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Research into SDU had been conducted in 55 countries and 32 countries had recorded the use of a chem**** drug among MSM, although the drugs used to define chem**** varied. Among studies that researched MSM, SDU was most commonly investigated in relation to condomless anal intercourse (n=42), followed by HIV prevalence (n=35), and then STI diagnoses (n=27). Drug use was generally associated with ****ual health outcomes, but particularly in chem**** studies. SDU research is lacking among WSW and trans people, despite trans women having a high