The London boroughs of Lambeth, Southwark and Lewisham (LSL), like other boroughs across the capital, have seen a rise in the number of new diagnoses of HIV and other STIs among gay men.
Evidence from drug treatment and support services, such as Antidote and the central London Club Drug Clinic, suggests recreational drug use is also on the increase among gay men.
Fears among public health practitioners surround the growing use of the internet and social media apps as a means of connecting with potential sexual partners, the easy availability of drugs such as crystal methamphetamine and a less risk-adverse attitude to HIV may be creating the ‘perfect storm’.
In response, the three boroughs have commissioned the first qualitative research in the UK into ‘chemsex’ sometimes referred to as ‘party and play’ or ‘sex when you’re wired.’
Paul Steinberg, Lambeth’s HIV prevention and sexual health commissioning manager, who led the commissioning of the research on behalf of all three boroughs, said:
There has been a change in gay cultural, social and sexual networks. In the 80s and 90s, gay men would meet in bars, clubs, and community centres, but with the rise of the internet and social media apps such as Grindr and Scruff, there has been a shift towards a technology and home-based cultural scene.
"Antiretroviral drugs mean that HIV has been transformed from a fatal to a chronic life-long illness, which is nothing short of a medical miracle and excellent news for people living with HIV. However, one consequence is that there is no longer the ‘fear of death,’ which led to safer sex practices in the past.
"Many of the drugs used by gay men are illegal, but the rise of novel psychoactive substances, otherwise known as legal highs, has also facilitated the rise in home-based drug use with sex, as those drugs are available on the internet, often very cheaply.
"With all these drugs, there are no guidance and no dosage instructions to help people reduce the potential risks, so people who take them can often need urgent medical treatment for overdose or unexpected side effects.
"Of course, people using such drugs also become very disinhibited, meaning they can take sexual risks they wouldn’t do when sober. We are concerned this is a key factor in rising HIV and STI rates."
A commitment by the three boroughs to use funding, previously earmarked for the former pan-London HIV prevention programme, for local prevention efforts, has led to pioneering research on this issue.
Conducted by Sigma Research at the London School of Hygiene and Tropical Medicine, the research has involved new analysis of gay men’s health surveys, as well as one-to-one interviews and focus groups.
Its aims are, not only to identify risk-taking behaviour, but also to establish the reasons behind that behaviour in order to help commissioners identify possible future interventions.
The findings were published last year and have informed future commissioning of media and social marketing campaigns.
Our aim will be to change or challenge attitudes which see drug use as ‘the norm.’ Changing the behaviour of habitual, hard-core drug users might prove difficult, but for people considering getting involved, we can highlight the dangers of what can be very risky behaviour with serious consequences for one’s health.