Peer-led education may be an effective harm reduction strategy for men who have sex with men engaging in ‘chemsex’

Party ‘n’ Play or ‘chemsex’ is the use of recreational drugs (crystal methamphetamine [ICE], gamma hydroxybutyrate [GHB], mephedrone and PDE5 inhibitors) during sex with one or multiple sexual partners to enhance sexual pleasure and excitement. ¹ Use of these drugs has been associated with increased sexually transmitted infections (STIs), non-volitional sex, harm of injecting drug use and psychological poor health. ² Clinical and community-led services focussing on sexual health in men who have sex with men (MSM) are ideally placed to provide education and harm reduction for MSM engaging in chemsex. ³ In 2018, we created a chemsex patient information leaflet (PIL) for MSM attending our publicly-funded STI and human immunodeficiency virus outpatient service in North Sydney, Australia. The PIL was designed to provide basic information on the effects of chemsex drugs, safety tips and resources for additional support services. The aim of this study was to evaluate the PIL with MSM. We designed an anonymous electronic survey for MSM who had read the PIL. The survey asked MSM their age bracket, recreational drug use type and use in last six months, how they would use the information within the PIL, and if they believed the information would change their behaviour. This study was approved by our local Safety and Quality Committee.

Twenty-seven out of thirty MSM completed an electronic survey between September and November, in which the majority (14/27; 51.9%) were aged 25–34 years; 14/27 (52%) reported using a recreational drug during sex in the previous six months (36.4% GHB; 27.3% ICE and 22.7% cocaine); 19/27 (70%) said that they would use the information in the PIL to support their own harm reduction and 17/27 (63%) said that they would use the information to help or inform a sexual partner or friend; 18/27 (67%) stated that they had learned something new and 3/27(11%) said that they would use the information to change their current drug use behaviour.

In this small pilot survey, MSM suggested that they may use information provided in the PIL to help support friends or sexual partners with their drug use. Peer-led education in sexual health has been used to support partner treatment and support around STI diagnoses; however, there is little evidence on its use in chemsex harm reduction. Due to relatively low numbers in the study, we suggest further research to validate these findings; however, peer-led education and support could be an important avenue for public health to provide harm reduction strategies for MSM engaging in sexualised and non-sexualised drug use.