On 16 December 2021, APCOM with the support of PEPFAR and USAID-funded EpiC project organised a regional webinar to fully examine challenges and successful models for reaching and providing HIV Guide for Program Planners in Key Population-led HIV/Sexual Health Programs in Southeast Asia with the following objectives:
- To build a common understanding about chemsex amongst key populations and other stakeholders;
- To identify gaps and support needed in relation to chemsex issues at the country level;
- To highlight the chemsex and HIV cascade guideline;
- To advocate with government and other stakeholders on chemsex issues for policy changes and meaningful participation in decision-making processes.
There were 190 participants who joined on Zoom from 23 territories; Australia, Bangladesh, Bhutan, Cambodia, Germany, India, Indonesia, Japan, Kyrgyzstan, Laos, Malaysia, Myanmar, Nepal, the Netherlands, Pakistan, Papua New Guinea, the Philippines, Singapore, Switzerland, Taiwan, Thailand, Timor-Leste, and Vietnam.
“Chemsex is one of the last milestones that we need to tackle to end AIDS and USAID will continue to support and promoting innovative approaches.”Dr. Pimpanitta Saenyakul, HIV Deputy Team Leader, USAID RDMA, Bangkok
Link to Resources
Needs at country-level
“Another challenges that we’ve been facing is the mindset of public health personnel and national health agencies that really don’t understand and the complication of the chemsex problems. They would think that it is another drug problem.”Akkraset Chwengchinnawong, founder of KRUBB Bangkok, Thailand
Representatives from Indonesia, Kyrgyzstan, Malaysia, the Philippines, Thailand, and Vietnam shared their concerns on:
- MSM engaging in chemsex are more likely to engage in condom-less sex, making them more vulnerable and at risk of contracting HIV and STIs.
- Messaging and education around knowledge of drugs, harm reduction, HIV prevention and treatment has to be targeted to those that are engaging in chemsex
- MSM experience personal challenges such as self-stigma, substance dependency, and mental health problems, and these needs to be part of the interventions
Findings from the APCOM survey after the webinar, which asked participants what are the needs at the country level – support on advocacy, financial and technical assistance for each country to implement and integrate chemsex interventions into their HIV programme.
Criminalisation and Stigma and Discrimination
Drug use, including chemsex is illegal across all settings. As it viewed by authorities, the public and health care personnel as a criminal activity it creates a stigmatizing and discriminatory environment for not only not only people who use drugs, but also to MSM and transgender women.
Thus, HV programme targeting MSM and transgender women have not yet integrated intervention for those that are also using drugs. This also pushes the community to not seek support, and not enter the health care system for fear of going to jail.
Lack of Data
Chemsex can be really confronting because it combines the taboo of sex and drugs and MSM and transgender but not only that it talks about and confronts issue of sexual pleasure and emotional connection that chemsex participants talks about in their practices. Chemsex can be pleasurable, there is no doubt about it and chemsex does not need to be problematic but there are regular issue arising from participation in chemsex that can increase the risk of HIV, STI and other forms of bloodborne infection.”Ed Chamberlain, Lead consultant on Chemsex Guidelines
There is a need a for more interventions from NGOs, governments and funders and having more understanding of the practice and the community. As the law and law enforcement criminalizes and penalizes people who use drugs, there is a lack of data on those that are engaging in chemsex. Without reliable data, resources will not be made for targeted interventions for those that are engaging in chemsex, in settings that they most comfortable in, and accessible to them, and what kinds of services they would like to see.
Participants voiced their concerns on the issues that law and enforcement still criminalize and penalize people who use drugs, lack of access to mental health services and that the community are still hard to reach.
Despite these obstacles there are opportunities that the participants suggested; advocate for a policy change within the government and officials and there is a need a for more intervention from NGO, governments and funders and having more understanding to the practice and the community.