After talking for some hours with this guy, the one with the “candy”- emoji (🍬) in his profile, we decided to see each other at his house to play some video games. With the talk, the euphoria of the gameplay, and the chemistry, things began to flow. Our lips were getting closed, our hands were discovering each other, when suddenly he took out a glass pipe and began to smoke from it, asking me if I wanted some of his “candies” … That was my first contact with what is more commonly known as “Chemsex”.

Chemsex  is the consensual and deliberate use of psychoactive drugs, such as methamphetamine and γ-hydroxybutyrate (GHB)/γ-butyrolactone (GBL), to increase sensitivity, delay orgasms, and reduce inhibitions during sex. This, however, brings with it risks to the mental and physical health of the user. The drugs may reduce inhibition, but they also may encourage an increase in the number of sexual partners, and lead to other high-risk sexual behaviours, putting the user at an increased risk of exposure to STIs. Non-consensual sex (rape, to be clear) is another risk. Alteration in the pain threshold may lead to physical injuries to the body. Users of methamphetamine and GHB/GBL reported exposure to injecting drugs, which increases the risk of HIV and hepatitis C.  In Sweden, 20% of the new cases of HIV have a story which can be traced back to Chemsex. The use of psychoactive substance, and high-risk sexual behaviours may also impact mental health including the risk of drug dependency.

Chemsex is thus a multi-layered concern that involves sexual, mental, and societal health. Risks have increased through easier access to illicit drugs via the internet, and dating apps have also made “access” to Chemsex easier. The objective here is not to stigmatize users of Chemsex nor to satanize these apps, but to offer some suggestions and mechanisms to reduce harm, now that Chemsex grows in popularity (mainly among gay and other men who have sex with men). Stigma can be reduced, for example, by creating a (safe) space to discuss the topic within and outside the healthcare sector. Online and offline spaces can be created to provide information and support to users as needed. Digital tools such as the ChemsexBudd App, a harm reducing app for people who engage in Chemsex, help users to be more aware of the risks related to chemsex, guiding and supporting them both during and after (Chemsex) parties. Other options are educational workshops, and toolkits that provide an overview of Chemsex and related guidelines for harm reduction organizations and syringe services programs. 

There may also lie an opportunity for the broader reproductive and sexual health rights agenda to include within its scope of work, emerging trends such as the use of drugs through Chemsex. Multidisciplinary strategies to improve reproductive and sexual health can be used to foster access to support groups for sexual and gender minorities, to reduce stigma towards the users and communities affected, and to ban use of specific drugs.

In sum, Chemsex is an increasing public health concern which needs to be addressed. The potential impact of Chemsex can be mitigated through increasing awareness on the risks of Chemsex, both for individuals and society, and creating multidisciplinary harm reduction strategies to limit exposure to these risks through the increased awareness of users and (better) access to support services.

Acknowledgement: many thanks to Radhika Arora for providing editorial support.