Sober Sex
I apologise this is one of my longer blogs as I felt I wanted to do the subject justice.
Recently, I went to see the ChemSex Documentory as part of the BFI London Film Festival - a hard-hitting and often graphic documentary about the ChemSex sub-scene in London’s gay community, directed by William Fairman, Max Gogarty; Producers Al Brown, Jacqui Edenbrow, William Fairman, Max Gogarty, Kevin Sutcliffe. I felt those taking a stand, telling their stories for such a worthy cause were both bold and brave.
Since this film I have been thinking a lot about Sober Sex. My main question from the film was ‘is it useful to put it in the public arena?’ After having processed the film, turning down the volume of my internalised homophobia, I would say ‘YES’, as what happens in one community, often starts filtering out into another, so I feel this makes ChemSex a public health issue. Today there are a small proportion of the LGBT community in London, where I live, that may feel they are managing their sex and drug use well. There is another part of the community wanting something different.
Let’s start with a definition of ChemSex. It is important to say that ChemSex is not the same as recreational drug use; as it is a specific form of recreational drug use. It is not just a London thing, it is happening in all major cities across the world. David Stuart et al, ‘a proposed definition for health workers’ HIV Bulletin (2015) gave this definition:
“Associated with extended sex for many hours/ several days; where more extreme sexual practices take place; may have multiple sexual partners; extreme sexual disinhibition/ sexual focus; unpredictable drug interactions (eg GBL & Alcohol); increased injecting amongst an injecting naive population, Blood Borne Virus risks and injecting relating harms; poor condom use; poor HIV medication adherence; frequent sexually transmitted infections, HIV or Hepatitis B or C diagnosis; multiple use of PEP (Post Exposure Provelaxis – the treatment you take within 72 hours of possible infection to prevent a diagnosis); psychosis.”
Today in my work with clients, I know both personally and professionally a now not so knew phenomenon called ‘Chemsex’. I first saw it starting to evolve through friends in about 2005 with people having small sex parties at the weekend. These were well organised and ground rules were established with attendees, which is very different from some of the ChemSex parties of today. Then when I worked at an HIV centre in West London, 2009-2013, we saw an increase in the complexity of needs that clients presented on registering at the service. They were often facing co-infection of HIV & Hepatitis C, and dual diagnosis of drug or alcohol issues presenting themselves.
Because the LGBT community is mostly based around a club and bar scene, the LGBT community is more encouraged to get involved with the taking of drugs and drinking of alcohol. I think as our gay scene gets smaller, with gay apps or the social media, we have entered into a commercialised age where we can get our needs met much more quickly. Just like Chemsex, the process of getting our sexual needs met and the validation we may receive from it, is gained much more quickly.
It can be a fine line and a balancing act going from a ChemSex blitz out once in a while, to it suddenly taking over your life and affecting the relationships with family, friends, lover or partners and work, particularly when you do not wake up on a Monday morning or you are seen falling asleep at your desk. A bit like waiting behind the yellow line when on the London Underground, those that stand close to the edge of the platform enjoy the rush of the speeding train, and are not clear of the dangers that this may pose them, although with Chemsex in my experience it is a drip, drip, and then it can slowly and suddenly take over your life.
The chill-out/ ChemSex parties of today may seem like an alien concept to some. If we look at them through different lenses, we can see that they provide some of us a way of belonging, a community, a tribe or a family. Something gay men may not have felt for some time and of course a way of saying fuck you to societal norms & the internalised or external homophobia we continue to experience from the world outside. The trauma that I have heard a minority of clients talk about is when waking up a few days after a ChemSex party, having flashbacks of what they got up to, and wondering when they gave consent for others to do things to them that they never would have done.
When talking about ChemSex, I feel we need to start having conversations around sexual consent. I went to a talk recently by Dr Meg-John Barker, where they discussed that we are better at talking about sexual consent with young people. When we get to adulthood we stop talking about this as an issue, but that issue has not gone away. I think there are many cultural, gender specific, social, economic and status factors that get in the way of adults talking about consent. I know Pink Therapy has great resources for therapists and a list of ChemSex & Kink Aware therapists. They may be a good first step.
As well as having pamphlets about reducing risk to STI’s & Blood Borne Viruses, we need new guidelines around consent, the law and how to have sober sex. With my HIV/ Hep C activist hat on, I think PreP is a great first step, the HIV prevention pill. I am insecure about it coming out when there is a growing pandemic of Hepatitis C coming to major cities like London, as there is a lack of access to the new medication to treat it quickly & prevent onward transmission. As with any new medication it is given to those who may have been living with Hepatitis C for a long time who may be facing liver cirrhosis or failure to provide better quality of life.
We need to take all we have learnt about HIV over to Hepatitis C, particularly with sexually active men who have sex with men. My main concern is that if you provide someone having riskier sex, with a pill, it does not prevent them getting other Blood Borne Viruses, so signing up to PreP (Pre exposure Provilaxis – the pill now available to prevent those having riskier sexually getting HIV) will not necessarily protect them from other resistant strains of sexually transmitted infections or Blood Borne Viruses. So people making these sexual choices may still need support in knowing how to have safer sex. People need to know that there are still risks. People need us not to judge them or stigmatise them, but need us to understand their needs. (If you want more information about PreP it is in the links below).
Getting sober is often the hardest step; there is a sense of being the party pooper. What I often hear is that people have used the drugs or alcohol to numb their feelings of anxiety of social spaces, or their anxiety around sex. From my professional experience, something a lot of gay men share. My sober sex clients often say that finding other gay men wanting sober sex in our great city feels like it is becoming an alien concept. An area not so talked about is body image and sexuality, diet and healthy living.
When wanting sober sex it is perhaps about re-writing the rules around the choices you make about sex. Asking questions like: ‘Where am I with my relationship to myself?’ or ‘What does intimacy mean to me?’ Deleting apps may feel a bit drastic. I guide those choosing sobriety, that there may be slip ups, though it is important not to be too harsh on you and provide yourself with some compassion. Hug yourself. Forgive yourself and then get back on the wheel of recovery if that is what you choose, otherwise seek help to find out what is re-triggering your use.
Good luck, be kind to yourself and keep safe out there.
PrEP protects you from HIV
HIV and AIDS at National AIDS Manual (NAM)
Sober Sex group work at Antidote - London Friend