Knowledge, attitudes and practices regarding chemsex prevention among community pharmacy professionals in France: a cross-sectional study.

Abstract

To describe the Knowledge-Attitude-Practices (KAP) of community pharmacy professionals regarding chemsex prevention in the Auvergne-Rhône-Alpes region of France, and to identify associated determinants. Regional, cross-sectional, web-based, self-administered KAP survey collecting quantitative and qualitative data, analysed using multivariable linear regression and inductive content analysis. Primary care, community pharmacies in the Auvergne-Rhône-Alpes region of France, February-March 2025. Of the 276 respondents entering the survey, 261 community pharmacy professionals fully completed it. Inclusion criteria were: (1) age ≥18 years; (2) pharmacists, pharmacy technicians or students in training and (3) employment in a community pharmacy in the Auvergne-Rhône-Alpes region. Exclusion criterion was non-consent. KAP domain scores derived from survey items; thematic categories identified through qualitative content analysis of open-ended responses; and factors associated with KAP scores. Participants were predominantly female (69.6%), pharmacists (64.5%), aged 18-29 (41.7%) and working in urban areas (61.6%). Overall, 67.4% were able to define chemsex. Mean (SD) KAP domain scores were 13.8 (4.4) (range 3-27) for knowledge, 9.6 (2.9) (2-16) for attitudes and 9.6 (2.9) (5-16) for perceived resource adequacy/need. Qualitative analysis identified insufficient knowledge or training (28.7%) and the taboo and intimate nature of the topic (21.1%) as the main barriers to discussing chemsex. The most frequently suggested levers for improving care were professional training (57.1%) and broader prevention efforts (36.4%).Higher knowledge scores were associated with more positive attitudes (p=0.015), male gender (p=0.004) and prior chemsex-related advice requests (p=0.027), while increasing age was negatively associated with knowledge (p=0.029). Positive attitudes were associated with urban practice settings (p<0.001 for city-centre; p=0.002 for near urban centre) and higher knowledge scores (p<0.001). Perceived resource adequacy/need was lower among participants who had previously provided chemsex-related advice (p=0.047).