This document provides an overview of chemsex, or sexualized drug use, among men who have sex with men (MSM) in Germany. It summarizes what is known and unknown about prevalence, contexts, motivations, and impacts based on qualitative interviews and one quantitative study. While a minority behavior, chemsex occurs mostly episodically in private or via social media. Both controlled and uncontrolled use exists. Harms can include physical, psychological and social issues. Support services need a holistic approach accepting both sexuality and drug use, but are limited outside Berlin. More research is still needed on topics like effective harm reduction strategies, social norms, differences in patterns, and definitions of satisfying sober sex.

1. ChemSex across Germany:
What's known and what's not?
European ChemSex Forum 2016
07.04.2016
Anna Dichtl, annadichtl@fb4.fra-uas.de
Niels Graf, niels.graf@fb4.fra-uas.de

2. Stigmatising media reports on chemsex
…caught with Hitler drug…

3. Stigmatising media reports on chemsex
…Hitler drug is flooding the gay
community…

4. Outline
1. Contexts of chemsex among MSM in Germany
1.1 Prevalences & general patterns of sexualised drug use
1.2 Settings of sexualised drug use
1.3 Social charactaristics of MSM who practice chemsex
2. Motivations for sexualised drug use
3. Impacts of sexualised drug use on well-being
3.1 Impacts on sexual well-being
3.2 Impacts on physical, psychological & social well-being
4. Drug using MSM & the current assistance system
5. Conclusion: priorities for future research

5. Data sources
Two qualitative studies:
• Club drug study: Deimel et al. 2015/2016
 Drug using MSM: N=14
• QUADROS project (DAH): Dichtl et al. 2016
 Drug using MSM: N=75
 Professionals: N=27
One quantitative study:
• Gay men and HIV/Aids: Drewes/Kruspe 2016
(forthcoming)
 MSM: 16.734

6. Contexts of chemsex among MSM in Germany
Prevalences of (sexualised) drug use
Adapted from Drewes/Kruspe 2016 (forthcoming)

7. Contexts of chemsex among MSM in Germany
General patterns of sexualised drug use
Sexualised drug use is…
 a minority behaviour
 episodic (rather than continuous)
2 groups of drug using MSM:
 „Controlled“ sexualised drug use (majority)
 „Uncontrolled“ sexualised drug use (minority)
„Slamming“ is not very common

8. Contexts of chemsex among MSM in Germany
Settings of sexualised drug use
private
setting
public
setting
social media/hook-up apps

9. Contexts of chemsex among MSM in Germany
Social characteristics of MSM who practice chemsex
Commonalities:
• well educated, in employment, well paid
Differences between subpopulations:
Sexualised drug use is more common…
• in larger cities
• among younger MSM (with the exception of crystal meth)
• among MSM with diagnosed HIV

10. Motivations for sexualised drug use
physical level psychological level
enhancement of sexual performance reinforcement of communication skills
enabling specific sexual practices peer pressure
intensification of sexual feelings
strengthening self-confidence
overcoming shame and inhibitions
→ importance of underlying social and community norms

11. Impacts of sexualised drug use on well-being
Sexual well-being
Positive consequence:
• very intense, extended sexual experiences
Negative consequences:
• erectile dysfunction and non-appearance of sexual feelings
• unintended loss of control
→ unintentional sexual risk-taking
→ sexual assaults
• inability to have sex without drugs

12. Impacts of sexualised drug use on well-being
Physical, psychological & social well-being
A range of harms related to physical health, psychological
and social wellbeing, inter alia:
physical harms psychological harms social harms
overdosing increased aggression problems in work
environment
vulnerability to diseases listlessness problems in private
settings
changing of one´s
appearance
hallucinations/loss of
touch with reality
social withdrawal
interactions with ART psychoses, anxiety,
depressions
legal consequences

13. Drug using MSM & the current assistance system
Support required by drug using MSM
Important characteristics of required assistance services:
• acceptance of both (homo-) sexuality and drug use (as a
fundamental attitude)
• services should be embedded in the sexual health sector,
not in the drug treatment sector

14. Drug using MSM & the current assistance system
Available support for drug using MSM
Berlin Frankfurt Hamburg Cologne Leipzig Munich Nuremberg
Specific
support for
drug-using
MSM
 x x  x x x
Interest of
relevant
actors to
provide
support
      

15. Conclusion: priorities for future research
• When is controlled drug use possible, what could effective risk
management strategies (with a focus on overall well-being) involving
chemsex look like and what are relevant factors that drive change in
drug use trajectories?
• What role do social and community norms play in the context of
chemsex?
• How can commonalities and differences of chemsex patterns be
explained?
• What could good, satisfying sober sex be like and under which
conditions can it occur?
• Is chemsex only a concern to MSM or is it also a matter for
heterosexuals?

16. References
• Deimel, Daniel; Stöver, Heino (unpublished): Clubdrug-Studie.
Drogenkonsum und Gesundheitsverhalten bei Männern die Sex mit Männern
haben in Deutschland. https://clubdrugstudie.wordpress.com/.
• Dichtl, Anna; Graf, Niels; Sander, Dirk (forthcoming): QUADROS.
Modellprojekt „Qualitätsentwicklung in der Beratung und Prävention im
Kontext von Drogen und Sexualität bei schwulen Männern“. Deutsche AIDS-
Hilfe, Berlin.
• Drewes, Jochen; Kruspe, Martin (forthcoming): Schwule Männer und
HIV/AIDS 2013. Schutzverhalten und Risikomanagement in den Zeiten der
Behandelbarkeit von HIV. Deutsche AIDS-Hilfe, Berlin.
THANK YOU!