The meaning of “chemsex” is a contested matter. In the late 2000s, London-based social worker David Stuart facilitated the introduction of the word—which he defines as the use of “specific drugs,” like methamphetamine, mephedrone and GHB/GBL, by men who have sex with men (MSM)—into the Anglophone public health lexicon, insisting upon its cultural and social specificity.
But the conceptual question of who can do chemsex may be jumping the gun. It assumes that chemsex itself is a settled term for MSM—which a new study suggests is far from the case.
In the study, published on June 6 in the International Journal of Drug Policy, Madrid-based researchers turn away from dissecting chemsex’s “antecedents” (demographic characteristics and motivations) or its “results” (like health outcomes, such as the transmission of diseases).
Instead, they concern themselves with “what ‘lies inside’ chemsex”—by which they mean what one does when participating. This may include the norms, trends, behavioral changes and geographies of chemsex.
Between September 2018 and February 2019, 11 MSM spoke with the researchers about the social practices that constitute chemsex in Madrid. “Nuances and differences among their actual practices and in the form of the [chemsex] sessions they attend” were revealed in the interviews. From these, researchers identified two primary variables that they speculate impact a chemsex session’s risks: the degree of anonymity and the involvement of friendships.
In light of these variables, four modes of chemsex are outlined: so-called “anonymous sessions,” “chill-sex,” “semi-closed parties among networks of friends” and “chemsex in saunas.”
Anonymous sessions were considered to be most common by the study participants. They typically involve large groups of men, unfamiliar with one another, in a private residential space, invited there via sex apps like Grindr. Such sessions can be lengthy, lasting a night or an entire weekend, with men constantly circulating in and out. As a result, the serostatus of party attendees tends to be unspoken.
“It was like: lots of people, porn on the TV, cool music, people were naked,” study participant Víctor, an HIV-negative gay man in his 30s, told the researchers about his first experience at an anonymous session. “[I]t was so attractive… so I stayed.”
Other men in the study cited the pleasures of the sessions, but the researchers also noted the presence of risks. Given the anonymity, participants may be vulnerable to “paranoias and conflicts between some participants,” thefts, and unsupportive peers if overdosing. Additionally, such spaces were described by some participants as enforcing normative ideals of masculinity that were exclusionary to some men.
“It’s the simplest way to go. And the cheapest.”
In contrast, chill-sex sessions are smaller, unplanned and involve a group of men who know each other. Described by the researchers as “explicitly a continuation of nightlife,” such sessions tend to happen after a night at the club, venues which are increasingly closing early, targeted by police if open after-hours, and charging high prices for alcohol.
“Yeah, a few guys get together and they put on a small party with drugs and sex. It’s the simplest way to go. And the cheapest,” said one participant.
This form of chemsex may have fewer risks. The researchers suggest that it “implies less presence of slamming [injecting] and more presence of alcohol and other non-chemsex drugs such as cocaine,” and “lesser presence of non-normative sex behaviours such as BDSM or fisting.”
But they can quickly become anonymous sessions, with greater risks. “Chill can become wild after a while. Because someone will start up on their phone, and another one too, and in the end… There were five people at the beginning and suddenly there are another 10 naked guys and you don’t know half of them or how they turned up there,” said another study participant.
Semi-closed parties similarly involve friends and (like anonymous sessions, as well) tend to be in residential spaces. They are distinguished, the study participants said, by involving men in open relationships, and those who don’t frequently practice chemsex. They’re “usually more controlled” than anonymous sessions—which are fundamentally uncontrolled—tending to encourage open discussions about HIV status.
“In a sauna, if there’s a guy you can’t stand, you just leave the room and go somewhere else, and that’s all.”
Sauna-based chemsex, unlike all three of the other categories, is in a public space. Similar to anonymous sessions, most men in these settings do not know each other and are constantly moving in and out of the space. There’s also little discussion about risks involved.
For Alex, a study participant, sauna-based chemsex lends greater autonomy. “It’s the same thing [as anonymous sessions] but I take however many drugs I want, I fuck whoever I want to, and when I don’t like someone I just leave. Because in sessions at homes you might be fucking people you don’t like, there’s no connection at all, but you still have to stick to it, there’s no alternative. But in a sauna, if there’s a guy you can’t stand, you just leave the room and go somewhere else, and that’s all.”
Men like Alex feel like they have more control in such spaces and are exposed to fewer risks, while others feel the opposite. For example, some participants reported that sauna-goers are less accountable for caring for those who have overdosed, or intervening in situations of potential sexual assault.
“[P]revention efforts should reflect upon risk reduction strategies that consider the peculiarities of different types of sessions,” wrote the study authors. “One urgent action, according to our results, would be to target saunas, as some of the most problematic situations appear to be gathering there.”