{
  "abstract": "Background Since 2017 we offer community-based services to address problematic chemsex, including group and individual therapy sessions. Since 2023, MDPV use and related requests for support sharply increased. This required scaling up service delivery, setting up a network with local facility-based addiction services, providing training and supervision to addiction services with knowledge gaps about chemsex. We assessed needs related to problematic chemsex to guide future activities and advocacy.Methods Sociodemographic characteristics of clients, characteristics of their requests and themes emerging from their first interview were collected between February 2025 and February 2026. First interviews were semi-structured and included discussion of: behavioural and socio-psychological aspects of drug use, motivations for requesting help, history of drug use, history of pharmacological or psychological treatment, HIV status, condom use. We used descriptive statistics and thematic analysis.Results We received 63 requests for support, with characteristics described in table 1. Clients were mostly male (96%), gay (87%), university graduates or higher (65%), aged 31-40 (44%), employees (59%), born in Northern Italy (43%), living in Milano (50%). Clients predominantly reached out to us because they felt they had lost control on drug use (53%), were severely scared by a specific episode (34%), and asking for help to quit chemsex (82%). Characteristics of clients’ drug use are presented in table 2. 98% used stimulant drugs, most frequently MDPV (77%). While clients most frequently practiced chemsex weekly (41%), 24% did it daily. 40% of clients practiced chemsex with occasional partners, 36% also alone. 36% first started chemsex due to traumatic events or loneliness, 48% to emulate their partners, 16% to reduce sexual inhibitions. 62% had been practicing chemsex for more than one year. 49% never used drugs before starting chemsex. 52% were not currently able to have sober sex. Clients’ history of treatment is presented in table 3. 32% had been hospitalized or accessed the ER at least once to treat chemsex-related issues. 61% had previously accessed another health service for problematic chemsex, while 50% of them felt their issue was not understood there, 33% felt welcome and supported. Only 14% never had psychotherapy previously. 95% reported never using condoms in the previous 3 months, and 29% were neither on ART or PrEP.Conclusions Clients who reached out to our service reported increasingly complex and severe cases, both for mental and sexual health. Networks between facility- and community-based services are needed to provide comprehensive care to them. To this end, providing supervision and training on psychological aspects of chemsex and long-acting ART/PrEP formulations to local addiction services are needed. All addiction services should receive training to address problematic chemsex, also considering its increasing geographical spread.Abstract OC22 Table 1–3",
  "authors": [
    {
      "affiliations": [
        "ASA ODV, Milano, Italy"
      ],
      "name": "A Bianchi"
    },
    {
      "affiliations": [
        "ASA ODV, Milano, Italy"
      ],
      "name": "PL Vinti"
    },
    {
      "affiliations": [
        "ASA ODV, Milano, Italy"
      ],
      "name": "A Antonino"
    },
    {
      "affiliations": [
        "ASA ODV, Milano, Italy"
      ],
      "name": "C Soligo"
    },
    {
      "affiliations": [
        "ASA ODV, Milano, Italy"
      ],
      "name": "PM Testoni"
    },
    {
      "affiliations": [
        "ASA ODV, Milano, Italy"
      ],
      "name": "M Manfredini"
    },
    {
      "affiliations": [
        "ASA ODV, Milano, Italy"
      ],
      "name": "G Fracca"
    },
    {
      "affiliations": [
        "ASA ODV, Milano, Italy"
      ],
      "name": "D Zagato"
    },
    {
      "affiliations": [
        "ASA ODV, Milano, Italy",
        "San Raffaele Hospital, Milano, Italy"
      ],
      "name": "M Cernuschi"
    }
  ],
  "title": "OC22 Chemsex and MDPV: assessing needs related problematic chemsex to provide comprehensive services",
  "uid": "47d6b9b3-0eab-52fe-8504-771cb28877b4"
}