Chemsex experiences: pleasures, harms and care
Context and purpose of the presentation
The early 2000s are known for heralding an influx of innovative technologies and practices, such as online dating websites, hook-up Apps, new psychoactive substances (NPS), and private house parties. Parallel to these developments, a marked evolution in sexualised drug use, also known as chemsex, was observed among gay men and other men who have sex with men (MSM). Some individuals participating in chemsex increasingly sought treatment for recurrent infections, drug dependency and related harms (i.e. accidents, overdoses, etc.), as well as for the adverse effects these experiences had on their daily lives.
While a number of chemsex studies focus on these harms, an approach that is integral to public health and to the care of individuals seeking assistance, this view of chemsex is limited. It ignores an individual’s strengths and the pleasures linked to substance use and sex, a key motivation for participating in chemsex. In addition, while a majority of studies provide quantitative data on the association between sexualised drug use, and risky behaviours, much less attention has been paid to individual voices about one’s involvement in chemsex.
Such a limitation in the dominant approach to chemsex limits our understanding of the dynamics of individual practices on the one hand and impedes the development of appropriate strategies to limit the potential harms associated on the other.
Based on in-depth interviews with French MSM involved in chemsex, this presentation aims to stress the perspectives of those actually participating in chemsex and to explore sexualised drug use from a “pleasurable” frame of reference.
Using a comprehensive sociological approach recognizing that participants in chemsex are social actors with their own reasoning and thoughts, the presentation will explore their definitions of pleasure as well as the role of stimulants, sexual activity, smartphones, and partners within the context of chemsex. It will highlight the conflicting dimensions of chemsex experiences that appear simultaneously pleasurable, ambiguous or painful. By doing so, the presentation will emphasize key dimensions at stake for dialogue with individuals involved in chemsex that are especially pertinent for “outsiders” and professionals seeking to assist gay men and other MSM.
The presentation is based on a qualitative study carried out among 40 French MSM engaging in chemsex. Participants were recruited across France using snowball sampling via key informants. Factors such as age, socioeconomic status, urban versus rural residence, current or former participant in chemsex, living with HIV or not, and being in contact with a care provider or not, contributed to the selection of a diverse array of profiles.
Given that the focus of care for MSM implied in chemsex is on risk behaviours, the findings of the study help nurture discussions where pleasure is integrated into a new, value-neutral framework of care that incorporates chemsex pleasures. In fact, welcoming and accepting the pleasures of chemsex are preliminary conditions to developing a dialogue with MSM who engage in sexualised drug use.