A position paper from organisers and participants of the 2nd European Chemsex Forum, Berlin 22-24 March 2018

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A call to action for effective responses to problematic chemsex

A position paper from organisers and participants of the 2nd European Chemsex Forum

Berlin, 22-24 March 2018

“It is time to work together to find solutions to the chemsex crisis. We all have a duty to repair and an ethical responsibility to work towards change. We will provide our experience and passion, our knowledge, resources and cooperation. People impacted by and responding to chemsex need commitment, respect, funding and support.” 1,2

The 2nd European Chemsex Forum brought together 230 chemsex responders from 32 countries across Europe, Central Asia and the Caucasus regions for 3 days. They included people who engage in chemsex, community organisers, researchers, HIV and hepatitis clinicians, therapists, social workers, colleagues and friends. Our purpose was to quicken, expand and improve responses to chemsex harms across Europe. These harms include threats to the health, wellbeing, lives and legacies of people in our communities and cities.

The Forum report presents the event activities and the evaluation is available here.

This position paper responds to issues that were discussed during the Forum, in the formal participant feedback survey and subsequent discussions amongst several Forum participants. As much as possible, we have kept our colleagues’ comments intact. These are our own words…

1. After the 2^nd European Chemsex Forum, the Forum secretariat send a survey to participants: “What are, for you, the most important messages about problematic chemsex, sexual health or harm reduction? What are your most important learnings from the Forum?” All quotes in this document and much of the text are developed from that survey and subsequent dialogues with chemsex responders.

2. This position paper was developed by the Forum secretariat with Stephen Pelton as the lead writer. Page 15 lists those people who reviewed and commented on the position paper as it progressed.  Thank to All your efforts.  If you and/or your organisation would like to add your signature to this position paper please sign here.

 The European Chemsex Forum is a project, initiated by David Stuart and Ben Collins, and administrated by the Forum secretariat, including Reshape and International HIV Partnerships (IHP) with the generous participation of chemsex responders around the world.

 Thank you to our funders: AIDES, Gilead, MSD and ViiV.

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Gay men are no strangers to drugs. Many gay men use substances to improve, spice up or intensify their sex lives. Alcohol and drugs have been good fun, social lubricants and part of people’s coping strategies for generations of LGBTQ+ people. Bars, pubs and clubs and the alcohol and drugs consumed there have been a part of LGBTQ+ society since its inception. Yet, it is essential to state as we begin this paper, that alcohol and drug (substance) use amongst LGBTQ+ far exceeds the average–in response to and resulting from stigma, self-stigma, discrimination and other factors.

We think it’s important to acknowledge that problematic substance use is an issue demanding focussed attention in its own right. However, grouping together all MSM, LGBTQ+, or all people, who are having issues with substance use, while possibly meaning to provide a feeling of inclusion, does a disservice to the unique needs of each individual and/or population.

This paper states our views specific to chemsex and the gay environments from which it has arisen. We hope our paper leads to better understanding of chemsex  and sexualised substance use in the context of LGBTQ+ communities.

The authors of this paper strongly ascribe to the notion of “the best sex with the least harm”. 3, We believe a holistic sexual health approach should be encouraged in order to enjoy one’s sex life with the least physical and psychological cost.

3. Bourne A, Hammond, G, Hickson F, et al. What constitutes the best sex life for gay and bisexual men? Implications for HIV prevention. BMC Public Health201313:1083

Not all sexualised substance use is chemsex.

Chemsex is a particular type of sexualised substance practice amongst gay and bisexual men, other men who have sex with men (MSM), and trans and non-binary people who participate in gay “hook-up culture”,4. Chemsex connects uniquely to gay sex, in the context of how the enjoyment of gay sex has been affected by:

• Societal attitudes toward LGBTQ+ people and gay sex
• The trauma the HIV/AIDS epidemic has had on LGBTQ+ people and on gay sex
• Chronic bullying of LGBTQ+ people
• Both explicit and more covert peer pressure amongst gay men
• The importance of shared ritualised activities in a stigmatised group
• Community tensions about masc/fem behaviours (or self-identities) particularly in regard to the enjoyment of sex and sexual fantasies
• Gay hook-up technologies and saunas
• The widespread availability of chems to gay men and trans and non-binary people via gay hook-up apps
• The reality that MSM, trans and non-binary people engaging in chemsex, can also be sexworkers, racial and ethnic minorities, migrants and/or prisoners. They may also have mental health diagnoses, other addictive disorders, disabilities, be living with HIV and/or HCV, or out of the workforce.
• The current trauma of so many lost gay men, trans and non-binary people as a result of chemsex.

In chemsex, different classes of substances are combined with sex to varying effects. Powerful stimulants like crystal methamphetamine and mephedrone, other stimulants like cocaine, and more recently other cathinones, are used by gay men and trans and non-binary people in the context of gay hook-up culture. Use of these stimulants (plus sildenafil) can result in long sex sessions with greatly increased high-risk sexual behaviour.

GHB/GBL is a depressant also commonly associated with chemsex. GHB/GBL is often used to ‘get into the mood’ before or to ‘mellow out’ after the speedy charge of crystal meth and other stimulants.

The power of the experience, the intensity and addictiveness of these particular substances, and the complexity of the emotional and social factors involved, can lead to problematic conditions and behaviours.

“Surely gay culture is not just something depressing? It’s also about self-discovery, adventure, relating to a group of peers, have meaningful relations, reaching out to others in order to lift each other up and having all sorts of primal instincts satisfied.”


4.A hookup culture is one that accepts and encourages casual sexual encounters, including one-night stands and other related activity, without necessarily including emotional bonding or long-term commitment.  https://en.wikipedia.org/wiki/Hookup_culture#CITEREFFreitas2013

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