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Methamphetamine Use and Chemsex: An Emerging Threat for gender and sexually diverse people

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Handbook of Substance Misuse and Addictions

Abstract

Chemsex refers to a practice which involves the use of substances to initiate, enhance, and prolong sexual intercourse. Although many substances are historically used to influence sexual practices, the literature documented methamphetamine as the most commonly used substance in chemsex globally. This book chapter aims to delineate the underlying contexts, bio-behavioral implications, and potential risk mitigation strategies for the use of methamphetamine among gender and sexually diverse people. Evidence revealed several underlying contexts which precipitated chemsex such as curiosity, the desire for assimilating into social groups, coping with emotional distress, and enhancing their sexual performance. Moreover, some behavioral changes emerged from chemsex such as multiple sex partners, engagement in transactional sex, coerced sex, and changes in sexual relationships and dynamics. This chapter also revealed some existing risk reduction strategies for mitigating the harms associated with chemsex.

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Abbreviations

APCOM:

Asia Pacific Coalition on Male Sexual Health

ATS:

Amphetamine-type stimulants

BCC:

Behavior change communication

BDSM:

Bondage and discipline, dominance and submission, sadism/masochism

DIC:

Drop-in center

HIV:

Human immunodeficiency virus

MSM:

Men who have sex with men

MSW:

Male sex worker

PWID:

People who inject drugs

PWUD:

People who use drugs

STI:

Sexually transmitted infections

TG:

Transgender (women)

UNODC:

United Nations Office on Drugs and Crime

References

  • Ameri A, Keshvardoost S, Bahaadinbeigy K (2020) Impact of mobile phone-based interventions on methamphetamine use and high-risk sexual behaviors in men who have sex with men (MSM): a systematic review. Addiction Health 12(1):58

    PubMed  PubMed Central  Google Scholar 

  • APCOM (2021) A qualitative scoping review of seuxalised drug use (including Chemsex). Asia Pacific Coalition on Male Sexual Health

    Google Scholar 

  • Arístegui I, Radusky PD, Zalazar V, Lucas M, Sued O (2018) Resources to cope with stigma related to HIV status, gender identity, and sexual orientation in gay men and transgender women. J Health Psychol 23(2):320–331

    Article  PubMed  Google Scholar 

  • Bailey JV, Murray E, Rait G, Mercer CH, Morris RW, Peacock R, Cassell J, Nazareth I (2010) Interactive computer-based interventions for sexual health promotion. Cochrane Database Syst Rev 9:CD006483. https://doi.org/10.1002/14651858.CD006483.pub2

    Article  Google Scholar 

  • Berg RC, Weatherburn P, Marcus U, Schmidt AJ (2019) Links between transactional sex and HIV/STI-risk and substance use among a large sample of European men who have sex with men. BMC Infect Dis 19(1):1–9

    Article  Google Scholar 

  • Bohn A, Sander D, Köhler T, Hees N, Oswald F, Scherbaum N et al (2020) Chemsex and mental health of men who have sex with men in Germany. Front Psychiatry 11:1100

    Article  Google Scholar 

  • Bosma-Bleeker MH, Blaauw E (2018) Substance use disorders and sexual behavior; the effects of alcohol and drugs on patients’ sexual thoughts, feelings and behavior. Addict Behav 87:231–237. https://doi.org/10.1016/j.addbeh.2018.07.005. Epub 2018 Jul 6

    Article  PubMed  Google Scholar 

  • Bourne A, Reid D, Hickson F, Torres-Rueda S, Steinberg P, Weatherburn P (2015) “Chemsex” and harm reduction need among gay men in South London. Int J Drug Policy 26(12):1171–1176. https://doi.org/10.1016/j.drugpo.2015.07.013

    Article  PubMed  Google Scholar 

  • Bryant J, Hopwood M, Dowsett GW, Aggleton P, Holt M, Lea T et al (2018) The rush to risk when interrogating the relationship between methamphetamine use and sexual practice among gay and bisexual men. Int J Drug Policy 55:242–248

    Article  PubMed  Google Scholar 

  • Choi EPH, Chau PH, Wong WCW, Kowk JYY, Choi KWY, Chow EPF (2021) Developing and testing of an interactive internet-based intervention to reduce sexual harm of sexualised drug use (‘chemsex’) among men who have sex with men in Hong Kong: a study protocol for a randomised controlled trial. BMC Public Health 21(1):713. https://doi.org/10.1186/s12889-021-10742-8. PMID: 33849517; PMCID: PMC8045193

  • Chomchoei C, Apidechkul T, Wongnuch P, Tamornpark R, Upala P, Nongkhai MPN (2019) Perceived factors influencing the initiation of methamphetamine use among Akha and Lahu youths: a qualitative approach. BMC Public Health 19(1):847. https://doi.org/10.1186/s12889-019-7226-y

    Article  PubMed  PubMed Central  Google Scholar 

  • Drückler S, Speulman J, van Rooijen M, De Vries HJC (2021) Sexual consent and chemsex: a quantitative study on sexualised drug use and non-consensual sex among men who have sex with men in Amsterdam, the Netherlands. Sex Transm Infect, sextrans-2020-054840. https://doi.org/10.1136/sextrans-2020-054840

  • Edmundson C, Heinsbroek E, Glass R, Hope V, Mohammed H, White M, Desai M (2018) Sexualised drug use in the United Kingdom (UK): a review of the literature. Int J Drug Policy 55:131–148. https://doi.org/10.1016/j.drugpo.2018.02.002

    Article  PubMed  Google Scholar 

  • Fletcher JB, Clark KA, Reback CJ (2020) Depression and HIV transmission risk among methamphetamine-using men who have sex with men. Addict Res Theory 29(3):1–8

    Google Scholar 

  • Flores-Aranda J, Goyette M, Larose-Osterrath C (2019) Online intervention as strategy to reach men who have sex with other men and who use substances in a sexual context. Development of the MONBUZZ.ca project. Front Psychiatry 10:183. https://doi.org/10.3389/fpsyt.2019.00183

    Article  PubMed  PubMed Central  Google Scholar 

  • Frankis J, Flowers P, McDaid L, Bourne A (2018) Low levels of chemsex among men who have sex with men, but high levels of risk among men who engage in chemsex: analysis of a cross-sectional online survey across four countries. Sex Health 15(2):144–150. https://doi.org/10.1071/sh17159

    Article  PubMed  PubMed Central  Google Scholar 

  • Gourab G, Khan MNM, Hasan AMR, Sarwar G, Irfan SD, Reza MM et al (2019) The willingness to receive sexually transmitted infection services from public healthcare facilities among key populations at risk for human immunodeficiency virus infection in Bangladesh: a qualitative study. PLoS One 14(9):e0221637. https://doi.org/10.1371/journal.pone.0221637

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Graf N, Dichtl A, Deimel D, Sander D, Stöver H (2018) Chemsex among men who have sex with men in Germany: motives, consequences and the response of the support system. Sex Health 15(2):151–156

    Article  PubMed  Google Scholar 

  • Guadamuz TE, Boonmongkon P (2018) Ice parties among young men who have sex with men in Thailand: pleasures, secrecy and risks. Int J Drug Policy 55:249–255

    Article  PubMed  PubMed Central  Google Scholar 

  • Harm Reduction International (2020) The Global State of Harm Reduction 2020. Retrieved from London, UK

    Google Scholar 

  • Hegazi A, Lee MJ, Whittaker W, Green S, Simms R, Cutts R, Nagington M, Nathan B, Pakianathan MR (2017) Chemsex and the city: sexualised substance use in gay bisexual and other men who have sex with men attending sexual health clinics. Int J STD AIDS 28(4):362–366

    Article  CAS  PubMed  Google Scholar 

  • Hibbert MP, Hillis A, Brett CE, Porcellato LA, Hope VD (2021) A narrative systematic review of sexualised drug use and sexual health outcomes among LGBT people. Int J Drug Policy 103187

    Google Scholar 

  • Homer BD, Solomon TM, Moeller RW, Mascia A, DeRaleau L, Halkitis PN (2008) Methamphetamine abuse and impairment of social functioning: a review of the underlying neurophysiological causes and behavioral implications. Psychol Bull 134(2):301–310. https://doi.org/10.1037/0033-2909.134.2.301

    Article  PubMed  Google Scholar 

  • Hood JE, Buskin SE, Golden MR, Glick SN, Banta-Green C, Dombrowski JC (2018) The changing burden of HIV attributable to methamphetamine among men who have sex with men in King County, Washington. AIDS Patient Care and STDs 32(6):223–233

    Article  PubMed  Google Scholar 

  • IPCD (2019) Report of the dignity project international conference on population and development

    Google Scholar 

  • Kevil Christopher G, Goeders Nicholas E, Woolard Matthew D, Bhuiyan Md S, Dominic P, Kolluru Gopi K et al (2019) Methamphetamine use and cardiovascular disease. Arterioscler Thromb Vasc Biol 39(9):1739–1746. https://doi.org/10.1161/ATVBAHA.119.312461

    Article  CAS  PubMed  Google Scholar 

  • Khan SI, Khan MNM, Hasan AR, Irfan SD, Horng LM-S, Chowdhury EI, Azim T (2019) Understanding the reasons for using methamphetamine by sexual minority people in Dhaka, Bangladesh. Int J Drug Policy 73:64–71

    Article  PubMed  Google Scholar 

  • Khan SI, Khan MNM, Irfan SD, Rumayan Hasan A, Ross AG, Horng LM-S et al (2020) The effects of methamphetamine use on the sexual lives of gender and sexually diverse people in Dhaka, Bangladesh: a qualitative study. Arch Sex Behav 50(2):1–15

    Google Scholar 

  • Lim SH, Akbar M, Wickersham JA, Kamarulzaman A, Altice FL (2018a) The management of methamphetamine use in sexual settings among men who have sex with men in Malaysia. Int J Drug Policy 55:256–262. https://doi.org/10.1016/j.drugpo.2018.02.019

    Article  PubMed  PubMed Central  Google Scholar 

  • Lim SH, Brown S-E, Shaw SA, Kamarulzaman A, Altice FL, Beyrer C (2018b) “You have to keep yourself hidden”: perspectives from Malaysian Malay-Muslim men who have sex with men on policy, network, community, and individual influences on HIV risk. J Homosex 67(1):104–126

    Article  PubMed  Google Scholar 

  • Liu L, Chui WH, Chai X (2018) A qualitative study of methamphetamine initiation among Chinese male users: patterns and policy implications. Int J Drug Policy 62:37–42. https://doi.org/10.1016/j.drugpo.2018.08.017

    Article  PubMed  Google Scholar 

  • Logie CH, Perez-Brumer A, Mothopeng T, Latif M, Ranotsi A, Baral SD (2020) Conceptualizing LGBT stigma and associated HIV vulnerabilities among LGBT persons in Lesotho. AIDS Behav:1–11

    Google Scholar 

  • Loza O, Curiel ZV, Beltran O, Ramos R (2020) Methamphetamine use and sexual risk behaviors among men who have sex with men in a Mexico-US border city. Am J Addict 29(2):111–119

    Article  PubMed  PubMed Central  Google Scholar 

  • Macapagal K, Kraus A, Korpak AK, Jozsa K, Moskowitz DA (2020) PrEP awareness, uptake, barriers, and correlates among adolescents assigned male at birth who have sex with males in the US. Arch Sex Behav 49(1):113–124

    Article  PubMed  Google Scholar 

  • Maxwell S, Shahmanesh M, Gafos M (2019) Chemsex behaviours among men who have sex with men: a systematic review of the literature. Int J Drug Policy 63:74–89. https://doi.org/10.1016/j.drugpo.2018.11.014

    Article  PubMed  Google Scholar 

  • Melendez-Torres GJ, Bourne A (2016) Illicit drug use and its association with sexual risk behaviour among MSM: more questions than answers? Curr Opin Infect Dis 29(1):58–63. https://doi.org/10.1097/qco.0000000000000234

    Article  CAS  PubMed  Google Scholar 

  • Meredith CW, Jaffe C, Ang-Lee K, Saxon AJ (2005) Implications of chronic methamphetamine use: a literature review. Harv Rev Psychiatry 13(3):141–154. https://doi.org/10.1080/10673220591003605

    Article  PubMed  Google Scholar 

  • Nimbi FM, Rosati F, Esposito RM, Stuart D, Simonelli C, Tambelli R (2020) Chemsex in Italy: experiences of men who have sex with men consuming illicit drugs to enhance and prolong their sexual activity. J Sex Med 17(10):1875–1884

    Article  CAS  PubMed  Google Scholar 

  • Pakianathan M, Whittaker W, Lee M, Avery J, Green S, Nathan B, Hegazi A (2018) Chemsex and new HIV diagnosis in gay, bisexual and other men who have sex with men attending sexual health clinics. HIV Med 19. https://doi.org/10.1111/hiv.12629

  • Platteau T, Herrijgers C, de Wit J (2020) Digital chemsex support and care: The potential of just-in-time adaptive interventions. Int J Drug Policy 85:102927

    Article  CAS  PubMed  Google Scholar 

  • Pufall E, Kall M, Shahmanesh M, Nardone A, Gilson R, Delpech V et al (2018) Sexualized drug use (‘chemsex’) and high-risk sexual behaviours in HIV-positive men who have sex with men. HIV Med 19(4):261–270

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Queiroz AAFLN, Sousa ÁFLD, Araújo TMED, Brignol S, Reis RK, Fronteira I, Moura MEB (2021) High rates of unprotected receptive anal sex and vulnerabilities to HIV infection among Brazilian men who have sex with men. Int J STD AIDS 32(4):368–377

    Article  PubMed  Google Scholar 

  • Race K, Lea T, Murphy D, Pienaar K (2017) The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men. Sex Health 14(1):42–50. https://doi.org/10.1071/sh16080

    Article  PubMed  Google Scholar 

  • Rahmani A, Mirzazadeh A, Allahqoli L, Sharifi H, Shokoohi M, Karamouzian M (2021) The prevalence of and factors associated with heterosexual anal sex among Iranian female sex workers. Sex Cult 25(2):646–659

    Article  Google Scholar 

  • Reback CJ, Fletcher JB, Mata RP (2021) A theory-based mHealth intervention (Getting Off) for methamphetamine-using men who have sex with men: protocol for a randomized controlled trial. JMIR Res Protocols 10(2):e22572

    Article  Google Scholar 

  • Regional Consultation for Harm Reduction in Chemsex Webinar (2020) Harm Reduction Network of Asia and the Pacific

    Google Scholar 

  • Rigoni R, Woods S, Breeksema JJ (2019) From opiates to methamphetamine: building new harm reduction responses in Jakarta, Indonesia. Harm Reduct J 16(1):1–13

    Article  Google Scholar 

  • Ruiz-Robledillo N, Ferrer-Cascales R, Portilla-Tamarit I, Alcocer-Bruno C, Clement-Carbonell V, Portilla J (2021) Chemsex practices and health-related quality of life in Spanish men with HIV who have sex with men. J Clin Med 10(8):1662

    Article  PubMed  PubMed Central  Google Scholar 

  • Stephens JH, Surjan A (2020) BARRIERS preventing access by men who have sex with men to HIV-related health services in SOUTHEAST Asia: a scoping review. Glob Public Health:1–19

    Google Scholar 

  • Tan RK (2019) Internalized homophobia, HIV knowledge, and HIV/AIDS personal responsibility beliefs: correlates of HIV/AIDS discrimination among MSM in the context of institutionalized stigma. J Homosex 66(8):1082–1103

    Article  PubMed  Google Scholar 

  • TNI (2020) Methamphetamine use in Myanmar, Thailand and Southern China: assessing practices, reducing harms. Transnational Institute, Amsterdam

    Google Scholar 

  • Tomkins A, George R, Kliner M (2019) Sexualised drug taking among men who have sex with men: a systematic review. Perspect Public Health 139(1):23–33. https://doi.org/10.1177/1757913918778872

    Article  PubMed  Google Scholar 

  • Treloar C, Hopwood M, Drysdale K, Lea T, Holt M, Dowsett GW, Aggleton P, Bryant J (2021) Stigma as understood by key informants: a social ecological approach to gay and bisexual men’s use of crystal methamphetamine for sex. Int J Drug Policy 94:103229

    Article  PubMed  Google Scholar 

  • UNODC (2019) World drug report. United Nations Office of Drugs and Crime: Geneva

    Google Scholar 

  • WHO (2019) Amphetamine-type stimulants fact sheet. World Health Organization, Geneva

    Google Scholar 

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Author information

Authors and Affiliations

  1. Program for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh

    Sharful Islam Khan, Samira Dishti Irfan & Mohammad Niaz Morshed Khan

Authors
  1. Sharful Islam Khan
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  2. Samira Dishti Irfan
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  3. Mohammad Niaz Morshed Khan
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Corresponding author

Correspondence to Sharful Islam Khan .

Editor information

Editors and Affiliations

  1. Department of Biomedical Sciences, University of Westminster, London, UK

    Vinood B. Patel

  2. Dept of Nutrition & Dietetics, King's College London, London, UK

    Victor R. Preedy

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Khan, S.I., Irfan, S.D., Khan, M.N.M. (2022). Methamphetamine Use and Chemsex: An Emerging Threat for gender and sexually diverse people. In: Patel, V.B., Preedy, V.R. (eds) Handbook of Substance Misuse and Addictions. Springer, Cham. https://doi.org/10.1007/978-3-030-67928-6_146-1

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  • DOI: https://doi.org/10.1007/978-3-030-67928-6_146-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-67928-6

  • Online ISBN: 978-3-030-67928-6

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