JMIR Publications

ABSTRACT

Background:

Introduction: This study proposes the development of a Line of Care (LC) for the health of people who engage in Chemsex, taking into account their specific needs and the challenges faced by public health services. Chemsex, characterized by the intentional use of psychoactive substances to intensify sexual experiences, has been associated with high rates of sexually transmitted infections (STIs), psychological distress, and social exclusion—especially among men who have sex with men (MSM). The proposal aligns with harm reduction policies and the strengthening of the Health Care Network (RAS).

Objective:

To develop a LC for the health of individuals who engage in Chemsex, based on the analysis of health needs and the experiences of users, managers, and professionals within the RAS.

Methods:

Methods and analysis: The study adopts a multi-method design based on the Knowledge-to-Action (KTA) framework, divided into three phases: Pre-Development, Knowledge Creation, and Action Cycle. The Knowledge Creation phase includes cross-sectional studies involving people who practice Chemsex, health managers, and professionals, as well as a scoping review. Data will be integrated through triangulation and thematic analysis.

Results:

The Action Cycle will involve workshops, the development of educational materials, professional training, and the pilot implementation of the LC in priority municipalities in the State of São Paulo. A mobile application and a digital guide on Chemsex will also be developed, focusing on prevention and care. The evaluation plan will include process and outcome indicators based on official health information systems

Conclusions:

The study it was approved by the Research Ethics Committee in April 2025 and is set to begin in June 2025. The expected outcome is to inform more inclusive public policies, reduce stigma, and improve access to and the quality of healthcare for this population. The project aims to strengthen the Unified Health System (SUS) by promoting intersectoral and evidence-based responses to emerging demands related to Chemsex in Brazil.