They warn that chemsex causes cases of gonorrhea and syphilis.

Therapists warned of an increase in cases gonorrhea, chlamydia, including LGV, and syphiliswhich is favored by chemsex (the use of drugs to facilitate or enhance sexual activity) and slam (a modality of chemsex, that is, the use of recreational drugs to intensify sexual relations), while a decrease in HIV incidence is perceived to be due to preventive therapy.

Currently, sexually transmitted infections (STIs) most common in Spain they gonorrhea, chlamydia (including LGV) and syphilis, according to the National Register of Notifiable Diseases (EDO).

In this sense, it should be noted that such sexual practices, which involve the use of drugs to maintain sexual relationships over a long period and with different sexual partners, cause intense disinhibition and reduce cognitive and emotional perception of the risk of contracting sexually transmitted infections. (STI).

Dr. Jorge Del Romero Guerrero, Medical Director of the Sandoval Medical Center of the Madrid Clinical Hospitalnoted that “not all” drug use in sexual relationships is considered chemsex. Thus, although there is no clear scientific consensus on its definition, it is defined as “the intentional use of drugs, mainly mephedrone (or other synthetic cathinones), methamphetamine and GHB/GBL, as well as other substances (often in polydrug abuse) for maintenance.” sexual, usually in groups (sessions, chills) over a long period of time (hours to days) in the socio-cultural context of the LGBTI community.”

Although chemsex consumption varies depending on the region where it is practiced, the most commonly used substances include mephedrone (“mephe”), which belongs to the synthetic cathinone pharmacological family. These substances are chemically modified to evade international controls, resulting in more than 220 variants, some of them “Alpha” (Alpha-PVP) or Monkey Dust (Alpha-PiCP), which are “10 times stronger than cocaine.” .

Dr. Romero noted that experience from the Sandoval Center in Madrid shows that currently “mephedrone (synthetic cathinones) is the most common substance,” followed by GHB and popper. It also finds an increase in intravenous drug use (especially mephedrone and methamphetamine), a phenomenon known as clap or clap. Sandoval, he adds, is all about the helmet.”has increased significantly” in recent years.

Risk perception decreases

“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. This produced in Sandoval Center -Madrid- a decrease in the number of diagnoses of HIV infection and a steady increase in cases of gonorrhea, chlamydia/LGV and syphilis,” the specialist noted.

Regarding “flapping” or “flapping” and “fisting” (inserting a hand into the rectum), practices closely associated with chemsex, he noted that they “facilitate” the transmission of hepatitis C virus (HCV) because they are in Sandoval “the vast majority» all diagnoses of acute hepatitis caused by HCV occur among MSM, chemsex users, some of them are associated with this practice.

In contrast, hepatitis B diagnoses are “rare” and are made mainly to unvaccinated migrants. “Stroke” is associated with “multiple complications” such as cellulitis, phlebitis or abscesses.

Finally, he points out that “integrated approach» therapeutic treatment of patients with drug use problems “should be multidisciplinary,” indicating that future goals include “increasing accessibility” of the health care system and reducing administrative barriers, early detection of HIV, HCV and other STIs (opportunistic screening), widespread availability PrEP and ART, universal and immediate.