Chemsex, homelessness, and deep social exclusion: a literature review exploring the effectiveness of support services for sexual- and gender-diverse people with high and multiple support needs who use drugs in a sexual context
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Authors
Emily Porro
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Issue Date
06-May-26
Type
Conference Abstract
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Keywords
Housing , Community safety , Implementation/scale up , Neighbourhood health & place-based working , Working with people and communities , Embedded researchers
Alternative Title
Abstract
Chemsex and sexualised drug use has been linked to a number of health and social care concerns such as HIV transmission, mental health needs, and involvement of criminal justice. These needs map onto the domains of deep social exclusion that characterise multiple exclusion homelessness. This study aims to find out (1) What research has been done so far that directly examines sexualised drug use and homelessness together, and in what ways are these experiences associated?, and (2) Are social support services able to reach, include, and support people practicing sexualised drug use with high support needs and/or experiencing deep social exclusion, and what approaches have they used? To answer these questions, a literature review was carried out using systematic methods. Searches for relevant literature between 2018-2025 were completed in November 2024-May 2025, in EBSCOHost (APAPsych Info, APAPsych Articles, CINAHLPlus, eBook collections, MEDLINE, Social Sciences Full Text, eBook Open Access) and Web of Science databases, two journal publishers' online libraries, and through contacting leading researchers in the field and specialised support services directly. 16 relevant studies were found, and were grouped according to their suitability to answer the two research questions. The results found that there is very limited research on homelessness and sexualised drug use, highlighting a gap in existing chemsex research. Findings indicated a shift in sexualised drug use towards disadvantaged populations, as well as identifying key service approaches to support those with high and multiple support needs or otherwise socially excluded. Service approaches underpinned by community participation could play a role in building wider ‘systems of care' that challenge stigma and improve practice. There is a need for further primary research on homelessness among sexual- and gender- diverse groups engaging in sexualised drug use, using methods that are accessible for this group.