Gay Men's Chemsex Survival Stories

Methods: Using a life course perspective, the present qualitative interview study examined participants' reflections to discern pathways in and out of chemsex engagement. Six participants (aged ≥18 years) were drawn from a cohort of men who had completed the tailored therapeutic Structured Weekend Antidote Program. Transcripts were analysed using a Labovian narrative analysis framework.

Results: Each man identified a multiplicity of incidents and feelings that contributed to their engagement in chemsex, and engagement in chemsex was connected to participants' identity development and desire to belong to a gay community. Underlying individual accounts, a common narrative suggested a process through which chemsex journeys were perceived as spiralling from exciting and self-exploratory incidents into an out-of-control, high-risk activity that was isolating and prompted engagement with therapy. Despite seeking therapeutic engagement, participants expressed uncertainty about maintaining a gay future without chemsex.

Conclusions: Chemsex was associated with a positive gay identity gain, which explained the ambivalence participants expressed in maintaining a gay future without chemsex despite their awareness of negative consequences. This is significant for understanding both why chemsex pathways may prove attractive and why they may be so difficult to leave.