There are many layers that surround and make up the growing phenomenon of chemsex parties . The outer layer, the one that tells us about endless sessions of sex and drugs, is so strident that it overshadows the bottom of the problem and we run the risk of remaining on the surface.
But, not much deeper, we will find a network of factors – from HIV stigma to internalized homophobia – that explain why this practice has become a public health problem.
The term, of British origin, arises from the union between the words chem and sex , that is, drugs and sex. Nothing new if one takes into account that, since classical Greece, there are references to the use of psychoactive substances in a sexual context.
But chemsex has a characteristic pattern of consumption, both in the type of substances and in the user profile and in the development of sexual encounters, which links it to risky practices that favor a greater probability of transmission of HIV and other infections of sexual transmission (STI), as well as to different psycho-emotional problems and complications for the health.
Methamphetamine, mephedrone, poppers or GHB / GBL are among the most consumed in thechemsex , but also ecstasy, ketamine or cocaine, all enhancers of disinhibition and reduce the perception of risk.
The user profile, mainly that of gay, bisexual men and other men who have sex with men (grouped under the abbreviation GBO), is especially vulnerable to the risks and damages associated with their practice. Another factor that adds to the problem is the proliferation of mobile applications that are used both to search for sexual partners and to buy and sell substances, which favors its viralization as leisure behavior.
All this emerges in a type of sexual parties – usually in groups, but also in threesomes, in pairs … – that can last for days and in which everything that has to do with prevention and care of the Health.
Experts speak of a challenge of yet unknown proportions. “It is known that chemsex is predominantly urban, more frequent in Madrid and Barcelona, as well as in popular tourist destinations among gays such as Torremolinos, Sitges, Ibiza or Valencia,” explains Jorge Garrido, director of Apoyo Positivo, an association dedicated to promoting and health care and highly focused on HIV and other STIs.
But it is very difficult to know its true magnitude because it moves in the clandestine circuits of illegal substances and in the opacity of applications with geolocation. To obtain an approximation there is no other than to pull surveys.
The most recent, EMIS-2017 (European online surveyamong men who have sex with men, and in which 10,652 residents of Spain participated) reveals that, of those who had had sex in the previous 12 months, 14.1% had practiced chemsex in that period, and 7, 6% in the last four weeks. The rate rose in some subgroups, such as men with HIV or those who received or paid in exchange for sex.
It is the photograph of a cliché. But radiography tells us about both visible and invisible causes behind the phenomenon. “The applications provide immediacy, availability and accessibility to couples and drugs, but they are not the cause”, Garrido points out. It was the associations, he recalls, the first to realize the turn that sex and drug revelries were experiencing.
“As we were seeing how the sexualized use of these substances, which was previously specific, ended up becoming a culture of leisure, and how it was permeating within the gay, bisexual and men who have sex with men community, we wanted to understand by what was expanding ”.
“We detected a significantly high number of patients with a history of abuse, harassment due to their desire orientation or sexual identity”, explains Jorge Garrido from Apoyo Positivo
It is then that they see that behind there is a network of emotional and mental health problems.
“It caught our attention that it was not, in principle, conflicting profiles: they were middle-aged young people, between 30 and 40 years old, with a certain level of education … They were not groups at risk of social exclusion,” Garrido details. It was about seeing what led them to enter that spiral of self-destructive consumption.
“By doing a more in-depth intervention, we detected emotional mismanagement. We find a significantly high number of patients with a history of abuse, harassment due to their desire orientation or their sexual identity ”. And phobias also appear:
“We live a toxic masculinity, a consequence of which we find internalized homophobia in the GBOs themselves and, in those infected with HIV, a latent serophobia. There are unmanaged trauma, a non-acceptance of sexuality. The culture of rejection towards what may seem feminine is established, the pen is condemned ”.
This is Garrido of self-destruction. As a specialist in infectious diseases, Dr. Pablo Ryan, from the Infanta Leonor University Hospital (Madrid), sees the clinical consequences of chemsex on a daily basis . “We are encountering more and more STIs and STDs, mainly due to the diminished perception of risk. Drugs give a feeling of euphoria and invulnerability ”.
At the same time, he points out, there is the paradox that the control of HIV infection provided by antiretroviral treatments has led to a relaxation of precautions: “The treatments work very well and patients know that they do not transmit the virus; Furthermore, chemsex usersThose who do not have HIV have PrEP (Pre-Exposure Prophylaxis) available to them, so they know that they will not become infected.
Thus, prevention and protection are reduced, and the condom is practically not used, ”explains Ryan. The consequence is a huge increase in other sexually transmitted diseases, such as gonorrhea or syphilis. “It also doesn’t help that some of these drugs are taken parenterally [that is, non-digestive, such as intravenous]. It is called slamsex , which further favors the transmission of infections ”, he adds.