Chemsex prevalence in Italy is lower than in other European countries.1 In 2019, the largest Italian survey on chemsex and sexualised drug use (SDU) found that 5.1% and 26.3% of the men who have sex with men (MSM) respondents reported chemsex and SDU, respectively.2 Following individual reports during MSM consultations, which suggested changes in chemsex/SDU prevalence and features, we conducted a pilot survey to investigate these behaviours. Our centre is 1 of the 12 sentinel clinical sites belonging to the Italian STI Surveillance System but performs more than a quarter of the …