Chemsex: The episodic influence of drug use on sexual behavior among MSM (men who have sex with men) in Metro Manila

The links between drug use and high risk sexual behaviors especially among Men who have Sex with other Men (MSM) have been understudied all throughout the HIV and AIDS epidemic. Chemsex is a term used among MSM that describes sex under the influence of drugs or psychoactive substances (typically crystal methamphetamine, MDMA, and gamma-hydroxybutyric acid (GHB). In the past few years, increasing studies have been made because of the concern on the relationship of chemsex on high risk sexual behaviors, which this qualitative study aimed to describe and explore via in depth interviews with MSM living in Metro Manila. The main method used in this research was an in-depth interview to gather data among 20 MSM in Metro Manila who use drugs in the context of sex either immediately before or during sex with another man at least once a month for the past 6 months to establish behavioral patterns. Data were then subjected to thematic analysis. Results showed that among the socio-demographic characteristics, age, length of drug use, income and HIV status seemed to affect the participants pattern of drug use. The social and sexual networks of the participants also could have influenced their drug use in terms of the visibility and accessibility of drugs among friends and acquaintances. Internet technology also has a big hand in making it easier to find other individuals who use drugs in the context of sex. Reasons for drug use of the participants in this study were mostly about curiosity when engaging in chemsex the first time and almost all continued chemsex because of the perceived added benefits the drugs give during sexual activities such as: intensifying pleasure, providing longevity, and enabling adventurism. Chemsex usually featured increased libido, longer sexual experiences, multiple sex partners, and risky sexual practices. The relationship between drug use and high risk sexual behaviors showed most men believed that engaging in chemsex increased pleasure seeking and decreased inhibitions and fear which resulted to risky sexual practices. Majority described difficulty in maintaining safe sexual practices during chemsex and often persuaded and engage in riskier choice. Overall, analysis among the participants responses revealed that chemsex increased their risk taking sexual behaviors. Harm reduction and sexual health interventions are needed to address the prevention needs of MSM when it comes to HIV and Sexual Transmitted infection especially those who engage in Chemsex