by Shaun Knittel -
SGN Associate Editor
A commissioned report into drug use during sex, dubbed 'chemsex,' has highlighted significant risks to the sexual and mental health of Gay and Bisexual men.
The findings of the report were produced by experts in HIV and sexual health at the London School of Hygiene & Tropical Medicine.
Three south London boroughs - Lambeth, Southwark and Lewisham - have high populations of Gay men. Health experts there said they are determined to tackle the problem of chemsex, or sex under the influence of drugs such as crystal methamphetamine, GHB/GBL and mephedrone, because they are believed to be behind rising rates of HIV and STIs in Gay men in the area. Chemsex was most commonly reported to occur in private homes, as well as in saunas or other sex-on-premises venues.
Researchers analysed survey data from 1,142 Gay and Bisexual men living in Lambeth, Southwark and Lewisham and conducted in-depth interviews with 30 Gay men from the area. They found that although chemsex was reported to increase sexual arousal and facilitate more adventurous sex, many men were using drugs to mask self-esteem or self-confidence issues. In other words, although seemingly contradictory with their actions, the majority of men were not happy with their sex lives and wanted a long-term partner for more intimate and emotionally connected sex.
Some other key findings were:
o Around a third of men interviewed found it difficult to maintain control of their behavior or negotiate safe sex while under the influence of drugs, and had unprotected sex with high risk of HIV/STI transmission, which they regretted.
o Overdosing, panic attacks, convulsions and sexual assault were all associated with chemsex.
o Many men also felt that the large amount of time they spent engaging in chemsex was detrimental to their social relationships and career progression.
According to the authors, visibility of drug use on social and sexual networking apps may be normalizing the injection of drugs such as crystal methamphetamine in a sexual setting, also known as 'slamming.'
According to David Stuart, substance abuse lead at London's 56 Dean Street sexual health clinic, said, 'The clinical term, which I hate, is sexualized drug use by men who have sex with men (MSM). Chemsex is a term that came from apps like Grindr, BBRT (Bareback Real Time) and others. Chemsex (chemical sex) is just the slang term for sexualised drug use by men who have sex with men.'
Stuart contributed to the study.
He says the problem of chemsex is growing. '... Sex and drugs have been going on in different populations going back hundreds and hundreds of years, so it's not incredibly new, but it has been growing recently. About ten years ago we really started to see it in an epidemiological way. It was mostly HIV positive older men, and that tells us something: why did this trend begin with HIV positive older men? It has something to do with their experience of living with HIV, their experience of sex, their experience of disclosure, their experience of what they felt in bed as sober and HIV positive, when these drugs seem to ... they like these drugs very much.'
Stuart says it's not just older HIV positive men engaging in chemsex, it's 15-year-olds. 'The first time they have sex is on drugs,' he said. 'I'm working with people like that in the clinic. It's also about 50/50 HIV positive and HIV negative men; it's across the board now and chemsex is a household name in the big cities that host big Gay communities across the world.'
The report showed that 19% of clients had used GHB/GBL in the previous 6 months, 10% had taken crystal meth and 21% had taken mephedrone within the same period. All figures of drug use were significantly higher among men diagnosed with HIV.
In addition, the Chemsex Study showed the use of crystal meth appears to be slowly increasing rather than rising exponentially. In 2007 a community survey of men who have sex with men in London estimated that 7.8% had used crystal meth in the last year. In this 2010 survey the figure was 8.7%.
Alcohol by far remains the most commonly used drug and is the drug of largest concern for MSM.
The rise of mephedrone over the past decade has been part of Britain's ever-changing drugs landscape. Until April 2010 it was considered a legal high and could be sold as plant food or bath salts, but given its potency and powerful side effects the drug was reclassified.
Stuart says that five Gay men are diagnosed with HIV in London every single day. 'That's a rise and it's a rise that started happening about two or three years ago, at the same time as the rise in chemsex,' he said.
Between 2011 and 2012, the number of men who have sex with men (MSM) taking an HIV test in London increased by 19%. An estimated 18% (7,300) of MSM in England who are HIV positive are unaware of their infection. New diagnoses in England reached a record high of 3,250 in 2012 but, according to Stuart, the role of chemsex in this has yet to be established.
'What we are trying to do is to find out: is there a connection or is it a myth, is it a scare?'
'At the moment we have 100 people every month coming to one sexual health clinic, just one, disclosing that they are using drugs for sex and haven't had sober sex in more than a year,' continued Stuart. 'A hundred a month, so that just gives you a number.'
Paul Steinberg, Lambeth's HIV prevention and sexual health commissioning manager, said that the trend towards chemsex is being aided by a 'perfect storm' of cheap, easily available drugs, but most importantly, a burgeoning number of social and sexual networking apps and websites that enable men to arrange to meet for sex at private parties.
'There has been a change in Gay cultural, social and sexual networks. In the 1980s and 1990s Gay men would meet in bars, clubs and community centers. But with the rise of the Internet and social media apps, there has been a shift towards a technology- and home-based cultural scene', said Steinberg.
The Chemsex Study, published on March 28, is the first research of its kind in the UK to look at the complex relationship between drug use and sexual behavior and documents the harms that some Gay men experience.
The Chemsex Study's key recommendations include the production of resources that provide drug harm reduction information, access to Gay-friendly drug and sexual health services that understand the issues around chemsex, coordinated work with managers of commercial sex-on-premises venues to develop harm reduction policies and procedures, and engagement with commercial companies and Gay media / apps to provide harm reduction as part of a corporate responsibility to their users.
Locally, chemsex happens without a doubt, but the slang term hasn't really caught on. In Seattle and other American cities chemsex is more commonly known as 'party and play' (PnP). The term is particularly prevalent on websites like Tribe.net, where a number of Seattle PnP 'tribes' have been established. One of the larger tribes, Seattle PnP, has over 200 active members. Another tribe called 'who p n p s' has over 300 members. There is no study about chemsex in Seattle.
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