Chemsex should be public health priority due to HIV risk, experts say

Practice mainly carried out by gay men using a combination of drugs to enable them to have extended sexual sessions

A new documentary says chemsex 'has led to young men being trapped in a vicious circle of sex, addiction and dependence' (Vice UK)

Chemsex, having sex under the influence of illegal drugs and often with multiple partners, is rapidly increasing and should be a public health priority due to increased HIV risk say experts.

The practice is mainly carried out by gay men using a combination of drugs such as mephedrone, GHB, GBL and crystal meth enabling them to have sexual sessions lasting hours or even days.

People who engage in chemsex are putting themselves at risk of not only sexually transmitted diseases but also serious mental harm due to drug dependency, according to research by sexual health experts published in the BMJ.

The authors referred to the Chemsex Study, the first British research project of its kind from earlier this year which used data from the European Men-who-have-sex-with-men Internet Survey (EMIS). Of 1,142 respondents in the London boroughs of Lambeth, Southwark, and Lewisham, around a fifth reported chemsex within the past five years and one in ten within the past four weeks, suggesting that it is practised by a minority of men who have sex with men.

However, a majority of those that do engage in the practice are seeking help for related health issues the researchers said.

Antidote, a specialist service for the lesbian, gay, bisexual, transgender community in London, reported almost two-thirds (64 per cent) of attendees seeking support for drug use reported using chemsex drugs in 2013-14. Of crystal meth and GHB/GBL users, most reported using them to facilitate sex, with around three quarters reporting injecting drug use.

Antidote’s Jamie Willis and Hannah McCall, a senior nurse in sexual health at the Central and Northwest London NHS Foundation Trust, who wrote the BMJ paper, said chemsex drug users often describe “losing days”—not sleeping or eating for up to 72 hours—and data from service users suggest an average of five sexual partners per session. Unprotected sex is the norm they found.

Shards of methamphetamine hydrochloride, also known as crystal meth - one of the chemsex drugs (Creative Commons) (Radspunk/Creative Commons)

The researchers said funding for drugs services in the UK is focused on tackling heroin, crack cocaine, and alcohol dependency and both chemsex drug users and health professionals may believe referral to traditional services is inappropriate. Although some services are now developing specific chemsex and party drug clinics, the lack of data limits the advice that clinicians can give, they said.

The 15th European AIDS Conference in Barcelona was shown research last week on patterns of sexual behaviour and drug use among 874 men who attended a chemsex support service over one year at the 56 Dean Street clinic, London’s busiest sexual health clinic.

The study found that 70 per cent of individuals attending the clinic reported no chem-free sex whatsoever in the previous six months “Most men couldn’t remember their last sober sex,” David Stuart, the services Substance Abuse Lead, told the conference.

Chemsex has also entered popular culture with 5 Guys Chillin’, a new play currently at the Kingshead Theatre in Islington, north London, following a sell-out run in Brighton. Attitude magazine called it “an original look into a drug-fueled, hedonistic, highly secret world of Chem-Sex, Grindr and instant gratification”.

A new documentary from Vice UK, below, also focuses on an allure which it says “has led to young men being trapped in a vicious circle of sex, addiction and dependence”.

The Royal College of GPs agreed the issue should be a public health priority.

Dr Richard Ma said: “Chemsex is a rapidly emerging pattern of drug use, not just amongst men who have sex with men as often assumed, but heterosexual patients as well. Taking recreational drugs during sex can lead to a number of potentially harmful side effects including facilitating the spread of common STIs and HIV, but also serious mental health problems, such as anxiety, psychoses and suicidal tendencies.

“As such, it is essential that both patients and healthcare professionals – including GPs and primary health care teams – are aware of these and take the issue seriously.”