Needs and experiences of people practising chemsex with support services: toward chemsex-affirmative interventions

Abstract

Chemsex involves the use of specific psychoactive substances, namely, methamphetamine, gamma-Hydroxybutyrate/gamma-Butyrolactone (GHB/GBL), ketamine and mephedrone, by sexually diverse men, trans and non-binary people, during sexual relations. This practice, when intensive and prolonged, can have repercussions on various aspects of people's lives. In this context, many turn to support services for their substance use and their sexuality. The literature on interventions with people practising chemsex is fragmentary. This article aims to identify possible interventions adapted to this practice, based on this population's needs and experiences with intervention services. Using community-based research, 64 semi-structured interviews were conducted among men and non-binary people residing in Quebec who use methamphetamine in a sexual context. Participants were mainly recruited by collaborating with addiction and sexual health community-based organizations and using snowball sampling. The sample composition shows diversity regarding the sexual orientation, gender identity, and cultural backgrounds of the participants. The themes addressed are needs and experiences with services, and ways to improve services to make them more responsive to the needs of this community. A thematic analysis was conducted. Participants identified intervention needs and community needs. Intervention needs refer to receiving support, according to one's goals, from professionals who understand the practice of chemsex. As for the community needs, they stressed the importance to integrate into a community in order to be able to reflect on chemsex. Experiences reported by the participants show that services are not adequately meeting all of the needs of people who practise chemsex, while it was particularly difficult for them to talk about methamphetamine use hand in hand with sexuality. The results show the relevance of putting specific, adapted and varied interventions in place to respond to all of the needs of people practising chemsex. Affirmative intervention is identified as a posture that better responds to the needs of this community.