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Substance use within the LGBTIQ community has been long established. However chemsex, the use of recreational substances within the context of sexual activity (for the purpose of enhancement), is a new and emerging area of research, particularly in Australia. Chemsex is most commonly associated with men who have sex with men (MSM) and often involves stimulants, such as crystal methamphetamine. The current study was developed in partnership with the Queensland AIDS Council to inform future health promotion. Participants were 663 MSM, the majority of whom resided in South East Queensland. Questionnaires were completed online or on paper. The questionnaire asked about demographic details, substances used in the last 12 months, sexual health details and engagement in a variety of sexual behaviours, including chemsex. Those who reported engagement in chemsex were asked further questions about these behaviours. Descriptive results provided rates of substance use within particular sub-groups. In addition, it was found that crystal methamphetamine was associated with increased rates of condomless anal intercourse (CAI); increased sexual session length was found to increase the likelihood of engagement in CAI; chemsex, use of PrEP and having an undetectable viral load (UVL) were also shown to be significant predictors of CAI. Finally, chemsex and PrEP were shown to be significantly associated with increased reporting of sexually transmitted infections. These results provide useful insight for future HIV prevention, health promotion and clinical intervention planning. Implications for chemsex participants and the wider MSM community are discussed and recommendations for future research are made.