Social networks of men who have sex with men engaging in chemsex in Germany: differences in social resources and sexual health

Meyer's minority stress model posits that sexual minority communities can act as protective factors for individuals within the sexual minority. Given that existing evidence on this proposition is inconclusive, a social network approach was employed to capture diversity in the social environment of individuals involved in chemsex that might account for variations in social resources and sexual health. This study examined the social networks of men who have sex with men (MSM) involved in sexualised drug use, using data from a cross-sectional online survey. Utilising cluster analysis, four distinct social network types were identified based on network composition: MSM-diverse, partner-focused, family-diverse, and chemsex-restricted. In terms of social resources, the four network types did not exhibit significant differences in social support. However, individuals with a chemsex-restricted social network reported stronger social influence related to chemsex and less social engagement outside of chemsex. Contrary to initial expectations, the four network types did not differ in chemsex-related consequences or sexual satisfaction. MSM engaged in chemsex for over 5 years reported more chemsex-related consequences and lower sexual satisfaction, particularly those with a family-diverse social network. Additionally, indicators of network quality, such as perceived emotional closeness, reciprocity with network members, and overall satisfaction with the network, were more influential in predicting sexual health outcomes than social resources. The findings of the study suggest that the social environment of MSM engaged in chemsex plays a role in shaping their experiences. Insufficient inclusion in a sexual minority community is potentially associated with an elevated risk of poor sexual health. These findings underscore the importance of tailoring interventions to address the diverse needs of individuals exposed to different social environments.