You may not be familiar with chemsex, but if you have been on a hookup app recently you will have come across similar terminology. "Chemsex" is the blunt, British way of describing "party 'n' play" or "high and horny" -- the use of drugs to facilitate sex between men, either one-on-one or in a group.
Drugs in sexual settings are not new in the gay scene, but in Britain the latest combination has earned chemsex some notoriety. It was the subject of a Vice documentary, and was recently dramatized in the BBC thriller London Spy, starring Ben Whishaw. A dedicated sexual-health unit has been set up in London, where a chemsex subculture is concentrated. The British medical journal BMJ has said that chemsex "needs to become a public health priority."
The use of sex apps to hook up while high isn't different in the United Kingdom from elsewhere. What is different is the combination of drugs: crystal meth, mephedrone, and GHB. Mephedrone, nicknamed "meow meow," is a cheap, illegal stimulant not widely available in the United States. Like crystal meth, it can raise the heart rate and blood pressure, induce feelings of euphoria, and make you very sexually aroused. GHB, or G, ramps that up.
The results, according to some chemsex drug users, are explosive. "Their ejaculations were much more intense -- they said everything about sex felt better," reports Dr. Adam Bourne, of the London School of Hygiene and Tropical Medicine, who interviewed chemsex participants for the foremost published research on the subject in the U.K. The stimulant drugs also keep you awake, so that sex sessions last hours or even days. "That means you are able to have more sex, and sex with more people," says Bourne.
These elements have created risks. The drugs are relatively new to the U.K., and users sometimes don't know how to handle them. There have been multiple deaths in London sex venues from GHB overdoses (the drug should be taken in tiny doses). "Slamming," a euphemism for injecting, has also raised concerns about the transmission of blood-borne viruses from sharing needles. Barebacking is another issue, as is the greater risk of STIs from an increased number of partners. Users have reported feeling paranoid or psychotic, and voiced concerns about "losing days" to chemsex parties.
The number of men using chemsex drugs compared to other substances such as alcohol is relatively low. In Bourne's study, concentrated in three South London boroughs with a higher density of gay men than elsewhere in the U.K., of the men who had sex with men 93.1% reported alcohol use in the previous four weeks compared to 18% who had used cocaine and 4.9% who reported crystal meth use in the same period. Still, some 3,000 gay men using "chems" access sexual-health support each month at 56 Dean Street, a national government-run clinic. The clinic diagnoses 40 to 60 gay men with HIV each month; it also dispenses close to 1,000 courses of PEP each month, according to David Stuart, manager of the clinic's chemsex-specific unit. "It would be a safe estimate to say that over half of these are chemsex-related," Stuart said in an email. "As a public health issue, that is undoubtedly a worrying problem." Those numbers lack context because wider data isn't available, and the story is not as straightforward as simply untrammeled risk-taking. HIV and STIs are on the rise in the U.K., but a causal link with chemsex has not been established. At least half the men on the scene are HIV-positive, and there is strong evidence of sero sorting, whereby sexual partners pick one another on the basis of HIV status.
Assessing the drivers behind the behavior is equally complex. Some, like Stuart, cite the specter of HIV/AIDS, the rise of apps, and internalized homophobia as possible factors. Others are looking closely at London. The changes in the city's gay scene are important here, says Jamie Hakim, an educator and researcher at the University of East Anglia and King's College London. "Because there are fewer affordable gay spaces in London where gay men can socialize, drink, dance, take drugs, and have sex, some men are now doing all of these things in private accommodations."
The business of chemsex is, however, conducted in a public setting: via sex apps, which can also give a sense that a lot of it is going on. "At this stage, the fact of it popping up on your Grindr grid may give the impression that it's a growing scene," says Bourne, who stresses the small numbers involved at present. It will take years for a fuller picture to emerge about the extent of the scene and if it has a direct effect on HIV and STIs. The question for London's gay community is how long it waits to see what harm has been done.
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