Therapists warn about “chemsex” – a dangerous sexual fad that provokes sexually transmitted infections

Therapists warn that “Chemsex”especially “cotton”, increases the risk of contracting sexually transmitted infections (STIs).

It consists of using drugs to maintain sexual relations over a long period and with different sexual partners. They cause strong disinhibition and reduce cognitive and emotional perception, which makes it easier to contract the disease during sexual relations.

As explained in 45th National Congress of Internal Medicinewhich will take place in Las Palmas (Canary Islands) from October 24 to 26, the most common STIs in Spain are:

• gonorrhea (gonorrhea)
• chlamydia
• syphilis

In the last decade, an increase in the incidence of all of them in men and women has been detected in Spain, especially after the COVID-19 pandemic.

He Dr. Jorge Del Romero Guerrero– explained during the presentation “Sexually transmitted infections. Chemsex” that “not all drug use in sexual relations is considered chemsex.”

And, although there is no clear scientific consensus on its definition, chemsex is defined as: the intentional use of drugs, mainly mephedrone (or other synthetic cathinones), methamphetamine and GHB/GBL, as well as other substances to maintain sexual relations, usually in groups. (“sessions, chills”), “over a long period of time (from several hours to days) in the sociocultural context of an LGBTI collective.”

What dangerous substances are used in Chemsex?

Consumption of chemsex varies depending on the region where it is practiced. However, the most commonly used substances include mephedrone (“mephe”), which belongs to the pharmacological family of synthetic cathinones.

These substances are chemically modified to evade international controls, resulting in more than 220 variants. Some, such as Alpha (Alpha-PVP) or Monkey Dust (Alpha-PiCP), are 10 times more powerful than cocaine. The use of methamphetamine (“tina”) and GHB/GBL (“chorry”) is also widespread.

In addition, the use of other substances is associated, such as ketamine, cocaine, tussie (or pink cocaine), popper and others. Likewise, drug use often involves the use of erection enhancers, especially sildenafil.

“Our experience at the Sandoval Center in Madrid shows that mephedrone is currently the most common substance, followed by GHB and popper. In addition, there has been an increase in intravenous drug use (especially mephedrone and methamphetamine), a phenomenon known as “slam.” In Sandoval, the prevalence of slamming has increased significantly in recent years.”

Fewer cases of HIV, but more gonorrhea and chlamydia

As for people who practice chemsex, the vast majority of them:

“Men who have sex with men (MSM) and transwomen (most of them sex workers). That is, this is a phenomenon that is very specific to the LGBT community,” Dr. Del Romero emphasized.

Regarding physical health risks, “drug use, by its very nature, involves disinhibition and decreased perception of risk of contracting an STI“

“In recent years, the high preventative effectiveness of HIV transmission demonstrated by ART and PrEP has reduced the perception of risk of acquiring or transmitting HIV and, as a result, condom use has significantly decreased among MSM (men who have sex with men).

This has led the Sandoval Center to “a decline in HIV diagnoses and a persistent increase in the incidence of gonorrhea, chlamydia/LGV and syphilis.”

On the other hand, “diagnoses of hepatitis B are rare and are made mainly in unvaccinated migrants. “Slam is also associated with multiple complications such as cellulitis, phlebitis or abscesses.”

Therapeutic developments for the treatment of HIV

The number of new diagnoses has decreased in recent years due to the introduction of PrEP and better infection control with antiretroviral therapy (ART).

However, Dr. Javier de la Fuente from the internal medicine service of the Ribera Povis Hospital in Vigo (Barcelona) emphasized that “what has not changed much is that almost half of new diagnoses are made in late stages.” infections.

• “Currently, ART options are numerous and very effective in controlling viral replication. The advent of long-acting drugs also improves the quality of life of patients by reducing the frequency of dosing, reducing stigma and anxiety of people living with HIV.”
• “The greatest therapeutic novelty comes from the results obtained in PrEP with semi-annual lenacapavir “which prevents new infections, has the greatest preventive efficacy observed to date, and which could represent a major milestone in the fight against HIV infection.”