Gay men’s chemsex survival stories
Vivienne Smith A C and Fiona Tasker B
+ Author Affiliations
- Author Affiliations
A Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London WC1E 6BT, UK.
B Department of Psychological Sciences, Birkbeck University of London, Malet Street, Bloomsbury, London WC1E 7HX, UK.
C Corresponding author. Email: vivsmith71@gmail.com
Sexual Health 15(2) 116-122 https://doi.org/10.1071/SH17122
Submitted: 18 July 2017 Accepted: 13 September 2017 Published: 22 December 2017
Abstract
Background: Chemsex (the combined use of drugs and sexual experiences) by men who have sex with men is associated with the transmission of sexually transmissible infections and blood-borne viruses, but psychosocial factors associated with chemsex engagement and remission remain unidentified. In the present study we considered how do gay men self-identify a chemsex problem and remain chemsex free? Methods: Using a life course perspective, the present qualitative interview study examined participants’ reflections to discern pathways in and out of chemsex engagement. Six participants (aged ≥18 years) were drawn from a cohort of men who had completed the tailored therapeutic Structured Weekend Antidote Program. Transcripts were analysed using a Labovian narrative analysis framework. Results: Each man identified a multiplicity of incidents and feelings that contributed to their engagement in chemsex, and engagement in chemsex was connected to participants’ identity development and desire to belong to a gay community. Underlying individual accounts, a common narrative suggested a process through which chemsex journeys were perceived as spiralling from exciting and self-exploratory incidents into an out-of-control, high-risk activity that was isolating and prompted engagement with therapy. Despite seeking therapeutic engagement, participants expressed uncertainty about maintaining a gay future without chemsex. Conclusions: Chemsex was associated with a positive gay identity gain, which explained the ambivalence participants expressed in maintaining a gay future without chemsex despite their awareness of negative consequences. This is significant for understanding both why chemsex pathways may prove attractive and why they may be so difficult to leave.
References
[1] Flentje A, Heck NC, Sorensen JL. Substance use among lesbian, gay and bisexual clients entering substance abuse treatment: comparisons to heterosexual clients. J Consult Clin Psychol 2015; 83 325–34.| Substance use among lesbian, gay and bisexual clients entering substance abuse treatment: comparisons to heterosexual clients.Crossref | GoogleScholarGoogle Scholar |
[2] Hickson F, Bonell C, Weatherburn P, Reid D. Illicit drug use among men who have sex with men in England & Wales. Addict Res Theory 2010; 18 14–22.
| Illicit drug use among men who have sex with men in England & Wales.Crossref | GoogleScholarGoogle Scholar |
[3] Keogh P, Reid D, Bourne A, Weatherburn P, Hickson F, Jessup K, Hammond G. Wasted opportunities: problematic alcohol and drug use among gay men and bisexual men. London: Sigma Research; 2009.
[4] Bourne A. Drug use among men who have sex with men: implications for harm reduction. In Stoicescu C, editor. Global state of harm reduction. London: Harm Reducation International; 2012. pp. 147–155.
[5] National Treatment Agency for Substance Misuse. Club drugs: emerging trends and risks. London: National Treatment Agency for Substance Misuse; 2012. Available online at: http://www.nta.nhs.uk/uploads/clubdrugsreport2012%5B0%5D.pdf [verified November 2017]
[6] Abdulrahim D, Bowden-Jones O, on behalf of the NEPTUNE Expert Group. Guidance on the management of acute and chronic harms of club drugs and novel psychoactive substances. London: Novel Psychoactive Treatment UK Network (NEPTUNE); 2015.
[7] Moncrieff M. Out of your mind: improving provision of drug and alcohol treatment for lesbian, gay, bisexual and trans people. London: London Friend; 2014.
[8] Drumright LN, Patterson TL, Strathdee SA. Club drugs as causal risk factors for HIV acquisition among men who have sex with men: a review. Subst Use Misuse 2006; 41 1551–601.
| Club drugs as causal risk factors for HIV acquisition among men who have sex with men: a review.Crossref | GoogleScholarGoogle Scholar |
[9] Mayer KH, Colfax G, Guzman R. Club drugs and HIV infection: a review. Clin Infect Dis 2006; 42 1463–9.
| Club drugs and HIV infection: a review.Crossref | GoogleScholarGoogle Scholar |
[10] Melendez-Torres GJ, Hickson F, Reid D, Weatherburn P, Bonell C. Nested event-level case-control study of drug use and sexual outcomes in multipartner encounters reported by men who have sex with men. AIDS Behav 2016; 20 646–54.
| Nested event-level case-control study of drug use and sexual outcomes in multipartner encounters reported by men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC2MbpsFGjug%3D%3D&md5=f9d7e5a4f107f8691d22d22476092ab1CAS |
[11] Hunter LJ, Dargan PI, Benzie A, White JA, Wood DM. Recreational drug use in men who have sex with men (MSM) attending UK sexual health services is significantly higher than in non-MSM. Postgrad Med J 2014; 90 133–8.
| Recreational drug use in men who have sex with men (MSM) attending UK sexual health services is significantly higher than in non-MSM.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC2czhvFalug%3D%3D&md5=2c48f56122027eb7452c984f221e0900CAS |
[12] Ruf M, Lovitt C, Imrie J. Recreational drug use and sexual risk practice among men who have sex with men in the United Kingdom. Sex Transm Infect 2006; 82 95–7.
| Recreational drug use and sexual risk practice among men who have sex with men in the United Kingdom.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD287osFCltg%3D%3D&md5=be7f43fbd0e997a109cac9449bfaf899CAS |
[13] Bourne A, Reid D, Hickson F, Torres Rueda S, Weatherburn P. Illicit drug use in sexual settings (‘chemsex’) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study. Sex Transm Infect 2015; 91 564–8.
| Illicit drug use in sexual settings (‘chemsex’) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC28%2FitlWgtA%3D%3D&md5=49d2d960931146946ddefadbc3ff4d63CAS |
[14] Daskalopoulou M, Rodger A, Phillips AN, Sherr L, Speakman A, Collins S, Elford J, Johnson MA, Gilson R, Fisher M, Wilkins E, Anderson J, McDonnell J, Edwards S, Perry N, O’Connell R, Lascar M, Jones M, Johnson AM, Hart G, Miners A, Geretti AM, Burman WJ, Lampe FC. Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study. Lancet HIV 2014; 1 e22–31.
| Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study.Crossref | GoogleScholarGoogle Scholar |
[15] Bolding G, Hart G, Sherr L, Elford J. Use of crystal methamphetamine among gay men in London. Addiction 2006; 101 1622–30.
| Use of crystal methamphetamine among gay men in London.Crossref | GoogleScholarGoogle Scholar |
[16] Bonell CP, Hickson FCI, Weatherburn P, Reid DS. Methamphetamine use among gay men across the UK. Int J Drug Policy 2010; 21 244–6.
| Methamphetamine use among gay men across the UK.Crossref | GoogleScholarGoogle Scholar |
[17] Semple SJ, Strathdee SA, Zians J, Patterson TL. Sexual risk behavior associated with co-administration of methamphetamine and other drugs in a sample of HIV-positive men who have sex with men. Am J Addict 2009; 18 65–72.
| Sexual risk behavior associated with co-administration of methamphetamine and other drugs in a sample of HIV-positive men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[18] National Statistics UK. Illicit drug use among adults by ethnicity and sexual orientation: drug misuse 2013 to 2014. In Tables for ‘Drug misuse: findings from the 2013 to 2014 CSEW’. Home Office; 2014. Available online at: https://www.gov.uk/government/statistics/tables-for-drug-misuse-findings-from-the-2013-to-2014-csew [verified 19 September 2017].
[19] Bourne A, Reid D, Hickson F, Torres Rueda S, Weatherburn P. The chemsex study: drug use in sexual settings among gay & bisexual men in Lambeth, Southwark & Lewisham. London: Sigma Research; 2014.
[20] Hickson F, Weatherburn P, Reid D, Jessup K, Hammond G. Consuming passions: findings from the United Kingdom Gay Men’s Sex Survey. London: Sigma Research; 2005.
[21] Green KE, Feinstein BA. Substance use in lesbian, gay and bisexual populations: an update on empirical research and implications for treatment. Psychol Addict Behav 2012; 26 265–78.
| Substance use in lesbian, gay and bisexual populations: an update on empirical research and implications for treatment.Crossref | GoogleScholarGoogle Scholar |
[22] Gilbart VL, Simms I, Jenkins C, Furegato M, Gobin M, Oliver I, Hart G, Gill ON, Hughes G. Sex, drugs and smart phone applications: findings from semistructured interviews with men who have sex with men diagnosed with Shigella flexneri 3a in England and Wales. Sex Transm Infect 2015; 91 598–602.
| 1:STN:280:DC%2BC2Mjos1SrtQ%3D%3D&md5=c6e2a9c3c7948bca7b17c671d1e6d516CAS |
[23] Halkitis PN, Fischgrund BN, Parsons JT. Explanations of methamphetamine use among gay and bisexual men in New York City. Subst Use Misuse 2005; 40 1331–45.
| Explanations of methamphetamine use among gay and bisexual men in New York City.Crossref | GoogleScholarGoogle Scholar |
[24] Kurtz SP. Post-circuit blues: motivations and consequences of crystal meth use among gay men in Miami. AIDS Behav 2005; 9 63–72.
| Post-circuit blues: motivations and consequences of crystal meth use among gay men in Miami.Crossref | GoogleScholarGoogle Scholar |
[25] Bourne A, Hammond G, Hickson F, Reid D, Schmidt AJ, Weatherburn P, The EMIS Network What constitutes the best sex life for gay and bisexual men? Implications for HIV prevention. BMC Public Health 2013; 13 1083
| What constitutes the best sex life for gay and bisexual men? Implications for HIV prevention.Crossref | GoogleScholarGoogle Scholar |
[26] Dingle GA, Cruwys T, Frings D. Social identities as pathways into and out of addiction. Front Psychol 2015; 6 1795
| Social identities as pathways into and out of addiction.Crossref | GoogleScholarGoogle Scholar |
[27] Allen KR, Henderson A. Family theories: foundations and applications. London: Wiley-Blackwell; 2016.
[28] Elder GH. Time, human agency, and social change: perspectives on the life course. Soc Psychol Q 1994; 57 4–15.
| Time, human agency, and social change: perspectives on the life course.Crossref | GoogleScholarGoogle Scholar |
[29] Elder GH. The life course as developmental theory. Child Dev 1998; 69 1–12.
| The life course as developmental theory.Crossref | GoogleScholarGoogle Scholar |
[30] Rutter M. Pathways from childhood to adult life. J Child Psychol Psychiatry 1989; 30 23–51.
| Pathways from childhood to adult life.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL1M7nsFWntg%3D%3D&md5=c85900bacf2c270ed74eef767dcbe24fCAS |
[31] Murray M. Narrative psychology. In Smith JA, editor. Qualitative psychology: a practical guide to research methods, 2nd edn. London: Sage; 2008. pp. 111–132.
[32] Labov W, Waletzky J. Narrative analysis: oral versions of personal experience. Journal of Narrative & Life History 1997; 7 3–38.
| Narrative analysis: oral versions of personal experience.Crossref | GoogleScholarGoogle Scholar |
[33] Patterson W. Narratives of events: Labovian narrative analysis and its limitations. In Andrews M, Squire C, Tamboukou M, editors. Doing narrative research, 2nd edn. Sage: London; 2013. pp. 77–104.
[34] Reissman CK. Narrative methods for the human sciences. California: Sage; 2008.
[35] Hammack PL, Cohler BJ, editors. Narrative perspectives on the gay and lesbian life course. New York: Oxford University Press; 2009.
[36] Public Health England. Promoting the health and wellbeing of gay, bisexual and other men who have sex with men: summary document. London; 2014. Available online at: https://www.gov.uk/government/publications/promoting-the-health-and-wellbeing-of-gay-bisexual-and-other-men-who-have-sex-with-men [verified 5 January 2015].
