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Chemsex among gay, bisexual, and other men who have sex with men in Singapore and the challenges ahead: A qualitative study

Tan RKJ 1 , Wong CM 2 , Chen MI 3 , Chan YY 4 , Bin Ibrahim MA 5 , Lim OZ 6 Show all authors , Chio MT 7 , Wong CS 8 , Chan RKW 9 , Chua LJ 10 , Choong BCH 11

Affiliations 

  • 1 Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Tahir Foundation Building #10-01, 117549, Singapore. Electronic address: rayner.tan@u.nus.edu
  • 2 FHI 360, 359 Blackwell St #200, Durham, North Carolina 27701, USA. Electronic address: cwong@fhi360.org
  • 3 Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Tahir Foundation Building #10-01, 117549, Singapore; National Centre for Infectious Diseases, Department of Infectious Diseases, Tan Tock Seng Hospital, Moulmein Road, 308433, Singapore. Electronic address: mark_chen@nuhs.edu.sg
  • 4 Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Moulmein Road, 308433, Singapore. Electronic address: yinying.chan@gmail.com
  • 5 Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Moulmein Road, 308433, Singapore. Electronic address: muhamad_alif_ibrahim@ttsh.com.sg
  • 6 National Centre for Infectious Diseases, Department of Infectious Diseases, Tan Tock Seng Hospital, Moulmein Road, 308433, Singapore. Electronic address: oliverlimzk@gmail.com
  • 7 Department of STI Control (DSC) Clinic, National Skin Centre, 31 Kelantan Ln, #01-16, 200031, Singapore. Electronic address: martinchio@nsc.com.sg
  • 8 National Centre for Infectious Diseases, Department of Infectious Diseases, Tan Tock Seng Hospital, Moulmein Road, 308433, Singapore. Electronic address: chen_seong_wong@ttsh.com.sg
  • 9 Department of STI Control (DSC) Clinic, National Skin Centre, 31 Kelantan Ln, #01-16, 200031, Singapore. Electronic address: roychan@nsc.com.sg
  • 10 Faculty of Law, National University of Singapore, Eu Tong Sen Building, 469G Bukit Timah Road, 259776, Singapore. Electronic address: lynettechua@nus.edu.sg
  • 11 National Centre for Infectious Diseases, Department of Infectious Diseases, Tan Tock Seng Hospital, Moulmein Road, 308433, Singapore. Electronic address: briax.choong@gmail.com
Int J Drug Policy, 2018 11;61:31-37.
PMID: 30388567 DOI: 10.1016/j.drugpo.2018.10.002

Abstract

BACKGROUND: Sexualised substance use, or 'chemsex' has been shown to be a major factor driving the syndemic of HIV/AIDS in communities of gay, bisexual, and other men who have sex with men (GBMSM) around the world. However, there is a paucity of research on chemsex among GBMSM in Singapore due to punitive drug laws and the criminalisation of sexual behaviour between men. This qualitative descriptive study is the first to explore perceptions towards, motivators to engaging in, and the barriers to addressing the harms associated with chemsex among GBMSM in Singapore.

METHODS: We conducted 30 semi-structured in-depth interviews with self-identifying GBMSM between the ages of 18-39 in Singapore following a purposive sampling strategy. Interview topics included participants' perceptions of drug use among GBMSM in Singapore, perceptions towards chemsex, reasons for drug use and chemsex, and recommendations to address the harms associated with chemsex in Singapore. Interviews were audio-recorded, transcribed, coded, and analysed using thematic analysis.

RESULTS: Participants reported that it was common to encounter chemsex among GBMSM in Singapore as it could be easily accessed or initiated using social networking phone apps. Enhancement and prolongation of sexual experiences, fear of rejection from sexual partners and peers, and its use as a means of coping with societal rejection were three main reasons cited for engaging in chemsex. The impact of punitive drug laws on disclosure and stigmatisation of GBMSM who use drugs were reported to be key barriers towards addressing chemsex. Participants suggested using gay-specific commercial venues as avenues for awareness and educational campaigns, and social media to reach out to younger GBMSM.

CONCLUSIONS: This study highlights the complexities behind chemsex use among GBMSM in Singapore, and the range of individual to institutional factors to be addressed. We recommend that community-based organisations and policy-makers find ways to destigmatise discussion of chemsex and provide safe spaces to seek help for drug use.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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