{"id":54000,"date":"2026-05-28T21:11:41","date_gmt":"2026-05-28T21:11:41","guid":{"rendered":"https:\/\/i-base.info\/htb\/?p=54000"},"modified":"2026-05-30T05:18:17","modified_gmt":"2026-05-30T05:18:17","slug":"bhiva-2026-chemsex-services-needs-data-and-how-to-help","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/54000","title":{"rendered":"BHIVA 2026: Chemsex data, service needs and how health workers can help"},"content":{"rendered":"

Simon Collins, HIV i-Base<\/strong><\/p>\n

Although the complicated outcomes related to chemsex have been known within the community for at least 20 years and these led to increased development of NHS services over the last 10 years, there is still no formal data, even for London, on the extent of chemsex-related morbidity and mortality.<\/strong><\/p>\n

This includes still not having an NHS ICD-10 code specific to chemsex and still no record of chemsex-related deaths, including from overdose. This data is essential to justify funding to develop appropriate services.<\/p>\n

This data gap especially affects people living with HIV who take part in chemsex, and these issues were included in a lunchtime workshop at the 6th Joint BHIVA\/BASHH Conference with four key talks.<\/p>\n

Chemsex is broadly defined as the use of long-acting stimulants, notably crystal methamphetamine, mephedrone and GHB\/GBL (although sometimes including ketamine and other substances) to enhance and prolong sex. As a social phenomenon it is closely connected to social media apps that make it easy to advertise and connect with other people interested in chems and able to supply them.<\/p>\n

However, the intensified intimacy of chemsex also carries significant risks, especially with prolonged use. These include paranoia, psychosis, dependency, addiction, social disconnections, risk of assault, overdose and death.<\/p>\n

Chemsex cases at King’s: 50% disconnected from HIV care\u00a0<\/span><\/h2>\n

Naomi Fitzgerald, chair of the London Chemsex Steering Group gave an overview of the range of cases seen at King’s College Hospital in South London. [1]<\/strong><\/p>\n

Seven harmful chemsex cases in people living with HIV seen over a six-week period prompted the clinic to retrospectively review cases over the previous year.<\/p>\n

Symptoms in the original seven cases presenting at A&E included meth-induced psychosis, worsening of pre-existing mental health issues, sepsis, severe STIs including neurosyphilis, trauma and mortality. Five of these cases had disengaged from HIV care. In addition to ambulance, A&E and intensive care services, management often also involved sexual health, psychiatry, addiction, police, security, housing and social services.<\/p>\n

The retrospective review ran from November 2024 to December 2025 and identified 177 cases using ICD-10 codes for intoxication, recreational drug misuse and drug-induced psychosis, with the presenter noting that there still isn\u2019t a specific code for chemsex.<\/p>\n

Of these, 48\/177 (27%) cases were linked to chemsex drugs: 25\/48 had physical injuries or medical complications and 23\/48 presented with psychosis, suicidal ideation, self harm or behavioural complications.<\/p>\n

Roughly 25% were people living with HIV, half of whom had disconnected from HIV care, often reporting previous history of assault and STIs. The median viral load and CD4 count of those disconnected from care was 250,000 copies\/mL and 250 cells\/uL, respectively.<\/p>\n

Many of these people also had multiple intersecting vulnerabilities. Of the 25 people living with HIV, 18 had a concurrent mental health diagnosis, 11 required admission for drug-induced psychosis, 21% were unemployed linked to drug use, 13 had unstable housing and 5 were living on the street.<\/p>\n

The talk highlighted important guidance for health professionals. This included actively engaging with people in your care and with community organisations to learn about chemsex to both educate and advocate for appropriate care, including to commissioners. Also that management of chemsex-related complications will likely depend on having an informed cross-sector MDT.<\/p>\n

Data and local services: 30:30:30<\/span><\/h2>\n

In the second talk, Drew Hawkinson from City and Hackney Public\u00a0<\/span>Health talked about the importance of developing local chemsex services. [2]<\/strong><\/p>\n

Although there is still no single source for chemsex-related complications, rough estimates have been compiled from GUMCAD, emergency services, A&E admissions, mental health referrals and National Drug Treatment Monitoring data. These sources suggest that perhaps 30% of gay and bisexual men and transgender and gender non-conforming people in London have used chemsex at some time. They also suggest that London has approximately 30 ambulance call outs every month, 30 hospitalisations every month and 30 deaths a year. These figures have likely been continuing for years.<\/p>\n

Managing complex cases depends on developing supporting services that are person-centred, trauma-informed, free of stigma and still remain sex-positive. City and Hackney has done this by developing clear and flexible pathways that connect sexual health, mental health and substance use services.<\/p>\n

This involved connecting more than 20 services including community support to cover domestic abuse, homelessness, sex worker outreach and LGBTQ+ organisations. See: City & Hackney model below.<\/p>\n

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People with lived experience of chemsex<\/span><\/h2>\n

The importance of c<\/span>ommunity organisations and their approaches to chemsex was covered by Monty Moncrieff from London Friend, an LGBTQ+ organisation that has been delivering chemsex support services at the Antidote service since 2008. [3]<\/strong><\/p>\n

This includes providing individual and group psychosocial interventions that are by and for LGBTQ+ communities, and drug treatment and sexual health services.<\/p>\n

In 2025 the group also undertook a chemsex needs assessment survey with results based on over 300 LGBTQ+ respondents with experience of chemsex or drug use, mainly (68%) London-based. Roughly half were white British, 89% men, 7% trans-identifying, with mean age 45 years old.<\/p>\n

Approximately 70% used chemsex with various frequencies, including 10% daily, 17% multiple times a week and 15% every few weeks. The most commonly used drugs were: crystal meth (68%), GHB\/GBL (63%), cocaine (54%) and ketamine (51%).<\/p>\n

The most frequent concerns involved: mental health (73%), over-use (66%), dependence\/addiction (65%), physical health (62%), impact on work (57%), impact on social life (54%), risk of overdose (35%) and stigma\/shame (43%).<\/p>\n

Roughly half had accessed chemsex services and although these were generally helpful, roughly 1 in 6 people found the intervention was poor or very poor and was not helpful.<\/p>\n

Recommendations included the need for more stable funding and for support for LGBTQ+ peer services, i<\/span>ncreased professional training, improved alignment with mental health services and coordination between multiple agencies.<\/p>\n

Full details are available in the online report. [4]<\/span><\/p>\n

How health workers can help<\/span><\/h2>\n

The final talk in the workshop was given by Helen Corkin from UKHSA, Fast Track Cities and other agencies, and<\/span>\u00a0<\/span>included practical ways that health workers can be part of a proactive public health approach to chemsex rather than just waiting for it to happen. [5]<\/span><\/strong><\/p>\n

This needs to be founded on harm reduction and integrated care. She advised health workers to:<\/span><\/p>\n

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