What is chemsex?
Chemsex refers to using certain drugs to enhance or prolong sex. It is most often described among men who have sex with men but can involve anyone.[1]
Care should be non-judgemental and prioritise physical safety, consent and mental wellbeing.[1] The aim is harm reduction, not blame.
Why non-judgemental care matters
Many people who use drugs with sex do not tell their doctor for fear of judgement or legal trouble, and so miss out on HIV prevention, STI testing and mental-health support.[1]
Non-judgemental care improves access to services and reduces preventable harm.[1],[2]
How common is it?
Patterns of use vary by community and location. Figures from clinic attendees do not represent prevalence in the general population.[1]
The risks involved
Drugs used around sex can affect people in several ways, depending on the substance and how it is used.[1],[2]
- Awareness and consent: some substances reduce awareness, making consent difficult to give or read and increasing the risk of assault.
- Reduced prevention: forgetting condoms or PrEP, or prolonged sessions causing tissue injury.
- Mixing substances: especially GHB/GBL with alcohol or other sedatives, which risks unconsciousness and stopped breathing.
- Drug interactions, including with some HIV medicines and erection medicines.
- Sharing needles, which risks HIV and hepatitis C.
- Sleep loss and mental health, such as low mood or anxiety afterwards.
Assessment
Good assessment asks for honest information without judgement.[1],[2]
- Substances, amounts, route and timing.
- Other medicines, to check for interactions.
- Withdrawal symptoms or dependence.
- Exposures, to consider PEP and STI and HIV testing.
- Safety, including coercion or assault.
Harm reduction that fits your goals
Talk to a clinical team about the actual substances, frequency, sleep, consent and HIV/STI prevention.[1],[2]
Prevention to have in place: PrEP for HIV, regular STI testing, hepatitis A and B vaccination, and access to PEP within 72 hours after a new exposure.[2],[3]
Reducing harm: do not use alone, have someone you trust present, never share needles, and know how to call for emergency help.[1]
Goal-based care. Harm reduction and support to cut down or stop should follow the person's own goals. Care should not depend on first achieving abstinence.[1],[2]
How we care for you at Dr. Kris Clinic
We provide confidential, non-judgemental care: HIV prevention with PrEP and PEP, site-specific STI testing, hepatitis vaccination and checks for interactions with medicines you take, in English or Thai.
If you want to cut down or stop, or are struggling emotionally, we connect you with suitable services, and Kris Care Space offers a safe space to talk.
Frequently asked questions
Do I have to stop using drugs to get PrEP?
No. Access to HIV prevention should not depend on stopping drug use.
Will the doctor report me to the police?
Your health information is confidential under professional standards. Our aim is your health.
Can I take erection medicine with other substances?
Some combinations are seriously dangerous, especially with poppers. Tell your doctor honestly so safety can be assessed.
My friend passed out after using. What should I do?
Call emergency services immediately, place them on their side, and do not leave them alone.
Agree on harm-reduction goals together and make prevention and treatment accessible.[1] Non-judgemental care reduces preventable harm.
Talk to a doctor about this
Confidential care in Surat Thani, the mainland gateway to Koh Samui, Koh Phangan and Koh Tao. Tue–Fri 17:00–20:00 · Sat–Sun 10:00–15:00 (UTC+7)
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Dr. Krida Uakridathikarn (Dr. Kris)
Board-certified family physician with certificate training in clinical sexology and sexual medicine. He works at Suratthani Hospital and provides sexual health, hormone and LGBTQ+ inclusive care at Dr. Kris Clinic. Profile and CV
References
- NYSDOH AI: Chemsex—Questions and Answers
- WHO Consolidated HIV, viral hepatitis and STI guidelines for key populations (2022)
- CDC nPEP Recommendations 2025. MMWR 74(RR-1)
Keep reading
Main guide: Gender-affirming care
Understanding the Dimensions of Sex and Gender
Gender Identity and Sexual Orientation: The Difference and Why It Matters
Non-binary Identities: Healthcare That Respects Individual GoalsThis article is general education, not personal medical advice or a promise of results. Diagnosis and treatment require assessment by a doctor. Content reflects the cited sources as of the update date.