A contextual behavioral model of chemsex: structural equation modeling of psychological predictors of hypersexuality and drug use

Abstract

Chemsex, defined as the intentional use of psychoactive substances in sexual contexts, is increasingly prevalent among gay and bisexual men and is associated with a range of mental, physical and social implications. This study aimed to test a contextual behavioral model examining how psychological inflexibility, loneliness, intimacy difficulties, and internalized homophobia contribute to hypersexuality and sexualized substance use. This study offers a novel contribution by modeling chemsex-related behaviors as forms of experiential avoidance shaped by psychological inflexibility, loneliness, and internalized homophobia. The findings highlight the potential utility of Acceptance and Commitment Therapy (ACT) in reducing chemsex vulnerability by promoting psychological flexibility and values-based living.