|
Background:
Chemsex, the use of stimulant drugs to enhance sexual experiences among men who have sex with men (MSM), presents complex health and social risks. Strong’s Chemsex Harm Reduction Framework highlights the intersection of drug use, HIV, and sexual health risks. Currently data on chemsex and its associated risks in South Africa remain limited.
Approach
This qualitative study explored the risks of chemsex and MSM preferences for harm reduction services using Strong’s Framework. We conducted semi-structured interviews (n=10) and three focus group discussions (n=30) with MSM engaging in chemsex. The research concentrated on specific urban and township areas in Johannesburg and Cape Town, representing a cross-section of the South African MSM population that is demographically and socioeconomically diverse. Participants were recruited via social media and MSM community networks. Data were transcribed, coded, and analysed using Atlas.ti.
Analysis
Participants described chemsex as intensely pleasurable and psychologically meaningful, facilitating sexual and emotional exploration. Methamphetamine was the most widely used ‘chem’. Long-term engagement was reported to be associated with increased HIV and STI risk, declining mental health, loss of social connections, relationship instability, and financial insecurity. Socioeconomic factors, including poverty and transactional chemsex, influenced participation in chemsex sessions. Psychosocial challenges, such as isolation, stigma, and discrimination, were both drivers and consequences of chemsex. Participants emphasized the need for accessible mental health support and services that focus on drug use and sexual practices that emphasise harm reduction over abstinence.
Conclusion
These findings highlight the dual nature of chemsex—providing emotional fulfilment while posing significant health and social risks. The expressed need for harm reduction services underscores the importance of integrating mental health support, stigma reduction, and culturally tailored interventions. Addressing the structural and psychological drivers of chemsex through community-driven approaches will be critical in improving harm reduction efforts for MSM in South Africa.
|