In April of this year, a ‘Chemsex Forum’ was held in London. People came from across Europe to discuss issues of health and wellbeing associated with the rising use of easily accessible drugs within sexualised contexts.
The aims of that first Forum included preliminary intelligence gathering and networking, identifying key trends across Europe, and sharing examples of effective clinical and community responses. I had the honour of chairing the two days of meetings. The dialogue now continues and plans are in process for a second Forum in 2017 in Berlin.
The Chemsex phenomenon cannot be disassociated from wider events happening especially in larger cities in Europe and globally. Austerity politics continues to result in the loss of safe community spaces for vulnerable groups like gay men and other men who have sex with men (MSM). Simultaneously, there is an expansion of new drugs that are easily available on the internet. The internet also enables new apps for accessing potential sex partners. And there is an expansion of commercial opportunities to meet potential sex partners, including via sex tourism and the ‘party circuit’. In other words, we find ourselves in a perfect storm where safe community spaces are disappearing to be replaced by attractive new technological and commercial spaces.
Taking a ‘harm reduction’ approach to this phenomenon, it is most important to focus on drug usage that puts the user in difficulty relative to his physical or mental health, and/or his/her social, professional and personal relationships. The risks are not insignificant. The more sexual partners, the more the risk of HIV and other STIs. Drugs can have unwelcome interactions not only with other drugs but also with prescription medications. One’s capacity to have sober interpersonal relationships can be weakened. And there is the question of determining when sex is consensual or not if one or both partners are using drugs.
Several clinical and community responses are being explored: closer collaboration between sexual health and drugs services, with access to some sexual health services available within drugs services, and vice versa; more community events and outreach to ensure better education and address stigma and prejudice; and the easiest possible access to healthcare appointments, testing/screening, PEP, PrEP, etc.
Going forward, a key consideration is the strength of the community response in support of the health and wellbeing of people engaged in Chemsex. Communities not only have a role in awareness-raising and education about the relevant issues, as well as addressing stigma and prejudice. They also have a role to play in the delivery of services and care relative to people engaged in Chemsex, including those who want to exercise a controlled drug use as well as those who want to withdraw from the scene.
Bryan Teixeira (October 2016)