For several years, chemsex has been on the radar of public health agencies in the UK and around the world.
While chemsex itself is nothing new, more modern iterations of the practice have given rise to certain behaviours that can put participants at risk.
But what are these behaviours, and why should you know about chemsex?
Keep reading to find out.
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Chemsex is a fairly new term used to describe a fairly old practice: having sex while taking drugs. However, chemsex describes, specifically, sexual activity between men who have sex with men using particular drugs in a group sex setting. Most often, these men will not have engaged in sex until these drugs have been taken. “Chemsex” can sometimes go by the term “party and play” (PnP). Medically, it’s referred to as “sexualised drug use” since the activity can be very addictive.
The drugs used during chemsex, like crystalised methamphetamine and mephedrone, are meant to facilitate and enhance sexual activities, lasting several hours or sometimes days and involving multiple sexual partners. The drugs used are often physiological stimulants, increasing heart rate and blood pressure, as well as triggering euphoria and sexual arousal, and often lowering inhibitions. These drugs are most often snorted or smoked, but they can also be injected.
People who engage in chemsex report a more intense sexual experience because the drugs allow them to overcome inhibitions such as lack of confidence and self-esteem, homophobia, stigma about their HIV status, increased stamina and pleasure, and sustained arousal.
The aftereffects of chemsex can also be quite harsh. Unwanted side effects can include agitation, anxiety, paranoia, aggression, and even bouts of psychosis. Chemsex users often describe losing entire days or not sleeping or eating for long periods, which can all negatively affect their overall health.
STIs are infections that most people get through sexual activity, which can include vaginal sex, anal sex, oral sex, and sharing sex toys.
The vast majority of STIs are contracted through unprotected sex. Without barrier contraception being used, pathogens can transmit easily from one person to another during the sexual act.
You can also get STIs in other ways, like foreplay and sharing needles when injecting drugs.
Chemsex has been implicated as an important potential risk factor for STIs.
The drugs used during chemsex are linked to a higher number of sexual partners and higher levels of high-risk sexual behaviours. This alone is the main explanation for the staggeringly high numbers of cases of Gonorrhoea, Chlamydia, Syphilis, and Mycoplasma we see in men having chemsex.
Additionally, chemsex practices have also been linked to physical trauma during sexual activity, which provides further opportunities for STI transmission. We see more “Super Chlamydia” (lymphogranuloma venereum) in this setting. These risks can be elevated when the needles used to inject these drugs are shared, increasing the risk of transmission of certain infections, like HIV and Hepatitis C.
Moreover, coexisting STIs may facilitate the acquisition of other STIs, including HIV. Having STIs like Herpes, Syphilis, Chlamydia, Gonorrhoea, and Mycoplasma may increase a person’s susceptibility to HIV infection.
While the use of drugs during sex will not directly cause someone to get an STI, chemsex tends to take place in a context and amid social and sexual dynamics that make the transmission of STIs extremely likely.
It’s important to remember that all sexual activity carries a certain amount of risk. The best way to protect yourself and your sexual health is to consistently use barrier methods of contraception like condoms, female condoms, and dental dams.
The next best way is to get tested for STIs regularly if you are sexually active, especially after you begin a new sexual relationship with a new partner or multiple partners.
If you enjoy chemsex then it’s always best to be upfront and direct with your healthcare providers and test for STIs more often than other people. This way, you can get treated and help reduce the high numbers of STIs seen in chemsex.
If you think you’re experiencing an addiction to chemsex, your doctor can arrange for you to see a specialist team to help you reduce activity or stop altogether, if that is what you need.
If you have any concerns about your sexual health, it’s always Better2Know by getting tested.
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This article has been medically reviewed by Dr. Steve Chapman, 22/01/2025.