Training Manuals

Achieving the global target to eliminate HIV transmission among men who have sex with men (MSM) faces additional challenges from the lack of effective and scaled intervention to address a part of the population who use drugs in sexual settings (colloquially known as chemsex). In this report, we intend to deliver a practical toolkit for community-based organisations (CBOs) who work to improve health outcomes for MSM, particularly in Asian countries. This manual provides the contextual information on chemsex practices among MSM in Asia and offers information and interventions to respond to the situation appropriately.

Chemsex is a term generally used to describe the psychoactive substance use by MSM at the sex event-level, which typically includes mephedrone, GHB/GBL, or crystal methamphetamine. In Asia, the definition of chemsex (local terms: high fun, chemfun) seems to be adjusted to reflect the local pattern that may involve different drugs such as poppers, ecstasy, 5-metoxy-n or foxy, cocaine, ketamine, cannabis, or non-prescription drugs. Overall, the prevalence of this practices among MSM in Asia ranges from 3.1% to 30.8%. Several reasons influencing the decision of MSM in Asia to practice chemsex include the direct benefit of using the drug, persuasion from peer network, and external prejudice directed towards MSM existence. For now, the practice is more likely to be done by MSM who live in urban areas, have higher educational degree and income, and engage in habitual online behaviours, can be categorized as money boy, and have been identified as HIV+. Executive Summary 4 Chemsex in Asia: A Community Manual on Sexualised Substance Use among MSM engagement, facilitating users’ needs, professional clinical intervention, collaborating with drug-based organisations, or promoting safe practice and wellbeing. Nevertheless, some challenges remain to be addressed, including but not limited to the lack of appropriate data, funding limitation, stigmatisation and punitive law, hidden population, limited universal coverage, unfriendly health services, and the lack of patient’s confidentiality.

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