Chemsex Training: Substance Use and Sexual Activity Among Gay Men and Men Who Have Sex with Men (MSM)
This training module from the Australian context provides an introduction to working with MSM who PnP, covering the history of PnP, key terminology and important considerations for service providers working in the substance use sector. Although, in this module, the term chemsex is used as an alternative to PnP. The module begins by defining chemsex, reviewing relevant terminology and underscoring the importance of recognizing that desires for engaging with service providers regarding chemsex differ for each individual. In connection, the module creates space to reflect on the historical queer sociocultural context which has led to the current context in which chemsex exists.
The next section of the module reviews risks associated with chemsex, including considerations for STBBIs and PrEP use. In addition, geo-social dating/hook-up apps (Grindr, Scruff, etc.) are contextualized as facilitators for connection and chemsex. A unique aspect of this module are the considerations for how unrealistic body standards may create sexual insecurities for MSM, making sober sex challenging for some.
Another unique and important aspect of the module is the section which overviews motivations for chemsex, recognizing intersections with sexual attraction, sexual arousal, sexual sensations, emotional intimacy, sexual confidence, sexual adventurism, sexual longevity and loss of inhibitions. By including these diverse motivations for chemsex, the module attempts to shift away from a deficit’s focus, and instead, describes chemsex as a facilitator for connection, sensation and adventure. The latter section of the module focuses on practical considerations for service providers. To begin, the module overviews the relevance of internalized homophobia, rejection, discrimination and minority stress for understanding chemsex amongst MSM. Again, a noted strength of this module is its sensitivity to emphasizing the sociocultural context in which chemsex exists, prompting service providers to understand how historical and ongoing marginalization may culminate to barriers to accessing care and support.
The module closes by providing guidelines for discussing chemsex-related risks with clients, such as a risk of paranoia. In relation, basic tenets of harm reduction are introduced, wherein the module emphasizes the importance of regular testing, access to needles and pipes, and the establishment of boundaries. Ultimately, this module serves as a comprehensive introduction to substance use in the queer community and PnP for providers who might be less familiar. As well, the explicit considerations regarding mental health and self-esteem that are present throughout the module are useful for understanding the enmeshment of sexual health, mental health and substance use.
Queensland AIDS Council; Queensland Network of Alcohol and Other Drug Agencies (QNADA). (2019). Chemsex Training: Substance Use and Sexual Activity Among Gay Men and Men Who Have Sex with Men (MSM). QNADA. https://qnada.org.au/wp-content/uploads/sites/2/eLearning/Chemsex/story_html5.html
