Chemsex and Harm Reduction: A Practical Guide for Gay, Bisexual, and MSM

Chemsex has become a buzzword in conversations about sexual health, particularly within the gay, bisexual, and MSM (men who have sex with men) communities. Let’s unpack what it is, why it matters, and how to navigate it safely through harm reduction strategies.

Sexualized Drug Use (SDU) refers to any use of drugs or intoxicants used within a sexual context, such as going out and having a drink, then having sex with someone afterwards. But chemsex is more specific.

What is Chemsex?

Chemsex refers to the intentional use of certain drugs to specifically enhance or prolong sexual experiences. It often involves:

Specific Drugs: Common substances include crystal meth (Tina), GHB/GBL (Liquid G), and methcathinone (Cat).

Casual Sexual Partners & Group Sex: Sessions often involve multiple sexual partners and can last hours or even days.

Tech-Driven Encounters: Dating apps and hookup platforms play a significant role in facilitating chemsex meet-ups.

Why It Matters

Chemsex can enhance and extend pleasure, but it also carries risks. Understanding it helps reduce harm and stigma for those who participate.

Harm Reduction: Meeting People Where They Are

Harm reduction is about offering practical, non-judgmental support and strategies to reduce the harms associated with substance use and is recommended by the World Health Organization. It acknowledges that people will engage in chemsex and SDU, and focuses on minimising risks. 

Chemsex participants often face barriers to healthcare due to stigma, so it’s important to offer judgment-free support and care which encourages people to seek help when needed.

Common Chemsex Drugs and Their Effects

Crystal Meth (Tina, Tik): A stimulant that boosts energy and arousal for prolonged periods.
GHB/GBL (Liquid G): A depressant that lowers inhibitions and induces euphoria.
Methcathinone (Cat): A stimulant that increases sexual desire and intensity.
Others: Cocaine, ketamine, MDMA, alcohol, poppers, and erectile dysfunction drugs often complement primary chems.

How Drugs Are Used and Their Risks

Injecting (Slamming): High risk of infections (HIV, Hepatitis C), abscesses, incorrect injecting, missed veins/vein collapse and overdose.
Smoking: Can damage the lungs and increase overdose risk, especially when more than one drug is smoked together.
Snorting: Can harm nasal passages and transmit infections.
Booty Bumping: Involves rectal administration, which can cause tissue damage and increase infection risk.
Swallowing: Swallowing pills, drugs or liquid like G can lead to overdose.

Harm Reduction Tips for Safer Chemsex

Injecting:

• Use clean needles and avoid sharing equipment.
• Never inject alone.
• Rotate and opt for less-risky areas like arms. Never inject in high risk sites like the neck, wrist, top of foot or worst area being groin area.

Smoking:

• Use clean pipes or bongs.
• Avoid sharing and take breaks between hits.

Snorting:

• Use personal snorting devices. Use clean snorting equip like plastic straws as opposed to cash notes or nails.
• Switch nostrils to minimize damage.
• Rinse nostrils after snorting to prevent bumps/particles from corroding the septum and nostril tissue.

Booty Bumping:

• Use clean equipment and adequate lubrication.
• Avoid sharing syringes.

Eat, Hydrate and Rest:

• Remember to eat, hydrate and rest after chemsex sessions to allow for the body to regulate and return to “normal”. Works well for any drug or intake method and often makes the biggest difference between substance-use management and “mismanagement”.

Your Sexual Health

Chemsex can lead to activities that could increase the risk of HIV and STIs. Here’s what you can do:

• Test regularly for HIV and STIs to know your status (3 – 6 months depending on your sexual activity).
• If you are living with HIV, stay on consistent ARV treatment so that you can become undetectable and no longer pass on the virus (known as U=U: Undetectable = Untransmittable).
• If you are HIV negative, get PrEP, the free daily HIV prevention pill that is widely available.
• Keep condoms and water-based lube with you when engaging in chemsex as they remain effective at preventing both HIV and STIs

Drug Interactions and Overdose Risks

GHB + Alcohol: Both are depressants and can cause dangerous respiratory depression or overdose.

Poppers + Viagra: Can lead to a sudden and dangerous drop in blood pressure.

Smart Dosing Tip: Always start with small dose and wait for the effects of a dose to kick in before using more.

When Chemsex Becomes Problematic

While some people engage in chemsex without issue, others may experience:

• Physical Health Risks: Infections, overdose, and bodily damage from unsafe practices.
• Mental Health Risks: Anxiety, paranoia, depression, drug-induced psychosis and addiction.

Where to Get Information and Support

1. HarmLess AI ChatBot & Support Line

A FREE 24/7, anonymous AI WhatsApp service for judgement-free advice on SDU and chemsex substance side effects and interactions, safer drug use and health. WhatsApp: 087 250 2762
A FREE helpline and WhatsApp service with human support during weekdays (08.30 – 16.30). Call or WhatsApp: 060 985 5443

2. Engage Men’s Health You in Mind” Counselling

FREE in-person or online individual or couples counselling specifically for gay, bi and other men who have sex with men. Reach out to book a session:
• Rosebank (Johannesburg): 067 597 2565
• Braamfontein (Johannesburg): 077 601 8069
• Gqeberha: 077 601 8070
• East London: 077 601 8071

3. Engage Men’s Health Free Sexual Health Services

Engage Men’s Health provides free HIV, STI and other sexual health services (including PrEP, PEP and ART) to gay, bisexual and other men who have sex with men (MSM) in Johannesburg, Pretoria, Nelson Mandela Bay and Buffalo City. Call or WhatsApp: 082 607 1686 (Referrals to services in other areas can also be provided.)

4. SANCA (National Council on Alcoholism and Drug Dependence)

Specialised and affordable prevention and treatment services for alcohol and other drug dependence. Head office: 011 892 3829 | WhatsApp 076 535 170 | email: sancanational@telkomsa.net | For details of Sanca facilities around the country, visit: www.sancanational.info

5. Department of Social Development Substance Abuse Line

24hr helpline Substance Abuse Line 24hr helpline. Call: 0800 12 13 14 or SMS 32312

Chemsex can be a complex topic, but harm reduction offers a compassionate way to minimize risks and support well-being. If you or someone you know engages in chemsex, know that help and resources are available. Stay safe, stay informed, and reach out for support when needed.

 

Article courtesy of Engage Men’s Health, which offers free PrEP, ARVs, HIV management and other friendly and confidential sexual health services in Joburg, NMB, and Buffalo City for gay, bi, and other men who have sex with men. For more info or to make an appointment visit www.engagemenshealth.org.za or call/WhatsApp 082 607 1686 now!