The article is based on presentations by Daniela Rojas, David Stuart and Cristiana Oprea at the 15th European AIDS Conference organized by EACS on the 21-24th October 2015 in Barcelona, Spain.

By Christina Antoniadi, Registered Nurse and Communications Specialist and Apoyo Positivo European volunteer liaison and coordinator of the European network “Positive Support” developed beside our organization.

  1. What is chemsex?

The term chemsex that is being used very frequently lately, signifies the substance use within a sexualized context. Ok. So, what does that mean? Many of the psychoactive substances influence sexual disposition, while others lower the inhibitions, we all inevitably have. When used in a sexual context our sexual behaviour is influenced. Chemsex as a term includes both the use of psychotropic substances as well as the attitudes related to those specific substances. In essence, we are talking about sexual activity that can last for days (during which the person does not sleep) with multiple partners. Occasionally, the person adapts behaviours related to the substance use and perhaps even risky behaviours. That is mostly attributed to the fact that very few of us can practice harm reduction strategies.

  1. Why do we keep hearing about it?

We keep hearing about it because it seems to become more often as a sexual practice. In addition, he are hearing about it because it is being studied more intensely and we are starting to have results being published. Some of that research was presented at the 15th European AIDS Conference.

  1. Who does it regard?

Potentially all of us. It can regard all of us. Every one of us that chooses to use substances to enhance their sexual practice. However, the evidence presented by Daniela Rojas and David Stuart, from France and London respectively, point to the practice being more popular among men who have sex with men. In the evidence presented from Romania by Cristiana Oprea the specific substances seem to be more popular among heavy drug users, since they cost far less than the widely known narcotics such as heroin.

  1. What substances are we talking about?

Different kind of substances seem to be involved. Depending on geographic region the availability of the substances differs. Research so far reports the use of mephedrone, GHB and crystal methamphetamine in London and cocaine and mephedrone in France.

  1. Is it dangerous?

The use of substances is always associated with risks. The specific aforementioned substances have additional risks. For example the substance mephedrone which is sold as soil fertilizer in the UK has never been studied in humans. Therefore, we are unaware of the effects on the human body, especially if we are talking about long term use. Moreover, all substances, pharmaceutical or not, ranging from paracetamol to Echinacea, interact with other substances. It is therefore, very important for the people under treatment of any kind (especially the ones in ARV Treatment) to notify their doctor since there is already available literature which means there are adverse effects.  In addition, another potential problem is related to the development of addiction. Some of these substances are highly addictive and it is very possible using them could lead to addiction. Finally, there are several risks related to injecting use such as the dissemination of Blood Born Viruses (BBV) like Hepatitis C or other infections such as staphylococcal or fungal infections.

  1. This is not about “junkies”? Are you sure?

No this is a practice that does not have to do only with Problematic Drug Users and yes I am pretty sure, even though the data is different between different locations and countries, the economic status and drug policy legislation of each country. Daniela Rojas presented the profile of the people who practice chemsex and participated in AIDES research in France: young age, employed males. 40% of them were unaware of their HIV status while 67% of them were unaware of their HCV status. Cristiana Oprea presented evidence showing that the specific substances are more commonly used among Problematic Drug Users in Romania.

  1. Am I at risk of infection?

Depends. According to the AIDES research data people practicing Chemsex by injecting the substances were at risk of infection because they were not practicing safer use techniques and harm reduction practices. According to Cristiana Oprea’s presentation an extra risk is associated to the frequency of use and the sharing of syringes and paraphernalia, which increases the chances for staphylococcal and fungal infections.

  1. When should I go to healthcare services?

If you notice any bodily changes such as rush, ulcers, oedema anywhere in your body but especially around the genitals or if you notice any cognitive changes or changes in mental or emotional activity, it is best to go to your doctor or a healthcare service.

  1. When should I approach addiction services?

If you are using psychoactive substances or you know someone close to you is using psychoactive substances it is best to call the anonymous hotline 1114 (Therapy Center of Addicted Individuals). Trained professionals can respond to your needs and guide you accordingly. In general, if you notice changes in the way you respond to everyday challenges or if you feel you need to use psychotropics to get through the day it would be best to seek out a specialised professional. As Apoyo Positivo, we can support you to find the best resource for your situation. Contact us on +34 91 358 14 44 or info@apoyopositivo.org

  1. How can I get more information?

Presently most of the related literature is in English. You can find accurate information at the Internet site of European Monitoring Center for Drug and Drug Addiction (EMCDDA) and in the following links:

We add a video of the british resource to control sexual health, Dean Street, where the specialist David Stuart works , in which you can see a role-playing of an intervention with a chemsex user who visit the clinic for a STIs screaning.