Stevens Oliver, Forrest Jamie I
45C Northdown St, London, N1 9BL, United Kingdom.
School of Population and Public Health, University of British Columbia, Vancouver, Canada.
Sex Health. 2018 Apr;15(2):108-115. doi: 10.1071/SH17153.
Chemsex is a growing public health concern in urban centres, and few interventions exist to mitigate the significant sexual, drug-related, and social harms potentially experienced by people who participate in chemsex. In much of the world, these immediate harms are further compounded by the criminalisation and stigmatisation of both homosexuality and drug use, preventing participants fully engaging with treatment services or provision of health care. Gay, bisexual and other men who have sex with men participating in chemsex fall between the traditional definitions of key populations and consequently are poorly provided for by existing drug and sexual health frameworks. Aetiologically complex issues such as chemsex require multifaceted interventions that may fall outside conventional frameworks. Existing interventions have been designed and implemented at the local level. The use of international policy to mitigate these structural barriers, however, has largely been ignored. International policy is broad in nature and its implementation is, in principle, binding for member states. We believe that despite its low international prevalence, international policy can be of use in improving the lives of people who participate in chemsex. Through stimulating a much-needed debate on the interplay between sex and drugs within global health and harm reduction frameworks, this paper aims to address the paucity of substantial discussion surrounding the applicability of international language to chemsex. We analyse international policy aimed at addressing HIV, illicit drugs, harm reduction, and development, and make recommendations for both national advocacy, and advocates working to alter the positions of member states internationally.
在城市中心，“化学性爱”正日益引发公共卫生问题，针对参与“化学性爱”的人群可能遭受的重大性、毒品相关及社会危害，几乎没有相应的干预措施。在世界上许多地方，同性恋和吸毒的刑事定罪及污名化进一步加剧了这些直接危害，使参与者无法充分利用治疗服务或获得医疗保健。参与“化学性爱”的男同性恋者、双性恋者及其他与男性发生性行为的男性处于关键人群的传统定义范围之外，因此现有毒品和性健康框架对他们的保障不足。诸如“化学性爱”这种病因复杂的问题需要多方面的干预措施，而这些措施可能超出传统框架。现有的干预措施是在地方层面设计和实施的。然而，利用国际政策来消除这些结构性障碍在很大程度上被忽视了。国际政策性质广泛，原则上对成员国具有约束力。我们认为，尽管国际上对其关注较少，但国际政策可用于改善参与“化学性爱”者的生活。通过在全球卫生和减少危害框架内激发关于性与毒品相互作用的急需辩论，本文旨在解决围绕国际语言在“化学性爱”适用性方面缺乏充分讨论的问题。我们分析旨在应对艾滋病毒、非法药物、减少危害及发展的国际政策，并为国家宣传以及致力于改变成员国在国际上立场的倡导者提出建议。
