20th International AIDS Conference - Melbourne, Australia


WEPE308 - Poster Exhibition

A perfect storm? Modern technological and structural facilitators of drug use during sex among gay men in London

A. Bourne1, D. Reid1, S. Torres Rueda1, F. Hickson1, P. Steinberg2, P. Weatherburn1

1London School of Hygiene & Tropical Medicine, Sigma Research, London, United Kingdom, 2London Borough of Lambeth, London, United Kingdom

Background: While drugs such as ecstasy, cocaine and ketamine have long been a common feature of the gay commercial scene in London, recently published data indicates a shift towards drugs such as mephedrone, GHB/GBL or crystal methamphetamine. These latter drugs are commonly utilised during sex, a practice referred to as “chemsex”, and have been associated with higher HIV transmission risk behaviour. This study explored the personal and social context of chemsex and the facilitators of change regarding both the type and setting of drug use.
Methods: In-depth qualitative interviews were conducted with 30 gay men who reported having used crystal methamphetamine, mephedrone or GHB/GBL during sex in the previous 12 months. They were recruited via commercial advertising across South London. Interviews explored experiences of engaging in chemsex, including motivations and rationales, as well as perceived community norms relating to the practice. Four topic related focus groups were also convened with members of the gay community, clinical, health and social care providers. Data was subjected to an inductive thematic analysis.
Results: In contrast to historically popular drugs, mephedrone and GHB/GBL were perceived as good quality and relatively inexpensive, yet still provide a very intense high. The increased sexual arousal that they generate, in combination with their low cost, facilitates sexual sessions with large numbers of men that can be sustained over long periods of time. Community norms relating to the acceptability of these drugs in sexual settings appear to be evolving in tandem with technological change. Location-based, sexual networking applications for mobile phones have made drug use more visible and have facilitated rapid, local, connection for chemsex. Relaxed licensing of clubs and saunas where sex occurs has also facilitated round-the-clock access to drugs within environments where high sexual-partner turnover is commonplace.
Conclusions: Cheap, visible, and seemingly highly accessible, there is a well-documented association between chemsex drugs and physical, mental and sexual-health related harms. Interventions seeking to manage chemsex related harms should engage with both online and physical commercial gay spaces and attend to reducing harm that some men experience, but also challenge perceived community norms about chemsex that may be emerging.

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