The Steam Room is broadcast on GaySA Radio every Wednesday from 19:00 to 21:00, and is brought to you by the National Department of Health’s Phila programme.

The Phila programme encourages all South Africans to be inspired to live, and is about keeping fit, knowing about your health and body, eating well and taking action about your health in general.

In episode 5 of The Steam Room we talk about a controversial topic in the community of men who have sex with men: chemsex.

What is chemsex?

Chemsex is sex that happens between men while under the influence of illegal substances. These substances may include things like marijuana, Methylenedioxymethamphetamine (MDMA, commonly known as ecstacy), crystal methamphetamine (crystal meth), gamma hydroxybutyrate (GHB, also referred to as “G”) and methcathinone (commonly known as CAT), among others. Another legal substance that may be used is a class of alkyl nitrites that is inhaled, commonly referred to as poppers.

In the gay subculture, chemsex sometimes forms a part of a hook-up where the purpose is to take drugs with the intention of having sex. On dating apps like Grindr, men who want to engage in chemsex refer to it as “chemfun” or “party and play”.

Bruce Little, Content Creator at the Anova Health Institute, says that there are numerous reasons why men may want to engage in chemsex, including low self-esteem or other insecurities. Taking substances makes them feel more confident and takes away their inhibitions. Other men may feel that it enhances their sexual experience or allows them to engage in sexual activity for longer.

Juan Nel says that chemsex has become a part of the gay subculture, as a result of the underground gay culture of the past. Substances are often used by men who have sex with men to disinhibit themselves or to maximise the experience of sex. This can become a problem when the substance does not provide the same high as it used to, and a user needs a larger amount to enjoy the same experience as before.

Poppers are often the first substance that men who have sex with men encounter. Even when using poppers, users should be aware that the long-term effects are inconclusive, and take care when using poppers on the long-term.

What are the health implications of chemsex?

The disinhibition people experience when engaging in chemsex means that they often don’t take as much care to protect themselves during sex. In addition, there may be risks involving the mental after-effects of chemsex.

“People potentially do things that they later regret,” says Nel.

Little says that there are indications that men who engage in chemsex are much more likely to have unprotected sex and to have more than one sexual partner at a time, which automatically puts them at a much higher risk of infection with sexually transmitted infections and HIV. Some drugs impact different organs adversely, and mixing different substances also carries significant risk.

“Any drug that you take has an effect on the brain, and have very powerful neurological effects. That’s why we feel this intense high or this amazing sense of euphoria. The problem is that our bodies are not designed for such intense highs, particularly over a period of time, and then it will lead to some kind of damage. That’s why there are so many people who, having used drugs for an extended period of time find that they don’t have the same cognitive abilities that they had before.”

Needing a higher dose to get your fix may potentially also lead to addiction. Because of the association that the substances that are used with sex, sex addiction and substance addiction could go hand-in-hand. Should people not be able to have sex without taking a substance as well, this could lead to significant issues relating to their sexual health.

How to protect yourself

If you do engage in chemsex, learn to use chems responsibly. Even though there are high risk factors, Bruce Little advises that people who partake in chemsex do so responsibly.

OUT LGBT Well-being’s Harmless Project offers a needle exchange programme, which allows drug users to exchange old needles for new ones to prevent the spread of diseases that are carried in the blood. OUT advises that you always use clean needles and never share needles when injecting substances.

The use of condoms and water-based lube cannot be overstated. Test yourself for STIs and HIV regularly, and if you suspect that you might have been exposed to an STI or HIV, go to your nearest men’s health clinic and find out if you can go onto PrEP.

“The number one thing that you should do is to educate yourself. If there is a certain drug that you prefer to take and are taking regularly, find out everything you can about it,” says Little.

“When people are able to manage the substances that they use, rather than be managed by the substances, that’s one scenario, but when you become a slave to whatever the substance may be, in the long-term, there’s a loss of control, potentially your drive being affected.”

Read more about chemsex

Carl Collison, journalist and the Other’s Rainbow Foundation fellow at the Mail & Guardian, wrote a comprehensive article for that publication about his experience with chemsex, and his resulting addiction. Carl’s article provides insight into a world that he got out of, as he describes it, “relatively unscathed”.

Carl’s story is hard-hitting, honest and worth a read.

Click on the player below to listen to our full discussion about chemsex on Episode 5 of the Steam Room, brought to you by the National Department of Health’s Phila programme.