Don’t cure, but care': affirmative intervention amongst men of sexual and gender diversity in the context of chemsex

The use of psychoactive substances within a sexual context (chemsex), in particular methamphetamine, by men of sexual and gender diversity (SGD), can generate needs for substance use services. However, these are not adapted to their realities. The purpose of this presentation is to identify the support this population needs, as well as to identify principles for affirmative intervention in the context of chemsex.

Semi-structured interviews were conducted within Québec with 21 professionals working within substance use resources, in addition to 29 men of SGD who have had or still having chemsex pratices. A thematic analysis was carried out.

Three different levels of needs were identified: individual, community, and intervention. Self-authenticity in relation to one’s reality has been identified as the main individual need. A community need concerns the desire to belong to a specific group with whom one may share common experiences and relate them. As for the intervention, openness and positive reception as it relates to sexuality and substance use is named as an essential need.

To meet their needs within an affirmative practice, four principles must be observed: adopting a posture of openness and welcoming experiences in matters of substance use and sexuality, being mindful of the impacts of homophobia and transphobia on the use of psychoactive substances, maintaining an intersectional perspective; and ensuring that interventions are performed in proximity to their environment, ensuring safety within the context of chemsex, with an emphasis on harm reduction.

We propose different avenues to promote the implementation of affirmative intervention in relation to chemsex. Maintaining well-versed knowledge on the sexuality of SGD men, their consumption and chemsex is essential, but insufficient. Substance use services must develop links with the chemsex community, with an emphasis on harm reduction, re/establishing the confidence between men practicing in chemsex and service providers.