ChemSex

This article proposes and outlines a critical approach to the study of chemsex. The vast majority of chemsex research takes place within the broad field of health, particularly LGBTQ+ health, which ultimately frames such work using a paradigm of risk. This article follows previous research that calls attention to the limitations of this perspective, and suggests the value in formalising more generative, explorative and critical approaches to the phenomenon. Based on this previous scholarship and the contributions to the special issue, we propose that 'critical chemsex studies' operates along three axes: one working within public health that attempts to move beyond the risk paradigm; another which attempts to understand its cultural dimensions as it interrogates the discursive, sociopolitical, technological and economic landscapes in which chemsex has materialised, and finally; a third centering pleasure and its organisation of gay identity, intimacy, and sociability. Finally, we look to the future of critical chemsex studies, calling for more diverse works on national and regional differences in chemsex culture, as well as how the framework can be adapted in order to leverage its capacities for the women, trans and nonbinary people who are under-represented in the current literature.

My analysis of the changed landscape of gay partying in Sydney, "Complex Events" looks at the impact of current policing practices (drug dogs) on the shapes gay partying is taking: its forms, pleasures, risks, contexts and sociomaterial implications – especially in the context of the increased use of online hook-up apps

The concurrent use of recreational drugs and excessive sex has become more popular across the MSM community all around Europe, also Central and Eastern Europe. The unprecedented low price of and easy access to drugs, the general status of gay communities in Europe, and increasing institutionalised homophobia in several countries all contribute to this growing phenomenon. This presentation tries to provide an explanation to why this problem is emerging from a queer philosophical stance. The presentation also suggests that the work focus of LGBTQ organisations needs to incorporate health issues in addition to the tradition of rights advocacy. This was presented at the series of the EATG European Networking Zone programs at the IAS2014 Conference.

Use of ‘party drugs’, a particular set of recreational drugs used in the context of ‘ChemSex’, is frequent among MSM living with HIV. A recently published observational study showed that more than half of HIV-infected MSM interviewed reported use of illicit substances in the previous 3 months, with frequent concomitant use of three or more drugs. These substances are a combination of ‘club drugs’ (methylenedioxymethamphetamine, gamma-hydroxybutyrate, ketamine, benzodiazepine) and drugs that are more specifically used in a sexualized context (methamphetamine, mephedrone, poppers and erectile dysfunction agents). Although formal data on pharmacokinetic or pharmacodynamic interactions between recreational drugs and antiretroviral agents are lacking, information regarding potentially toxic interactions can be theorized or sometimes conclusions may be drawn from case studies and cohort observational studies. However, the risk of coadministering party drugs and antiretrovirals should not be overestimated. The major risk for a drug–drug interaction is when using ritonavir-boosting or cobicistat-boosting agents, and maybe some nonnucleoside reverse transcriptase inhibitors. Knowledge of the metabolic pathways of ‘party drugs’ may help in advising patients on which illicit substances have a high potential for drug–drug interactions, as this is not the case for all.

As chemsex becomes more common within our gay communities, it’s more common to hear from our friendship circles and networks, stories of chemsex psychosis. Perhaps we’ve hooked-up with people who are experiencing these complicated symptoms – or maybe even we’ve experienced these symptoms ourselves.
Although it’s frightening, and difficult to understand, difficult to manage... we need to talk about it more, so we can understand it better, de-mystify it, and to help each other out when it happens.

This document is a community resource; a guide that seeks to explain;
-what chemsex psychosis is, the most common symptoms
-what is causing it
-how we can help ourselves
-how we can help our our friends and lovers

Chemsex – a subcultural phenomenon where men who have sex with men consume drugs to facilitate sex sessions, usually accompanied by electronic dance music (EDM) – has received a lot of media attention recently. Both the media and the limited existing research have tended to focus on chemsex as a public health concern, with both drug use and risky sexual behaviour implicated in physical and mental harm. But chemsex is also an arena of illegal drug use and drug supply, and this chapter explores the nature of drug distribution within this subcultural scene. Drawing on observational research and interviews with 17 drug dealers, we found that retail-level dealers tend to emerge from within the scene rather than coming from outside, and that they reflect and maintain the ethos and norms of the subculture. Benefits of drug dealing (both financial and interpersonal) encourage existing chemsex participants to take on the role of dealer, while challenges of maintaining the lifestyle (the physical and emotional demands of ongoing participation in drug and sex sessions) mean that their drug dealing careers are often short-lived. We argue that here that, as in other drug-using scenes, retail level dealing is a product of the subculture – and the patterns of use and social supply within it – rather than parasitical to it.

In 2009, psychoanalyst and queer theorist Tim Dean released Unlimited Intimacy, an anthropologically-tinged yet creatively psychoanalytic account of the bareback and bug-chasing subculture(s). Since then, a relatively new term has taken the place as the ‘new frontier’ for the study of gay sexual risk: chemsex. The intense medical and media focus on the practice of gay sex with drugs has led to numerous reports, sexual health strategies and sensational coverage on the practice, which has in part led to the theoretical consolidation of the subculture and the growing entanglement of sex and drug taking in the ‘urban’ gay male community. The documentary ‘Chemsex’, is a particularly famous example of such sensational coverage. Focusing on pornographic depictions of the act, it seeks to present itself as a ’neutral’ examination of the rise of chemsex while at the same time giving space for heavily medicalised and pathological arguments for its desirability among urban gay men. In offering a ‘gendered’ analysis of ‘Chemsex’, this essay will focus on the use of ‘bodies’ in the documentary, asserting that an amalgamation and syncretic reading of primarily two psychoanalytic theoretical frames is required. The first frame used by Tim Dean and Leo Bersani in their writings on bareback (unprotected sex) and bug-chasing (the fetishisation and practice of having sex to actively be infected with HIV), will be used to place chemsex as a practice within a subcultural tradition of sexual risk in the gay community. This will be used in conjunction with Laura Mulvey’s psychoanalytic work on representation in order to better imprint the lacanian frame onto a critique of filmic technique in “Chemsex” and explore how notions of gender and sexuality are communicated to the audience, and how that audience is constituted against the chemsexual subjects. Reflections will also be made on bell hooks and Judith Butler who offer insights into the role of spectacle and precarity respectively in constituting the audience. Ultimately, the gendered analysis of this essay rests on acknowledging how “Chemsex” misrepresents chemsex as a practice primarily through its hypersexualisation of gay subjects, pandering to the heterosexual matrix of the male gaze and already existing heteronormative conceptions of sexual deviancy. While this essay unarguably views “chemsex” as a mostly problematic portrayal of the subculture, an appraisal of new masculinities represented in the film will allow us to appreciate new gender paradigms being created in gay sexual subcultures via sexual risk.

A szexualizált környezetben folytatott szerhasználat (chemsex, "bulizás") a melegközösségekben ismert, de nyilvánosan csak ritkán tárgyalt téma Magyarországon. A Magyar Pszichológiai Társaság LMBTQ szekciójának konferenciáján 2018. május 12-én megtartott előadásban részletesen elemzem a chemsex jelenséget, annak jelentőségét a HIV terjedése és a mentális egészség szempontjából, és jó gyakorlatokat mutatok be ártalomcsökkentésre és korai intervenciókra.

Background: Recent evidence has suggested that chemsex (the use of mephedrone, crystal methamphetamine and γ-hydroxybutyrate/ γ-butryolactone (GHB/GBL) to enable, enhance and prolong sexual interactions) has increased among men having sex with men (MSM) attending sexual health clinics in large UK cities. To date there has been no data from the UK or Europe that describes changes in chemsex over time within a cohort of MSM. Methods: The prospective cohort study, Attitudes to and Understanding Risk of Acquisition of HIV over Time (AURAH2), collected online questionnaire data from HIV negative or undiagnosed MSM (at enrolment) from 2015 to 2018, recruited from sexual health clinics. We aim to investigate changes in chemsex, three individual drugs associated with chemsex, frequency of chemsex sessions and measures of sexual behaviour, among the cohort of MSM over the study's 3 year follow-up period. Results: In total 622 MSM completed at least one online questionnaire for the AURAH2 study, of which 400 (64.3%) were still engaged with the study within the last six months of follow-up. Prevalence of chemsex significantly declined during the follow-up from 31.8% (198/622) at the first online questionnaire, to 11.1% (8/72; p < 0.001) at the 9th. This decline was reflected in the proportion of MSM reporting use of two of the three individual chemsex drugs: mephedrone use had significantly declined from 25.2% at the first online questionnaire to 9.7% (p < 0.001) at the 9th, GHB/GBL use had also declined from 19.9% to 8.3% (p = 0.001). While crystal methamphetamine use declined, but not significantly (11.1%-6.9% [p = 0.289]). Most measures of sexual behaviour (any anal sex, group sex, recent HIV test and bacterial STI) also tended to decline over the follow-up period, with the exception of CLAI with more than one and more than two partners. Conclusions: Chemsex and use of two individual chemsex drugs (mephedrone and GHB/GBL) significantly declined over time among individuals in the study, alongside most measures of sexual behaviour with the exception of those related to CLAI. Focusing health promotion and HIV prevention, such as awareness of post-exposure prophylaxis (PEP) and access to pre-exposure prophylaxis (PrEP), on MSM that report chemsex, and in particular problematic chemsex, would be highly beneficial, potentially only necessary for a relatively short period of time for individuals, and could have long term benefits for HIV and STI prevention.

The act of taking risks in a sexual context is by no means new. One may think immediately of BDSM (Bondage, Domination and Sadomasochism): its associations with tangible pain and the rituals and lifestyles surrounding it render BDSM a clear example of the profoundness and commonplace nature of the fetishisation of sexual risk. Likewise, the variety of ways in which one may engage in BDSM (and the plethora of reasons one may desire it) also show it to be site open to subjective definition. Interestingly however, there are forms of ‘risk sexualisation’ that occur within urban gay communities such as bareback, bug-chasing and chemsex that have particular processes of psychic risk sexualisation unique to – and entangled with – the historical social positioning of the gay male, thus making them distinct from other forms of sexual risk, while sharing similar terrain.

Understanding how the changing social positioning of the gay male has enabled particular sexual practices or ‘sexualisations’ to occur  is a sensitive affair that requires both an understanding of the political, social and medical discourses that embellish the symbol of the gay male in the cultural imaginary, and an understanding of the psychic process that determine how one psychosexually responds to and internalises information – as a gay male - that may influence their sexual desires and practices.

This paper attempts to satisfy the titular question through looking inward at psychoanalysis as a discipline, specifically the work of Melanie Klein, Freud, Bersani and Dean as well as outward towards the object of study: gay sexual risk. By examining the changing relational dynamic between the discipline and object of study, alongside a critical analysis of how psychoanalysis has - at different points - failed and succeeded in explaining gay desires for sexual risk; this paper hopes to offer an answer that speaks to: the ways in which psychoanalysis has changed in its approach to sexual risk; how it deals with modern actualisations of gay sexual risk, and how well its tools can blend with other forms of analysis in order to temper its own inabilities to account for such actualisations.

Although clearly defined within communities that engage in chemsex, and although very commonly understood within gay communities, “chemsex” still has no universally agreed-upon academic definition. As an invited contributor to this special Chemsex edition of Drugs and Alcohol Today, and as the first person (to my knowledge) who had ever used the term “chemsex”, I will share some of the experience I have gained from working one to one with tens of thousands of gay men over the last decade or so, who engage in chemsex; I will share from the humbling and informative experience of engaging with international gay communities on this topic. I will seek to contextualise the term, the phenomenon and to provide a history of its origins, its culture and a definition that is respectful to that culture.

Queerness is many things, for example: an identity; a state of being; a characteristic; a mark of the unknown…The number of ways in which ‘queerness’ has been utilised is testament to not only the enigmatic properties of the term, but also the key thread that ties these utilisations together: politics. In every instance that the queer appears as a descriptive category, it represents an opposition to norms, discourses of truth and ways of doing. In this, queerness is inherently political. This essay seeks to explore the oppositional nature of queerness as explored in the first chapter of Lee Edelman’s forceful polemic ‘No Future’, which outlines his rationale for an embracing of the anti-normative attributes of queerness; with a critique informed by ‘Non-reproductive Futurism’ by Nina Powers, who considers the politics of Jacques Rancière to remedy what she sees as ‘Edelman’s body apolitic’. It is through a consideration of the call-and-response of these texts, alongside other readings, that will hopefully offer a way to simultaneously embrace the oppositional nature of queerness while forming a pragmatic politics that operates within current systems of power while also rejecting ‘cisheterorepronormative futurism’ (!)

Gender, Sexuality and Relationship Diversity (GSRD) therapy is at the forefront of current thinking on working with the more traditionally known LGBT(IQ) (lesbian, gay, bisexual, transgender/sexual, intersex, questioning). This chapter outlines the core ideas.

Les grandes enquêtes sur les hommes ayant des rapports sexuels avec des hommes (HSH) en France, initiées par Michael Pollak et Marie-Ange Schiltz il y a trente ans dans la presse gay, ont introduit la consommation de drogues à partir de 1997, au lendemain de la mise sur le marché des combinaisons hautement actives de médicaments antirétroviraux (ARV), efficaces contre le VIH, et qui ont entraîné la chronicisation du sida. Si le chercheur australien Kane Race identifie ce moment comme le début d’une lifetime of drugs, l’intérêt des enquêtes pour l’usage de substances psychoactives chez les gays deviendra plus courant à la décennie suivante, lorsqu’on découvre que les ARV maintiennent la charge virale à un seuil indétectable chez les sujets séropositifs qui, dans ces conditions, ne transmettent plus le virus. Au tournant des années 2010, la consommation de drogues devient une thématique prépondérante dans les enquêtes sur la sexualité gay et plus particulièrement leur usage en contexte sexuel désigné par le terme de chemsex (pour chemical sex). Le profil des hommes s’adonnant à cette pratique se caractérise par une sexualité intense avec un très grand nombre de partenaires sexuels dans les derniers 12 mois, une fréquentation régulière de plusieurs lieux de rencontres sexuels, des pratiques sexuelles spécifiques, l’abandon du préservatif pour les pénétrations anales, et par l’implication majoritaire d’HSH séropositifs au VIH, mais aussi d’HSH négatifs sous PrEP. À ce jour, les nombreuses recherches et publications n’appréhendent la pratique du chemsex que sous le prisme des risques associés en termes d’addiction et de compulsivité. Nous nous proposons ici de montrer comment l’émergence d’une littérature scientifique sur le chemsex contribue aujourd’hui à masquer les comportements strictement sexuels associés. Pour ce faire, nous nous appuierons sur deux types de matériaux complémentaires. D’une part, plusieurs enquêtes quantitatives sur les comportements sexuels et préventifs du VIH auprès des gays et autres HSH (Prevagay 2015, enquête rapport au sexe 2017). D’autre part, les premiers résultats de l’enquête Attentes et PArcours liés au CHEmSex (APACHES), menée à partir d’entretiens biographiques pour le compte de l’OFDT en 2018, et centrée sur les scripts sexuels, en même temps que sur la place du plaisir et des modes contemporains de socialisation dans cette subculture.

This paper considers how certain functions of online hook-up devices are participating in the emergence of new forms of sexual relation, new distributions of intimacy and new sexual arrangements. Though not without precedent, online hook-up devices generally act in gay culture as “framing devices”, framing sex as a “no-strings” encounter via their default application. These frames are variously rejected, reconfigured, re-embedded or confounded by participants; they become subject to various forms of overflowing. Understanding this dynamic – its typical forms of connection and estrangement – is pivotal for grasping the emergence of new forms of sexual community and new sexual publics among gay men – and/or “un-community”, as some have put it.  My analysis prompts a series of methodological reflections wrought from the encounter it stages between queer theory and Science and Technology Studies. At a time when marriage and monogamy are increasingly monopolising the public discourse of gay life, digital devices are affording novel ways of arranging sex, intimacy, and sexual community with their own qualities and limitations.

The public health response to chemsex, when understood objectively, is actually a simple model of multidisciplinary interventions.
Unfortunately, however, you can’t remove the sex from chemsex; and where
there is sex, there are moral and religious judgments and stigmas. Make that gay sex, include HIV, and chemsex becomes something that can require some untangling before an effective public health
response can be mounted. This article attempts to untangle the context from the controversy.

In partnership with Roche and 56 Dean Street, this booklet was produced to aid clinicians who wish to better understand the contexts and language associated with ChemSex, to better inform their patients about the HIV/hepatitis C (HCV) risks encountered in a ChemSex environment.

Grounded on an ethnography of the European gay party circuit, this article analyzes gay men’s identity shift, and the maximization
of their (sexual) contacts, in relation to substance use and trade. Breaking away from the psychological and medical
normalization at stake in the years of the Aids epidemic, these homosexual transactions may rely on an economy of self and
collective excess to be thought out in terms of sumptuary affirmation of social and sexual identity.

A 3 day recreational drug use survey of all attendees at 56 Dean Street GUM/HIV clinic; this survey was an early initiative to support the recruitment of the first full time ChemSex advisor in a UK sexual health clinic.
Jodie Scrivener, Dr Alan McOwan, David Stuart

The major studies on men who have sex with men (MSM) in France (which began with Michael Pollak and Marie-Ange Schiltz forty years ago in Gay Press) introduced the idea of drug use in 1997, just after highly effective antiretroviral treatment (HAART) combinations were made available for HIV, making AIDS a manageable chronic condition. Australian researcher Kane Race identifies this time as the beginning of a “lifetime of drugs”, but the utility of surveys into the use of psychoactive substances among gay people was to emerge in the following decades, after it was discovered that ARV treatments could keep viral load at undetectable levels in HIV-positive people, who could therefore no longer infect others. In the early 2010s, the use of drugs became a major theme in surveys of gay sexuality, and in particular the use of drugs in a sexual setting, which was named “chemsex”. Men who adopt this practice tend to have intense sex lives, with a very large number of sexual partners over the past 12 months, regular attendance at sexual meeting places, specific sexual practices and do not use condoms for anal penetration. The majority who are involved are HIV-positive MSM or HIV-negative MSM on PrEP. To date, the research and publications looking at chemsex have only investigated it through the prism of the associated risks linked to addiction and compulsive behaviour. In this article we intend to show how the emergence of a scientific literature of chemsex has contributed to a masking of the strictly sexual behaviours associated with it. We will draw upon two complementary types of material: several quantitative surveys of sexual and HIV prevention behaviours among gay men and other MSM (Prevagay 2015, the 2017 “Rapport au Sexe” survey, known as ERAS). and the initial results of the Attentes et PArcours liés au CHEmSex/Expectations and Experiences of Chemsex survey (APACHES), which used biographical interviews carried out on behalf of OFDT in 2018, focusing on sexual scripts as well as the role of pleasure and contemporary ways of socialising in this subculture.

Broadening sexual health and HIV care in NHS settings to holistically address the general and sexual wellbeing of gay, bisexual and other men who have sex with men (MSM), via community engagement, arts, theatre, film, spoken work and cultural spaces. Generating cultural dialogue and action around challenging, topical issues to better understand the lifestyle needs that impact the sexual wellbeing of our patients. With the purpose of affecting HIV/STI epidemiology and community/individual wellbeing.

Sexualised injecting drug use (‘SIDU’) is a phenomenon associated with a wide array of high-risk injecting and sex-related practices. This review establishes what is known about Men who have Sex with Men (MSM) and SIDU to assess implications for health care and policy. The Levac, Colquhoun & O’Brien, (2010) scoping review methodology was employed for the purposes of the search. Characteristics of MSM for ‘SIDU’ appear to include being on anti-retroviral treatment and urban residency with drivers being challenging social taboos; a search for intimacy; convenience of administration; relationship breakdown and increased restrictions in clubs and saunas. Attraction for use appears to be enhancement or prolongation of sexual experiences/ pleasure; intimacy and the facilitation of a range of potentially ‘unsafe’ sexual activity. Traditional services are ill-equipped to address ‘SIDU’ because of a lack of knowledge of practices, lack of associated vocabulary and a failure to integrate sexual health with drug services. For effective responses these issues need to be addressed.

An online tool for MSM reluctant or unable to attend ChemSex support services, or to assist healthcare providers who feel unskilled to support clients/patients with ChemSex behaviours.
This is an online, interactive tool that can help an ambivalent person to reflect on their own use, access harm reduction information, or make changes around their own use of drugs in sexual contexts.
También en Español.

En España, durante los últimos meses del 2015, se ha hablado y discutido mucho, sobre todo en los me-dios de comunicación, acerca del fenómeno del ChemSex. Si bien el uso de drogas para tener sexo entre hombres gais no es nuevo ni reciente, el ChemSex hace alusión al consumo intencional de drogas para tener relaciones sexuales durante mucho tiempo. Sin embargo, incluso hasta ahora, mucha de la información que se vierte contiene una serie de imprecisiones respecto a la terminología, al alcance de este fenómeno, las drogas que se consumen y los espacios en que se consumen. Este artículo busca entender la emergencia de este fenómeno desde una visión integral y holística, así como plantea una definición desde una perspectiva de la reducción de riesgos para la prevención del VIH, de otras ITS y para el cuidado de la salud sexual y de la salud en general. Finalmente, se plantean algunas consideraciones para abordar el ChemSex a nivel preventivo.

ABSTRACT: In Spain, during November and December 2015, the phenomenon of ChemSex was much talked about and discussed, especially in the media. Although the use of drugs for sex among gay men is not new, ChemSex refers to the intentional use of drugs to sustain sex for a long period of time. Even now, there are a number of misunderstandings about the terminology, the magnitude of this phenomenon, what drugs are consumed and the spaces where gay men consume them. This article seeks to understand the emergence of this phenomenon , using a comprehensive and holistic approach and providing a definition of ChemSex from the perspective of risk reduction for HIV, other STIs, sexual health, and health in general. Finally, some considerations on ChemSex from the perspective of prevention are presented.

BACKGROUND: The health and well-being of those sexual-minority men who are often behaviourally defined as men who have sex with men (MSM) is affected by a system of interlinked factors that interact on the structural, interpersonal, and individual levels. Recently, two of the most common MSM health issues have been (a) the risks of acquiring sexually transmitted infections (STIs), mostly HIV, and (b) the sexualized use of addictive substances, known as chemsex.
AIMS: On the basis of the first comprehensive Czech dataset to integrate several mutually interlinked factors on the behavioural, as well as the psychological and structural domains, we attempt to shed light on the barriers to HIV testing and adherence to safer sex practices, including the most thorough description of the chemsex phenomenon that is available. We aim to go beyond the behavioural perspective and draw links to the well-being and satisfaction of this sexual minority and their sex lives.
METHODS: A series of descriptive statistical analyses was conducted on a sample of 547 respondents obtained within a self-administered online survey.
RESULTS: More than half of our respondents (55%) and three-quarters (72%) of the men younger than 25 years have never been tested for HIV. One-third
of the respondents considered testing services to be insufficiently friendly to gay, bisexual, or other men, and they also reported stigmatization and discrimination by healthcare workers as a problem that exists. 84% of the MSM have experience with anal sex; 43% of them always use condoms. Of all the respondents, nearly 6% have had at least one chemsex experience during their life. Only 46% of the MSM reported being satisfied with their sex
lives; 52% of those who were dissatisfied attributed this to “not having a steady partner” and 49% to “not having any sex”.
CONCLUSION: The sexual behaviour of MSM and their experience with HIV testing, chemsex, perceived stigma, and satisfaction with their sex lives are among the phenomena that deserve to be more regularly covered by relevant epidemiological examinations. Although our current analysis was more exploratory than in-depth, it may contribute to a better understanding of the syndemic and multifactorial conditions that influence the sexual behaviour of MSM, including the minority stress that may be rooted in deficiencies in our understanding of these populations.

Since 2011, various public health organisations have observed the growth of the sexual practice ‘chemsex’ in the UK, primarily in London. The term chemsex refers to group sexual encounters between gay and bisexual men in which the recreational drugs GHB/GBL, mephedrone and crystallised methamphetamine are consumed. This article uses a conjunctural perspective to make sense of the rise of chemsex within the historical conditions in which it has emerged. Drawing on a document analysis as well as interviews with 15 gay and bisexual men, this article argues that the rise of chemsex can be interpreted as an embodied response to material conditions shaped by neoliberalism: specifically as a desire for an intimate mode of collectivity during an historical moment when collectivity itself is being superseded by competitive individualism as the privileged mode of being in the world (Gilbert 2013). In doing so, this article provides a different account to pathologising media and medical representations of chemsex that appeared in 2015, whilst also contributing to a growing literature that attempts to map the balance of forces of the present conjuncture.

The project “New Psychoactive Substance Use in Kazakhstan, Kyrgyzstan, Georgia, and Serbia” was undertaken to generate a more accurate picture of the use of new psychoactive substances (NPS) in Kazakhstan, Kyrgyzstan, Georgia, and Serbia, and to assess harm
reduction and law enforcement responses to the emerging issues related to use of NPS. In 2019, similar research was conducted in Belarus and Moldova. Results from this project
will supplement scarce international data on the use of NPS in these countries, present a more accurate picture of their use, and provide information to national civil society organizations (CSOs) for political advocacy.

INTRODUCTION
Recreational drug use has been linked with HIV/AIDS since the
beginning of the epidemic, with the commonest substances in
the early days being ‘street drugs’ such as opiates, crack and
cocaine.
In the past few years, other recreational drugs have become
more frequently used among MSM and bisexual men,
especially within HIV-positive patients.
These, commonly called ‘party drugs’ or ‘club drugs’, are
consumed in club or house parties, and are often used during
sex, which can last for several days. They consist of a mix of
agents such as methylenedioxymethamphetamine (MDMA),
gamma-hydroxybutyrate (GHB), ketamine, benzodiazepines
(e.g. diazepam) – and of substances that are more specifically
used in a sexualized context: methamphetamine, mephedrone,
poppers and erectile dysfunction agents (EDA).
According to the recently published ASTRA study, of 2248 HIV
MSM surveyed for HIV-related, socio-demographic and lifestyle
factors, half of the individuals (1138, 50.6%) reported use of
recreational drugs in the previous three months. About a
quarter of them reported use of at least three types of drugs
during that time period.
Consumption of party drugs during sexual activity (‘ChemSex’)
in people living with HIV (PLWH) on combination antiretroviral
therapy (cART) poses significant risks for the acquisition of
sexually transmitted infections (STIs), and has recently
dramatically contributed to the expansion of the HIV epidemic.
CITATION; D Stuart et al. ChemSex: data on recreational drug use and sexual behavior in men who have sex with men (MSM) from a busy sexual health clinic in London, UK. 15th European AIDS Conference, Barcelona, abstract BPD2/8, 2015.