Sexualised drug use is steeply on the rise among Thai gay and bisexual men living with HIV, and is linked to getting other sexually transmitted infections (STIs), including hepatitis C.
Researchers presented the results to the recent International AIDS Society conference; www.aidsmap.com is official scientific media partner for the conference.
A study in Bangkok has been recruiting people newly diagnosed with HIV since 2009. It only involves people diagnosed at a very early stage, having had the virus for a few weeks. Most of the 604 people recruited between 2009 and 2019 were gay and bisexual men, though some were trans women.
Before 2017, 21% reported using amphetamine-type stimulants and 4% said they injected crystal meth, but in people diagnosed after 2017, the figures were 33% and 20%. Use of erection drugs and heavy drinking have also increased in recent years.
People using recreational drugs were three times more likely to acquire syphilis or hepatitis C, and people who injected crystal meth over four times more likely to get hepatitis C. They were also 28 times more likely to engage in group sex. Other studies have also found that crystal meth is more closely linked with risky sex than other drugs.
The rise of chemsex is not limited to Thailand. The conference heard about small studies in Taiwan, Vietnam, Thailand, Malaysia, Singapore and Japan that have reported on it too.
Dr Stephane Wen-Wei Ku of the Taipei City Hospital in Taiwan said that support services for men having chemsex should be integrated into gay-friendly sexual health services, rather than provided by mainstream drug organisations.
He said a ‘harm reduction’ approach is needed. This means helping people to avoid or reduce the specific harms that drugs can cause, instead of just telling them to stop completely. For example, that might involve using drugs less often, avoiding becoming dependant, reducing the risk of an overdose, or providing clean syringes so that people don’t share them.