Evers YJ, Dukers-Muijrers NHTM, Kampman CJG, et al. - This study was conducted with swingers in order to determine the prevalence of drug use during sex and perceived advantages and risks. An online questionnaire that was advertised on Dutch swinger websites was completed by 1,005 swingers in 2018. Using backward multivariable logistic regression analysis, researchers evaluated the links between drug use during sex < 6 months (any drug use excluding alcohol and erection medicines) and sociodemographic features, alcohol consumption and condomless sex. Drug use during sex was reported 51% of women, 44% of bisexual men and 39% of heterosexual men, and XTC, GHB, and laughing gas were used most often. Most reported motives for drug use were prolonging sex and increasing arousal. Feeling happy and increasing energy were the most reported positive effects, while feeling tired was the most reported negative effect. Drug use was considered pleasurable in 94%, while 7% reported that they may become addicted or felt uncomfortable having sex without drugs. Drug-using swingers reported higher rates of condomless sex. Clinics were recommended to discuss drug use during sex among swingers and offer knowledge regarding safer sex and drug use.