The hidden dangers of having 'chemsex'.
Last December I had a letter from a worried parent because she'd found out her son was having chemsex. Even in the short time since then the British Medical Journal has highlighted the dangers of drugs and sex.
Chemsex is a word used mostly in relation to men who have sex with men (MSM), and describes the use of drugs during sex, which is increasingly leading to unsafe sex and sexually transmitted infections (STIs).
Gay sex has a long history of sexual liberation and drug use, says David Stuart, substance-use lead at London's 56 Dean Street sexual health clinic.
He pointed out three new drugs where recreational low-harm drug use has become acceptable, methamphetamine, mephedrone and GHB, gamma hydroxybutyrate, which are anything but less harmful.
They cause loss of sexual inhibitions and are associated with poor condom use, more sexual partners and high-risk sexual practices. And, according to Professor Jane Anderson, a consultant HIV physician at Homerton Hospital in Hackney, these substances are associated with unsafe sex, plus more and more people are injecting these drugs too.
Sexual networking apps, such as Grindr, have also changed the way gay men find sexual partners. They remove the need for socialising which may lead to easier access to drugs.
In a 2014 study of sexual behaviour in people living with HIV, more than half the 2,248 MSM included had used drugs in the past three months, and almost a quarter had used more than three drugs.
A 2013 survey showed that around 3,000 of the 7,000 MSM who attended the 56 Dean Street clinic every month were using chemsex drugs.
Last year, they published findings from a survey of 874 men involved in chemsex. Sexual episodes of 12 to 48 hours were found to be the norm, with nearly half reporting four to 10 partners per episode.
A third were living with HIV, almost a third were injecting drug users and 70% hadn't had sober sex in the previous six months.
"It's possible that at just one party, there are between three and six new HIV infections," says Stuart, who attributes the surge in HIV and hepatitis C infections in London and possibly other UK cities to chemsex.
Stuart now believes that offering drop-in support sessions like those he's pioneered at 56 Dean Street could easily be applied to other sexual health clinics.
It's leading to unsafe sex and more STIs