Delivered at Sex, Drugs & Scotland's Health Virtual Conference, this presentation was delivered by Lesley Bon & Stephan Vargas. More information about the virtual event is available here: http://ow.ly/YntW50GWhJ0

1. Working with frontline
staff in understanding the
chemsex community
STEPHEN VARGAS – THT
LESLEY BON - SDF

2. What we will cover
1. Training needs of community and staff
2. The training we offer – co-facilitated by SDF and THT
3. What do you think?
4. What else needs to be done?

3. 1: Training needs of
community and staff

4. Participant 116 – Understanding the Sexual Health and Blood Borne Virus
Risk Behaviours of Defined “at-risk” Groups to inform a Service Training
Programme – SDF Research Report published May 2020
“Yeah, getting them through the apps was really
common, [….] and then we’d start using that,
maybe the other people that’s with us, they’d
have the bit they came with, and then inevitably
whatever you think is going to be enough, never
is, and you then start to run out, so then you’d be
onto the app to get more and people would just
bring it in”

5. SDF Research Report Findings
 There is a lack of awareness of safe and appropriate dosing.
 Rational decision making is adversely affected by the effects of the drug
and the length of time people use drugs in a ‘session’
 Guidance of how much is ‘safe’ (with all the usual caveats on unknown
purity and content for illegal substances) for each administration and over
a period of time is required.

6. Participant 116 – Understanding the Sexual Health and Blood Borne Virus
Risk Behaviours of Defined “at-risk” Groups to inform a Service Training
Programme – SDF Research Report published May 2020
“I didn’t always feel comfortable bringing it up,
because I felt there was a bit of judgement there,
if I’m being completely honest, I mean, yeah, I’ve
never felt that I could, that it’s being brought up
in this, I didn’t feel like it was like a safe
environment to talk, I felt it was more the finger
was getting pointed”

7. SDF Research Report Findings
 Staff must be aware of potential embarrassment, shame and fear of
judgement in chemsex clients.
 Consideration of how questions are asked about chemsex, use of
language and informing clients of the reasons why the questions are asked
is useful to overcome barriers to disclosure
 Staff should be alert to potential paranoia as a side effect of the types of
drugs used. This can influence client behaviour and perceptions of staff
behaviour.

8. SDF Learning Needs Assessment
 Published Sept 2021
 287 responses from across Scotland
 13% felt informed around the sexual health and BBV needs of those involved in
chemsex
 37% felt confident to ask people about the sex they have
 47% felt confident to asking people about their sexual orientation or gender
identity
 32% felt confident to provide support to someone around their sexual
orientation or gender identity
 56% felt confident to ask people about their injecting practice and other drug
use

9. 2: The training we offer

10. Chemsex in Scotland
 Due to Covid – offered as half day on zoom introductory sessions for staff
 Run near monthly
 Co-facilitated by Lesley from SDF and Stephen from THT
 Aimed at all front line workers – especially those who work in sexual
health, drug services, LGBTQI+ and mental health.
 Learning Outcomes:
• Describe the context of chemsex in Scotland
• Reflect on how individual attitudes and beliefs can impact on clients and the services
they receive.
• Explore ways of engaging clients in discussing chemsex
• Identify key strategies to reduce harm in those who participate in chemsex

11. Chemsex in Scotland
 All fully booked – with waiting lists
 Increased capacity for next 3 courses
 The course runs as:
 What is chemsex, the main drugs used and the effects of those drugs
 Discussion groups exploring reasons people are involved in chemsex, and what harms could
be experienced
 Anonymous poll questions to reflect on if they have witnessed homophobia in their personal
life and in their work – followed by a discussion on impacts of homophobia and how staff and
services can be more welcoming to people
 3 Case studies – identifying ways to reduce harm and explore what else may be going on for
people (safer injecting packs, a young person entering the scene for the first time and
someone reaching crisis)
 Looking at making a referral for chemsex and asking questions

12. Trainers Reflections
 Chemsex Jargon
 Gay men or wider?
 The backdrop of “The Scene”
 Homophobia in Scotland
 Internalised shame
 Are drug services set up to support people with problematic use of
“chems”
 Sober sex?
 Understanding of Problematic and Unproblematic uses

13. Evaluations
 “I found Lesley and Stephen really approachable and well informed on
the subject matter. The conversational approach meant that people
were able to discuss their own views and experiences more so than if
the training was delivered predominantly via PowerPoint. “
 “I particularly liked the informal but informed and informative
approach”
 “Open discussions and clear explanations of culture n language
related to chemsex”

14. 3: Your thoughts

15. Time to hear from you
1. What do staff in different services need to know?
2. What additional skills are needed to support people involved in
chemsex?
3. Does Scotland need dedicated chemsex services? What are the
needs in different parts of Scotland? Large Cities vs towns vs rural?

16. 4: What else needs to be
done?

17. Future Training considerations
 Accepting and Letting go of our own judgments
 Internalised homophobia/Shame
 Holistic approach
 Chemsex First Aid
 Family Support
 Signposting
 Making our services acceptable for people who use chems
 Mental Health for Chemsex users

18. Participant 116 – Understanding the Sexual Health and Blood Borne Virus
Risk Behaviours of Defined “at-risk” Groups to inform a Service Training
Programme – SDF Research Report published May 2020
“it would have been useful to feel that you could
speak about it, and get the right advice, like so you
could say yeah, this is something I do, they [a service]
accept that, it is something people do, you know,
whether they like it or not...here’s what you can do to
be safer in those environments, and here’s what we
suggest you do and do not do”

19. Future Support considerations
 Counselling and mental health support
 Harm Reduction – i.e. provide injecting equipment from sexual health services
 A more holistic approach
 Sign posting and partnership work
 Podcasts – Groups – Online
 SDF Support
 THT Support
 Family Support
 Upskilling existing services
 Research into action – how do we ensure frontline staff are informed?

20. Participant 111 – Understanding the Sexual Health and Blood Borne Virus
Risk Behaviours of Defined “at-risk” Groups to inform a Service Training
Programme – SDF Research Report published May 2020
"talking groups, certainly, chemsex anonymous...
my worry about that, would be it would turn into
some kind of knocking shop... but I think if
something facilitated by someone who
understands... hear other people’s stories,
because those really help, those really help...

21. Existing Support in Scotland

22. Support outwith Scotland

23. “Its like you emerge from the closet expecting to
be this butterfly and the gay community just slaps
the idealism out of you. […] you go from your
mums house to a gay club where a lot of people
are on drugs and its like, this Is my community? Its
like the fucking jungle…”
Anonymous – Bernard Kelly presentation. European ChemSex Forum
Report 2018. Slide 14 of 36

24. Thanks and any questions?
Lesley Bon
Scottish Drugs Forum
National Training and Development
Officer, Sexual Health, Blood Borne Virus
and Harm Reduction
lesleyb@sdf.org.uk
www.sdf.org.uk
www.sdftraining.org.uk
Stephen Vargas
Terrance Higgins Trust
Lanarkshire Health Promotion, GBMSM
and LGBTi Communities
Stephen.vargas@tht.org.uk
www.tht.org.uk