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

Drückler, Susanne; Speulman, Jilke; Rooijen, Martijn van; Vries, Henry J. C. de

doi:10.1136/sextrans-2020-054840

Cited by 31 publications

(17 citation statements)

References 28 publications

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“…35 Non-consensual sexual activity can be associated with chemsex. 62 Death from unintentional overdose may also be seen. 63 Progression from occasional use to more pervasive substance use disorder can occur.…”

Section: Other Associated Problemsmentioning

confidence: 99%

Current Insights on the Impact of Gamma-Hydroxybutyrate (GHB) Abuse

Tay¹,

WKW²,

Murnion³

2022

SAR

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Recreational gamma-hydroxybutyrate (GHB) use, although less common than other substance use, is increasingly recognised and is over-represented in emergency toxicology presentations. This narrative review summarizes GHB pharmacology, current patterns of use, potential harms and management of GHB toxicity and withdrawal. There is a complex interplay between GHB and GABA as GHB is both a prodrug and metabolite of GABA and GHB activates both GHB and GABA receptors. GHB is rapidly absorbed, with effects seen within minutes of ingestion. Metabolism is non-linear at higher doses. While GHB is listed as a controlled substance, its precursor's gamma-butyrolactone (GBL) and 1,4-butanediol (1,4-BD) are easily available as both have industrial applications. National surveys indicate low rates of GHB use, with identification of high-risk populations in men who have sex with men and polysubstance users. GHB is one of the three drugs most commonly used in chemsex. GHB is often co-ingested with other interacting psychoactive substances. Acute toxicity is dose-dependent, and management is supportive care. Withdrawal management is generally with benzodiazepines with addition of baclofen for more severe withdrawal. Barbiturates may have a role. Titration and tapering of pharmaceutical GHB is commonly used in the Netherlands. Complicated withdrawal with delirium may require intensive care and treatment with intravenous sedation. There are high rates of relapse after withdrawal and medications for longerterm management are currently being investigated. Chronic use is associated with poorer mental, physical and sexual health, social dysfunction and poor work performance. Laboratory detection is complicated as GHB is an endogenous substance with a short halflife, and therefore not often routinely assayed in the clinical setting. Future research should focus on improving GHB detection and management of GHB withdrawal and dependence. Interventions specific for high-risk groups should be developed and assessed.

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Section: Other Associated Problemsmentioning

confidence: 99%

Current Insights on the Impact of Gamma-Hydroxybutyrate (GHB) Abuse

Tay¹,

WKW²,

Murnion³

2022

SAR

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“…Some chemsex participants also report being the victim of nonconsensual sex while under the influence of drugs [ 2 , 60 ]. A recent study among MSM in Amsterdam showed that 41.4% of the participants who engage in chemsex reported passing out and not remembering what happened while under the influence of drugs [ 77 ].…”

Section: Resultsmentioning

confidence: 99%

Using Intervention Mapping to Develop an mHealth Intervention to Support Men Who Have Sex With Men Engaging in Chemsex (Budd): Development and Usability Study

Herrijgers¹,

Platteau²,

Vandebosch³

et al. 2022

JMIR Res Protoc

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Background Chemsex refers to the intentional use of drugs before or during sex among men who have sex with men (MSM). Engaging in chemsex has been linked to significant negative impacts on physical, psychological, and social well-being. However, no evidence-based support tools have addressed either these harms or the care needs of MSM who engage in chemsex. Objective The purpose of this paper was to describe the development of a mobile health intervention (named Budd) using the intervention mapping protocol (IMP). Budd aims to support and inform MSM who participate in chemsex, reduce the negative impacts associated with chemsex, and encourage more reasoned participation. Methods The IMP consists of 6 steps to develop, implement, and evaluate evidence-based health interventions. A needs assessment was carried out between September 2, 2019, and March 31, 2020, by conducting a literature study and in-depth interviews. Change objectives were selected based on these findings, after which theory-based intervention methods were selected. The first version of the intervention was developed in December 2020 and pilot-tested between February 1, 2021, and April 30, 2021. Adjustments were made based on the findings from this study. A separate article will be dedicated to the effectiveness study, conducted between October 15, 2021, and February 24, 2022, and implementation of the intervention. The Budd app went live in April 2022. Results Budd aims to address individual factors and support chemsex participants in applying harm reduction measures when taking drugs (drug information, drug combination tool, and notebook), preparing for participation in a chemsex session (articles on chemsex, preparation tool, and event-specific checklist), planning sufficient time after a chemsex session to recover (planning tool), seeking support for their chemsex participation (overview of existing local health care and peer support services, reflection, personal statistics, and user testimonials), taking HIV medication or pre-exposure prophylaxis in a timely manner during a chemsex session (preparation tool), and contacting emergency services in case of an emergency and giving first aid to others (emergency information and personal buddy). Conclusions The IMP proved to be a valuable tool in the planning and development of the Budd app. This study provides researchers and practitioners with valuable information that may help them to set up their own health interventions. International Registered Report Identifier (IRRID) RR1-10.2196/39678

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“…People with existing mental health conditions (including in the GDS) reported greater increases in drinking during the pandemic [ 74 , 79 ]. Among men partnered with men in our sample, increased drinking potentially contributed to the higher prevalence of experiencing sexual abuse [ 74 , 80 , 81 ]. One study reported that experiencing IPVA during restrictions was positively associated with the number of casual sexual partners that men in a relationship with men met during the pandemic [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Experience and perpetration of intimate partner violence and abuse by gender of respondent and their current partner before and during COVID-19 restrictions in 2020: a cross-sectional study in 13 countries

et al. 2023

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Background Intimate partner violence and abuse (IPVA) includes controlling behaviours, psychological, physical, sexual and financial abuse. Globally, surveys and emergency services have recorded an increase in IPVA since restrictions were imposed to limit COVID-19 transmission. Most studies have only included heterosexual women. Methods Data from the Global Drug Survey (an annual, anonymous, online survey collecting data on drug use) Special Edition were analysed to explore the impact of COVID-19 on people’s lives, including their intimate relationships. Five relationship groupings were created using respondents’ lived gender identity: women partnered with men (46.9%), women partnered with women (2.1%), men partnered with men (2.9%), men partnered with women (47.2%), and partnerships where one or both partners were non-binary (1%). Self-reported experience and perpetration of IPVA in the past 30 days before (February) and during COVID-19 restrictions (May or June) in 2020 (N = 35,854) was described and compared for different relationship groupings using Fishers Exact Tests. Changes in IPVA during restrictions were assessed using multivariable logistic regression. Results During restrictions, 17.8 and 16.6% of respondents had experienced or perpetrated IPVA respectively; 38.2% of survivors and 37.6% of perpetrators reported this had increased during restrictions. Greater proportions of non-binary respondents or respondents with a non-binary partner reported experiencing or perpetrating IPVA (p < .001) than other relationship groupings. 22.0% of respondents who were non-binary or had a non-binary partner, 19.5% of men partnered with men, 18.9% of men partnered with women, 17.1% of women partnered with women and 16.6% of women partnered with men reported experiencing IPVA. Respondents with higher psychological distress, poor coping with pandemic-related changes, relationship tension and changes (increases or increases and decreases) in alcohol consumption reported increased experience of IPVA during restrictions. Conclusions This study confirmed that IPVA can occur in all intimate relationships, regardless of gender of the perpetrator or survivor. Non-binary respondents or respondents with non-binary partners reported the highest use and experience of IPVA. Most IPVA victim support services have been designed for heterosexual, cisgender women. IPVA support services and perpetrator programmes must be tailored to support all perpetrators and survivors during the pandemic and beyond, regardless of their sexual or gender identity.

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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

Cited by 31 publications

References 28 publications

Current Insights on the Impact of Gamma-Hydroxybutyrate (GHB) Abuse

Current Insights on the Impact of Gamma-Hydroxybutyrate (GHB) Abuse

Using Intervention Mapping to Develop an mHealth Intervention to Support Men Who Have Sex With Men Engaging in Chemsex (Budd): Development and Usability Study

Experience and perpetration of intimate partner violence and abuse by gender of respondent and their current partner before and during COVID-19 restrictions in 2020: a cross-sectional study in 13 countries

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