Freestone Jack, Xiao Bo Justin, Siefried Krista J, Bourne Adam, Ezard Nadine, Maher Lisa, Stirling Robert, Degenhardt Louisa, Varma Rick, Prestage Garrett, Hammoud Mohamed
The Kirby Institute, UNSW Sydney, Sydney, Australia.
ACON, Sydney, Australia.
Drug Alcohol Rev. 2025 Mar;44(3):711-722. doi: 10.1111/dar.13999. Epub 2025 Jan 29.
Some gay and bisexual men who have sex with men (GBMSM) who use drugs to enhance sex (chemsex/party and play) may experience harms and seek talk therapies. GBMSM who practice chemsex may not access drug services because of anticipated stigma and the perception that these services lack chemsex expertise. Barriers to services are documented, however, little is known about the service experiences of chemsex engaged GBMSM.
Semi-structured interviews were conducted with 24 participants reporting current practice of sexualised use of methamphetamine and/or gamma hydroxybutyrate. Interviews explored experiences of counselling and psychology services, participant's treatment goals and challenges. Data were transcribed verbatim and analysed in NVIVO14 with a qualitative description methodology.
Most in our study sought to reduce the frequency of methamphetamine use and used methamphetamine only in sexual contexts. When engaging with counsellors and psychologists in alcohol and other drug or mental health services for the general adult population, most censored the sexual drivers and types of sexual behaviours incumbent in their methamphetamine use. Participants' reliance on drugs for sex was spoken about as a major barrier to reducing methamphetamine. Sexual self-censorship within services inhibited participants' abilities to access meaningful support and achieve treatment goals.
Counsellor and psychologists working with GBMSM around drug use, must ask about context of drug use and sex. Training and supervision around sexual therapies for those working alongside GBMSM who practice chemsex may be beneficial. Research on treatment approaches to support the sexual wellbeing of people who practice chemsex is required.
一些与男性发生性关系的男同性恋者和双性恋者（GBMSM）使用药物来增强性体验（化学性行为/聚会与滥交），可能会遭受伤害并寻求谈话治疗。进行化学性行为的GBMSM可能因预期的耻辱感以及认为这些服务缺乏化学性行为专业知识而无法获得毒品服务。服务障碍已有记录，但对于参与化学性行为的GBMSM的服务体验知之甚少。
对24名报告当前有使用甲基苯丙胺和/或γ-羟基丁酸进行性相关使用行为的参与者进行了半结构化访谈。访谈探讨了咨询和心理服务的体验、参与者的治疗目标和挑战。数据逐字转录，并在NVIVO14中采用定性描述方法进行分析。
我们研究中的大多数人试图减少甲基苯丙胺的使用频率，并且仅在性情境中使用甲基苯丙胺。当在针对一般成年人群的酒精和其他毒品或心理健康服务中与咨询师和心理学家接触时，大多数人对其甲基苯丙胺使用中的性驱动因素和性行为类型进行了审查。参与者对药物用于性方面的依赖被认为是减少甲基苯丙胺使用的主要障碍。服务中的性自我审查抑制了参与者获得有意义支持并实现治疗目标的能力。
与GBMSM围绕药物使用开展工作的咨询师和心理学家必须询问药物使用和性方面的背景情况。为与进行化学性行为的GBMSM一起工作的人员提供性治疗方面的培训和监督可能会有所帮助。需要开展关于支持进行化学性行为者性健康的治疗方法的研究。
