This week's Public Health England (PHE) sexually transmitted infection (STI) figures reported large increases in infections in gay men, including a 46% increase in syphilis and a 32% increase in gonorrhoea. Better detection of gonorrhoea has been cited *high fives London sexual health services* as a potential factor but it's not the whole picture. One contributing factor associated with higher STI rates is chemsex which has affected certain parts of London's gay community. London's Club Drug Clinic sees a higher proportion of gay men than the main drug treatment system (which tends to be opiate users).
What is chemsex?
Chemsex is commonly understood as sex that occurs under the influence of drugs taken immediately preceding and/or during the sexual session – which often happen at organised parties and ‘chill outs’. Drugs of choice vary, but ‘Tina’ (crystal methamphetamine), ‘Gina’ GBH/L, mephedrone, cocaine and ketamine are popular.
Chemsex has become more prevalent for a number of reasons – some of the drugs' effects lower inhibition, increase stimulation and decrease pain or discomfort that can sometimes be experienced during sex (especially prolonged sessions). With this, however, come potential hazards in terms of STIs that can be contracted and the physical and emotional wellbeing of the people participating.
What are the risks?
Lowered inhibition can mean someone who usually takes a preventative approach to sexual health forgets, or decides not, to use a condom. Moreover, they might even forget they haven't used a condom as a result of the drug use. Sometimes, the chemsex party can be a big drain on a person's physical resources, and, in an extended recovery period they could miss the 3 day window to get to the clinic for PEP treatment. If you have been exposed to HIV, PEP (post exposure prophylaxis) can reduce your chances of developing the virus. It's not a guaranteed though, so avoiding the need to use this treatment by practicing safe sex is the safer bet.
Chemsex can be used as a way to avoid feelings around intimacy or a way of escaping other personal issues. Long term use of drugs to avoid feelings can lead to dependency and physical ill health. There are a number of London-based services for anyone who is LGBT who would like to talk to someone, London Friend is a good starting place, THT and London Lesbian and Gay Switchboard could also help.
How can SH:24 help?
In terms of what SH:24 does - if you've slept with someone in the previous 3 days and think you're at risk we advise you to go straight to a clinic - our site will signpost you to local services who can help. We do this at two points on our site; at the self-selecting 'is this test for me' decision tree and also within our order form. It's really important to us you get the right support at the right time. If, however, you don’t think you are at immediate risk but would like a check-up you can get tested for Chlamydia, Gonorrhoea, Syphilis & HIV at SH:24.
16% of people who order a test from SH:24 identify as men who have sex with other men – this is slightly lower than in clinics and we expected gay men to be early adopters of the service. Having spoken with LGBT community members at a recent event at the Eagle, we understood that some people have established testing practices with services they trust, which is good news (although if you are a gay man in Lambeth and Southwark try out our service – is very convenient and speedy!). We know there's still a significant number of gay men that don't access services and there is undoubtedly a role for SH:24 in improving access for all at risk groups in Lambeth and Southwark. We will continue to build trust through outreach, communication and word-of-mouth proof of the service. Feedback to-date has been very positive.
We'll be joining Saturday's Pride March and have a stall at Pride in the Park this weekend so do say hello (we'll have condoms!).
Further information and support
Get an objective view on your drug use: http://drugsmeter.com/