Getting a Grip on Sri Lanka’s Chemsex Issues

By April 10, 2024 April 12th, 2024 SKPA

Nicky Suwandi

Knowledge Management & Innovations, APCOM

A series of training focused on the theme of sexualized drug use took place in Colombo, Sri Lanka between 29 January to 2 February 2024. Sexualized drug use or chemsex, although not a new phenomenon in global HIV response, is still considered as a highly complex issue as it appears to have been amplified and facilitated by new technologies (e.g. social media, location-based dating applications) among communities who are highly impacted, and currently gauged as an emerging phenomenon in the country.

This SKPA-2-supported initiative – a joint effort between APCOM, Family Planning Association (FPA) Sri Lanka, Health Equity Matters, and Mainline (represented in the training by Center for Supporting Community Development Initiatives (SCDI)) – is aimed to build capacity of community-based organizations and stakeholders, with topics ranging from basic knowledge of chemsex to ways of delivering effective approaches to affected communities. “The training was a perfect example of how good team work between technical experts, program managers, community workers and people with lived experiences is the key to the success of such important activity,” mentioned Palani Narayanan, Senior Manager – Health and Human Rights of Health Equity Matters.

“The training was really useful and effective. It was the first crucial step for participants to come up with ideas for suitable chemsex interventions in Sri Lanka,” said one of the trainers, Vu Thi Hien, Learning Expert and Project Coordinator of SCDI. She added, “The participants were very well engaged and hopefully got ample insights from the training to be implemented into their own settings.” Conducted during the time when a controversial mass drug crackdown happened in the country, this training is possibly the first-of-its-kind, and unarguably a very much needed initiative to tackle issues related to chemsex.

The training on 29 and 30 January 2024 were exclusively aimed at public health officials and medical professionals covering a broad spectrum of topics related to chemsex. The participants recognized the need to view people who use drugs as individuals in need of support rather than as criminals, highlighting the importance of understanding the complexities of drug issues beyond just individual behaviour. Other than that, participants also recognized the critical role of engaging and empowering communities in developing and applying interventions. 

The trainers received overwhelmingly positive praises from training participants, particularly on the contents and facilitation skills. In the anonymous feedback form provided by the organizer, one participant cited topics around chemsex definition, effects of drugs, and methods of harm reduction as most valuable during the training, and another participant cited how all the information shared has helped in providing a better understanding of the mindset of people who engage in chemsex. 

The training for community and peer outreach workers – took place on 31 January and 1 February 2024 – highlighted intervention strategies for supporting clients involved in chemsex. Key points discussed were on promoting self-care, pre-exposure prophylaxis (PrEP) education, and possible methods to decrease chemsex activity. Discussions also explored the effects of chemsex on mental and physical health, its link to higher HIV risk, the need for specialized training in sexualized drug use support and HIV prevention, and the necessity for further research on sexualized drug use. 

The final day, 2 February 2024, was a community-focused consultation, which was held in the form of round table discussions with men who have sex with men (MSM) and transgender women participants regarding their experiences with chemsex. They shared deeply personal stories and challenges related to chemsex, healthcare access, and societal discrimination. Insights from this consultation will help design a better future response for communities highly affected by the issues in Sri Lanka.

There’s a need to provide further learning efforts on chemsex in local languages, in which an online resource will be developed to increase accessibility to accurate information on chemsex for health professionals and community members. As one of the next steps, there’s also a plan to develop a virtual communications strategy that is specifically-designed for outreach workers to meet the needs of individuals engaged in chemsex.

Based on data collected by local outreach workers, of those who tested positive for HIV (52), approximately 75% reported use of amphetamine type substances and engaging in chemsex, making it a significant contributing factor to the increasing HIV prevalence in Sri Lanka. Crystal methamphetamine (or commonly known as Ice), is reportedly the most used type of drug in sexualized settings among MSM and transgender women communities and it is predicted that this ‘trend’ is highly concentrated within the Colombo metropolitan area. Fast action and extra attention to this developing complex issue is eminent to reduce excess harm among the most marginalized and highly-impacted vulnerable communities.

Published on: 08-Apr-2024

About the Contributor

Nicky Suwandi (He/Him/His)

Knowledge Management & Learning
APCOM, Thailand

Nicky led the demand generation initiatives during SKPA-1, and with his current position, he is aiming to facilitate discussions and promote cross-learning in the SKPA-2 project and beyond. In addition, his work is deeply rooted in creating meaningful changes for key population communities, specifically on HIV online interventions, pre-exposure prophylaxis (PrEP) and sexualized drug use or chemsex. Hailing from Indonesia, he is equipped with a degree in communication studies, and have experience working in a national network for men who have sex with men (MSM) and transgender women, which comprises more than 80 community-based organizations and support groups across the archipelago.

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