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Vol.:(0123456789)Infect Dis Ther (2025) 14:2113–2130 https://doi.org/10.1007/s40121-025-01201-7ORIGINAL RESEARCHLong?Term Health Outcomes of People with HIV Engaged in Chemsex: A Prospective Cohort Study on Drug Use, Sexual Behaviour, Sexually?Transmitted Infections and VulnerabilityLorena De La Mora · Montserrat Laguno · Berta Torres · Ivan Chivite · Alberto Foncillas · Alexy Inciarte · Júlia Calvo · Ana González?Cordón · Juan Ambrosioni · Leire Berrocal · Elisa De Lazzari · Esteban Martínez · José Luís Blanco · Rubén Mora · Estela Solbes · Ana Rodriguez · Pilar Callau · Laia Miquel · Jordi Blanch · Duncan Short · Josep Mallolas · Maria Martínez?Rebollar Received: April 2, 2025 / Accepted: July 15, 2025 / Published online: August 5, 2025 © The Author(s) 2025gay, bisexual, and other men who have sex with men (gbMSM), is linked to high?risk sexual behaviours and increased sexually transmitted infections (STIs). Data on its long?term evolu?tion after implementing specif i c strategies in HIV settings are limited. We evaluated the inci?dence of drug use, sexual behaviour, STIs, and vulnerabilities over 3 years following a specif i c approach at the HIV Unit of Hospital Clinic in Barcelona, Spain.Methods: We included 209 gbMSM living with HIV who engaged in chemsex in a prospective cohort (2018–2022). Quarterly visits assessed sexual behaviours, drug use, and STIs screening. Data were collected via self?administered ques?tionnaires, medical records, and microbiological ABSTRACTIntroduction: Chemsex, the intentional use of drugs to enhance sexual experiences among Lorena De La Mora and Montserrat Laguno contributed equally to the study as co?f i rst authors.Josep Mallolas and Maria Martínez?Rebollar contributed equally to the study as co?senior authors.Prior Presentation: Preliminary results of the study were presented at 19th European AIDS Conferences, 18–21 October 2023 Warsaw, Poland, poster number MeP.T7.03.Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1007/ s40121? 025? 01201?7.L. De La Mora · I. Chivite · A. Foncillas · A. Inciarte · J. Calvo · L. Berrocal · E. Solbes · A. Rodriguez · P. Callau · M. Martínez?Rebollar (*) HIV Unit, Infectious Diseases Service, Hospital Clinic, IDIBAPS AIDS and HIV Research Group, Barcelona University, Villarroel 170, 08036 Barcelona, Spaine?mail: rebollar@clinic.catM. Laguno · B. Torres · A. González?Cordón · J. Ambrosioni · E. De Lazzari · E. Martínez · J. L. Blanco · J. Mallolas HIV Unit, Infectious Diseases Service, Hospital Clinic, IDIBAPS AIDS and HIV Research Group, CIBERINF, Barcelona University, Villarroel 170, 08036 Barcelona, SpainR. Mora ONG Stop, Barcelona, SpainL. Miquel · J. Blanch Addiction Unit (GRAC), Psychiatry and Psychology Department, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, Barcelona University, Barcelona, SpainD. Short ViiV Healthcare, Brentford, Middlesex, UK