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

Signatories

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Marcelo Alves

Magdalena Bartnik

PREKURSOR Foundation for Social Policy

Massimo Cernuschi

ASA Associazione Solidarietà AIDS - Milan, Italy

Competency Group on Sexual and Gender Diversity

Austrian Public Health Association

Nia Dunbar

ReShape and International Partnerships (IHP)

Ymke Evers

Public Health Service South Limburg

Anne Glew

The Brunswick Centre

Benjamin Hampel

Checkpoint Zürich and University of Zürich

Toni Hogg

London Friend

Simon Kovacic

DrogArt

Tomasz Małkuszewski

Social AIDS Committee

Sini Pasanen

Positiiviset, Hiv-Finland

Roger Pebody

Christel Protiere

INSERM

Dirk Sander

Deutsche Aidshilfe e.V.

Adam Schultz

chemsex responder

Adam Shanley

HIV Ireland

Miran Solinc

SKUC

Zoe Swithenbank

Liverpool John Moores university

Alexander Tanaskidis

MUN PLANET MEDIA Platform | UNITED NATIONS

Magdalena Ankiersztejn-Bartczak

CEO of Foundation for Social Education

Sladjana Baros

Researcher

Sophocles Chanos

Positive Voice (Greek Association PLWHA)- Ath Checkpoint

Giulio Maria Corbelli

Plus onlus

David Fawcett

Healing Path

Jan Groszer

Robert Hejzak

Czech AIDS Help

Zoe Kakota

AIDS Solidarity Movement - Cy Checkpoint - Cyprus

Leon Knoops

Mainline

Maxime Maes

UTSOPI (Belgium); ICRSE (UE)

Igor Medvid

HPLGBT

Monty Moncrieff MBE, CEO

London Friend

Marco Patti

High & Healthy - H&H UK

Sjef Pelsser

Mainline

Red Ribbon Istanbul

Turkey

Dr. Kiran Santlal

HSE-National Drug Treatment Centre

Kevin Singh

PhD Researcher, University of Amsterdam

Oli Stevens

Imperial College London

Christopher Tearno

HIV treatment center Haagland Medical Center/Chemsex Responder

Conor Toomey

Schwulenberatung Berlin

Arnd Bächler

Schwulenberatung Berlin

Sylvie Beaumont

Consultant at ReShape and International Partnerships (IHP)

Andrii Chernyshev

ALLIANCE.GLOBAL, Public Organization

Filipe Couto Gomes

Chemsex responder - Lisbon (PT)

Stu Fenton

Urs Gamsavar

Deutsche Aidshilfe e.V.

Rachel Halford

The Hepatitis C Trust

Juanse Hernández

Grupo de Trabajo sobre Tratamientos del VIH (gTt-VIH)

Stephen Karon

CHEMSafe

Lukasz Lapinski

Wroclaw Healthcare Center; Wroclaw Medical University

Irena Molnar

Re Generation

Giorgos Papadopetrakis

Positive Voice - Greece

Stephen Pelton

ReShape and International Partnerships (IHP)

Dinah de Riguet Bons

Daniel Santos

Mental and Sexual Health Activist

Sebastjan Sitar

LEGEBITRA

Miloš Stojiljković Rolović and JAZAS team

Association against AIDS - JAZAS, Serbia

Bryan Teixeira

Freelancer and HIV activist

Martin Viehweger

activist for sexual health, Berlin/Zürich

Peter Bampton

LGBT Foundation

Fred Bladou

AIDES

Ben Collins

ReShape and International Partnerships (IHP)

Viken Darakjian

Anna Dichtl

Frankfurt University of Applied Sciences

Jorge Garrido and the entire team of SEX, DRUGS and YOU

Apoyo Positivo, Madrid and Malaga, Spain

Ford Hickson, PhD

Sigma Research, LSHTM

Bernard Kelly

HIV Team Lead, Courtyard Clinic

Andrés Lekanger

Chemfriendly

Joe Lillie

chemsex survivor hep c/hiv volunteer

Niall Mulligan

HIV Ireland

Mark Pakianathan

Michał Pawlęga

MSM health lead

Tom Platteau

Institute of Tropical Medicine Antwep

Gennady Roschupkin

Axel Jeremias Schmidt

MD, Sigma Research, London School of Hygiene & Tropical Medicine; STI services at Cantonal Hospital St Gallen, Switzerland

Jernej Skof

SKUC Magnus

David Stuart

Gerrit Jan Wielinga

COC Nederland

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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

Introduction

“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 2nd 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.

Logo Deign: no.star

Sex and Drugs and Our Health
“It is of utmost importance that we have hope and understanding and always maintain a positive attitude towards sex. It is often the lack of these that leads to finding sober sex difficult, encouraging the use of substances in the first place.”

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

Chemsex

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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