Introduction: The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. A 12 workshop sexual health program was made in two Drug Dependence Clinics in Madrid. Shame, stigma, homophobia or ignorance of drug services assistance have been describe as barriers by chemsex drug users to accessing services. Facilitators such as creating a safe environment are necessary. Objectives: The objective of this study was to identify barriers and facilitators to the implementation of a sexual health program for chemsex users in two Drug Dependence Clinics in Madrid. Methods: The study is based on a qualitative research approach. We analyze an anonymous on-line survey with chemsex users with open answer questions about barriers and facilitators for implementing the sexual health program. Data analysis was based on thematic analysis of content. Results: Facilitators included: motivated stuff with LGBT cultural competence, close interaction between stuff and the patients, a nonjudgemental and multidisciplinary approach which includes sexual health and mental health. Barriers included: stigma related to attending drug dependence clinics, psychopathology in acute state (psychosis, anxiety), lack of perceived support from public institutions facing the mental and sexual health problems associated with chemsex. Conclusions: Chemsex, a public health problem in some Spanish communities, is a phenomenon that needs a collaborative approach between users and mental and sexual health professionals and other medical stuff. The described program is a pioneering initiative in Spain. [ABSTRACT FROM AUTHOR]