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

Objectives 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. Design Regional, cross-sectional, web-based, self-administered KAP survey collecting quantitative and qualitative data, analysed using multivariable linear regression and inductive content analysis.

Setting Primary care, community pharmacies in the Auvergne-Rhône-Alpes region of France, February - March 2025. Participants 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.

Primary and secondary outcome measures KAP domain scores derived from survey items; thematic categories identified through qualitative content analysis of open-ended responses; and factors associated with KAP scores. Results 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