialists. A primary barrier confronting individuals involved in chemsex is stigmatization and discrimination, especially in interpersonal contexts. This was followed by inadequate health awareness, manifested as insufficient knowledge of available support resources, suboptimal risk assessment, and deficient comprehension of chemsex practices. Conclusions: This scoping review enhances comprehension of health-care services targeting chemsex practices. Gaining insight into health-care access and unmet needs is essential to guide future drug policy and advocacy efforts.