In recognition that emerging drug subcultures such as PnP require novel approaches, this article sought to describe best practices for introducing harm reduction in primary care settings. The article centres around the UK context, but is directed toward all service providers working men who have sex with men (MSM) who PnP, and most especially, general practitioners. The researchers highlight the relationships between PnP and MSM sexual health and HIV management, underscoring the importance of a harm reduction approach for working alongside MSM who PnP. As well, the authors note that MSM who PnP might not feel that traditional drug services are an appropriate for them, and as a result, may be more likely to present to general practice. Accordingly, it is vital that service providers recognize their role in working alongside MSM who PnP.

It is commonplace in general practice for practitioners to ask questions about sexual history to make a risk assessment for sexually transmitted infections (STIs) and HIV, and to inquire about alcohol and drug use. Thus, the researchers highlight that inquiring about drug use during sex would not be far off typical practice. As well, asking about drug use during sex presents an opportunity for service providers to engage in secondary prevention, asking about sexual assault, overdose, and prevalence of STIs. By doing so, service providers can garner a better understanding of use and the appropriateness of referral to drug services for harm minimization.  

Ultimately, this article highlights the simplicity of integrating inquiries about PnP into regular discussions with MSM accessing healthcare and social services. Upon doing so, providers can better understand their client’s situation, and in turn, best meet their needs and/or refer them to tailored resources if necessary. See the link below to learn more about harm reduction from the lens of Dr. Jeffrey Hom, a health equity and social justice advocate seeking to improve treatment access and experiences for underserved communities. 

Ma, R., & Perera, S. (2016). Safer ‘chemsex’: GPs’ role in harm reduction for emerging forms of recreational drug use. British Journal of General Practice, 66(642), 4-5. https://doi.org/10.3399/bjgp16X683029