November 14, 2022
PA-20-200 - NIH Small Research Grant Program (Parent R03 Clinical Trial Not Allowed)
PA-20-183 - NIH Research Project Grant (Parent R01 Clinical Trial Required)
PA-20-185 - NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)
PA-20-184 – NIH Research Project Grant (Parent R01 Basic Experimental Studies with Humans Required)
PA-19-092 - NIH Exploratory/Developmental Research Grant Program (Parent R21 Basic Experimental Studies with Humans Required)
National Institute on Drug Abuse (NIDA)
Background and rationale
Chemsex is the use of drugs during sexual activity to sustain or enhance sexual pleasure. This practice has been reported as an addictive behavior, though little is known about prevalence, medical/psychosocial consequences, preventive measures and treatment of chemsex in the US. Chemsex can last for many hours at a time, often performed with multiple sexual partners at sexual parties, thus increasing the risk for HIV and STD transmission. Gamma-hydroxybutyrate (GHB, GHB/GBL-G, Gina, liquid ecstasy), crystal methamphetamine, mephedrone, ketamine and ecstasy/MDMA are the most common drugs used in chemsex. Sexual-enhancer medications (sildenafil, tadalafil, vardenafil, alkyl nitrites, etc.) are often used in combination. Polysubstance use presents a major danger, particularly when fentanyl, a substance that is 100 times more potent than morphine, is laced with ecstasy. Alcoholic beverages and media e.g. social networking sites, online fora and hookup apps used by sexual minorities (SM) all contribute to chemsex and associated risky sexual behaviors.
Chemsex is as a growing public health issue with a still unknown prevalence since there are wide variations in estimates due to the heterogeneous sampling in research studies. Chemsex is associated with increased risk of HIV transmission because it is accompanied by unprotected sexual behaviors. Chemsex may also increase the risk of COVID-19 and Monkeypox acquisition, particularly in immunosuppressed people with HIV (PWH).
Whereas heterosexual people may also practice chemsex, this behavior is widely noted in sexual minorities (SM), thus putting them at an additional risk for HIV infection. Little is known about other medical consequences of chemsex, but given the large doses and the pharmacological effects of the drugs that are being used, medical consequences such as those affecting cardiovascular, respiratory, hepatic, renal, and neuropsychiatric functions are expected.
The purpose of this notice is to support research on the epidemiology, medical/psychosocial impact, and preventive and therapeutic measures for chemsex in people with HIV and HIV-vulnerable populations including sexual minorities (SM) e.g. lesbian, gay, bisexual.
NIDA is interested in studies focusing on: 1. Epidemiology; 2. Acute and long-term medical consequences, and the psychosocial implications of chemsex in the context of HIV, with focus on HIV-most vulnerable populations; 3. Developing safe and effective pharmacological and non-pharmacological interventions for prevention and therapy and 4. Optimizing existing evidence-based interventions for key populations of interest.
• Epidemiological studies of the nature and extent of chemsex behaviors in HIV individuals, and in the general and SM population. Chemsex drugs of use patterns: types of drugs, not limited to, GHB, crystal meth, mephedrone, ecstasy, polysubstance use with fentanyl and other synthetic opioids, marijuana, cocaine and other stimulants, alcohol, etc. Combination with sexual-enhancing medications (sildenafil, nitrates, tadalafil, vardenafil, etc.). HIV diagnosis in individuals who practice chemsex. PreP use. HIV-comorbidities. ART adherence. Sexual-risk behaviors. Social environments of chemsex practices.
• Medical consequences of chemsex such as respiratory depression, opioid overdose, cardiac arrest, seizures, CVA, organ failures, and psychological and psychiatric impact (suicides, homicides, death). Subacute and chronic medical consequences (HIV, other sexually transmitted disorders, hepatitis C, Monkeypox, cirrhosis, hepatomas, cardiopulmonary and renal consequences, malignancies, etc.). Comparison of patterns of chemsex behaviors and comorbidities between SM and the general population.
• Preventive measures: sexual education; risk reduction strategies and interventions; rapid test/point-of-care diagnosis methods, harm reduction measures, chemsex and PreP, safer sex, etc.
• Pharmacological interventions: pharmacokinetics and pharmacodynamics of naltrexone, buprenorphine, methadone, benzodiazepines, in the context of HIV individuals who practice Chemsex; interaction of opioid agonists, antagonists, and stimulants with PreP; etc.
• Non-Pharmacological interventions: cognitive behavioral therapy, contingency management, support groups, 12-step, behavioral therapies, devices, digital health applications, etc.
Application and Submission Information
This notice applies to due dates on or after January 5, 2023 and subsequent receipt dates through January 8, 2026.
Submit applications for this initiative using one of the following funding opportunity announcements (FOAs) or any reissues of these announcement through the expiration date of this notice.
All instructions in the SF424 (R&R) Application Guide and the funding opportunity announcement used for submission must be followed, with the following additions:
Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.
Raul Mandler, MD
National Institute on Drug Abuse (NIDA)