About more

MORE is a selection of policy and strategy documents, research, and big thinking that’s caught our eye. We’ve indexed them using the website’s six key sections: YOU, MEN, BODY, SEX, STI, and DRUGS though and some of the documents fall under multiple headings. Please let us know here if you think we should add something.

Key

Exploring the experiences and visions of London’s LGBT+ organisations

Developing a coordinated response to chemsex across health, justice and social care settings: expert consensus statement

HMICFRS MPS Report 2023

Stephen Port murdered four young men in East London between June 2014 and September 2015 – but despite the obvious similarities, the Met failed to recognise the deaths were connected.

In its new report, His Majesty’s Inspectorate of Constabulary and Fire & Rescue Services (HMICFRS) found that the Met had made some improvements since the Port case, including better working arrangements between local officers and specialist murder investigation teams, and training and guidance for officers on chemsex.

However, inspectors also found that Met police officers admit they still rely on luck to identify links between deaths at a local level. Inspectors concluded that the Met’s flawed handling of the Port investigations could broadly be explained by the following issues:

-Poor training and supervision for inexperienced police officers responding to unexpected deaths
-Unacceptable record keeping, confusing case management systems and poor handling of property and exhibits
-Confusing policy and guidance
-Inadequate intelligence and crime analysis processes, which make it difficult for officers to link deaths

HMICFRS has made 20 recommendations for the Met, which include increasing the use of intelligence by officers responding to deaths and improving family liaison in unexpected death cases.

The Casey Review and Report

Recognising the grave levels of public concern following the kidnap, rape and murder of Sarah Everard by a serving Met officer and other deeply troubling incidents, the Metropolitan Police Service (the Met) appointed Baroness Louise Casey to lead an independent review of its culture and standards of behaviour. The review began in February 2022 and completed in March 2023, when the final report and recommendations were published.

Hate crime laws

Hate crimes are acts of violence or hostility directed at people because of who they are. Hate crime laws in England and Wales have developed in various phases over the past two decades, and the law currently recognises five protected characteristics: race, religion, sexual orientation, disability and transgender status.

But the criminal law does not treat all of those protected characteristics equally. This means that someone who is assaulted based on disability is not afforded the same protection as someone who is assaulted because of their race. Other major concerns include the complexity and lack of clarity in the current laws which can make them hard to understand; and concerns about the particular challenges in prosecuting disability hate crimes.

Consultation

In 2020, the Law Commission consulted on hate crime and hate speech laws England and Wales: in particular the aggravated offences regime under sections 28 to 32 of the Crime and Disorder Act 1998, the enhanced sentencing regime under sections 145 and 146 of the Criminal Justice Act 2003, the “stirring up” offences under Parts 3 and 3A of the Public Order Act 1986, and the offence of “racialist chanting” contrary to section 3(1) of the Football Offences Act 1991.

The consultation focused on two main questions:

• Who should these laws protect?
• How should these laws work?

Final report

The final report was published on 7 December 2021 making a number of recommendations for reform of hate crime laws. These include:

• Levelling up the protection for disability and LGBT+ victims
• Tackling sex and gender abuse
• Protecting freedom of expression

Commission on Race and Ethnic Disparities: The Report

“The purpose of this report is to lay the ground for a country built on the full participation and trust of all communities. We envisage a country more at ease with itself because it can recognise where progress has been made. One that is confident that, where unequal access to opportunity persists, whether among inner city ethnic minorities or the left-behind from the ethnic majority, it is being addressed. We do not believe that the UK is yet a post-racial society which has completed the long journey to equality of opportunity. And we know, too many of us from personal experience, that prejudice and discrimination can still cast a shadow over lives. Outright racism still exists in the UK, whether it surfaces as graffiti on someone’s business, violence in the street, or prejudice in the labour market. It can cause a unique and indelible pain for the individual affected and has no place in any civilised society.” Introduction (Extract).

Hidden Figures 2020

“Health inequalities arise at different stages of people’s lives, and LGBT people often experience specific further discrimination and marginalisation when accessing services to address these health inequalities. This report uses a life course ‘cradle-to-grave’ approach to highlight the importance of these stages and their cumulative impact on health and wellbeing. It also attempts to showcase the unique inequalities faced by LGBT people throughout the entirety of their lives.

The report marks the largest and most substantive look at the health inequalities faced by LGBT people across their lives, bringing together research and insights from a wide array of organisations and public sector bodies. It draws from relevant research, papers, surveys, and NHS and Government data and statistics. It also contains a range of data on LGBT Foundation’s services and insights from LGBT Foundation service users. These have been gathered through analysis of the wide range of community services offered by LGBT Foundation such as our Substance Misuse programme, Domestic Abuse programme and Talking Therapies programme.

Key findings included in the report include higher rates of homelessness, domestic abuse and sexual violence experienced by people from LGBT communities. It further demonstrates generally poorer health outcomes, with lower rates of physical activity and a substantially higher instances of mental health issues and drug/alcohol dependency. Overall, the report highlights how multiple health inequalities across a lifespan can impact sequentially and can lead to significantly worse health outcomes.”

ILGA Europe’s Annual Review 2020

ILGA-Europe’s Annual Review of the Human Rights Situation of Lesbian, Gay, Bisexual, Trans and Intersex People in Europe and Central Asia. Ninth edition covering Europe, and our first covering the entire region of Central Asia.

Includes events that occurred between January and December 2019. Provides a snapshot of what happened during the year, at national, regional and international levels, and it documents progress and trends regarding the human rights situation of LGBTI people.

ILGA stresses that the document is not an exercise in apportioning blame. ILGA-Europe’s goal is not to point fingers at specific countries. Instead, the publication intends to serve as a tool for the exchange of best practices and policies, and as an open invitation for enhanced cooperation between governments and LGBTI civil society.

Bias motivated violence

The UN Committee on the Elimination of Discrimination against Women urged the UK to combat hate crimes against trans people, ensure effective investigation and prosecution. Police records revealed that anti-LGBT hate crimes and incidents in England and Wales increased from 5,807 in 2014-15, to 13,530 in 2018-19. However, the rate of prosecution has dropped from 20 per cent to eight per cent. The number of homophobic attacks doubled, while transphobic attacks tripled. The Home Office’s Hate Crime statistics for 2018/19, released in October, also showed a 10 per cent increase anti-LGBT attacks in England and Wales, compared to the previous year.On 30 May, a female couple was attacked by a group of men in London. The case went viral after the victims posted a picture of their injuries. London’s mayor, Sadiq Khan, and then Prime Minister Theresa May condemned the attack. MPs also called for increased measures against anti-LGBT hate online. In 2020 a Law Commission will start reviewing whether current hate crime laws are effective in combating online and offline abuse.In Northern Ireland.

Public opinion

Results of the British Social Attitudes survey revealed that the acceptance of same-sex relationships has slowed down in UK, with a significant minority remaining hostile. Fewer respondents felt that prejudice against trans people is wrong in principle than in the case of anti-LGB prejudice.

Social security and social protection

Almost half of young homeless LGBT people become homeless because of family rejection. Of them, half come from religious backgrounds, primarily Christian or Muslim, as shared by the Albert Kennedy Trust (AKT). The country’s first permanent LGBT Shelter opened in London in May, run by the Outside Project.The UK’s first retirement home for LGBT people is planned The UK’s first retirement home for LGBT people is planned to be set up next year.

Extracts from United Kingdom review; period January -December 2019, pages 167-168.

LGBT in Britain 2018

Research from Stonewall, Britain’s leading charity for lesbian, gay, bi and trans equality, exposes alarming levels of poor mental health among LGBT people compared to the general population. Stonewall’s study also reveals a shockingly high level of hostility and unfair treatment faced by many LGBT people when accessing healthcare services.

Key findings:

• Half of LGBT people (52 per cent) said they’ve experienced depression in the last year.
• One in eight LGBT people aged 18-24 (13 per cent) said they’ve attempted to take their own life in the last year.
• Almost half of trans people (46 per cent) have thought about taking their own life in the last year, 31 per cent of LGB people who aren’t trans said the same.
• Forty-one per cent of non-binary people said they harmed themselves in the last year compared to 20 per cent of LGBT women and 12 per cent of GBT men.
• One in six LGBT people (16 per cent) said they drank alcohol almost every day over the last year.
• One in eight LGBT people aged 18-24 (13 per cent) took drugs at least once a month.
• One in eight LGBT people (13 per cent) have experienced some form of unequal treatment from healthcare staff because they’re LGBT.
• Almost one in four LGBT people (23 per cent) have witnessed discriminatory or negative remarks against LGBT people by healthcare staff. In the last year alone, six per cent of LGBT people – including 20 per cent of trans people – have witnessed these remarks.
• One in twenty LGBT people (five per cent) have been pressured to access services to question or change their sexual orientation when accessing healthcare services.
• One in five LGBT people (19 per cent) aren’t out to any healthcare professional about their sexual orientation when seeking general medical care. This number rises to 40 per cent of bi men and 29 per cent of bi women.
  One in seven LGBT people (14 per cent) have avoided treatment for fear of discrimination because they’re LGBT.

A long way to go for LGBTI equality

Imagine being afraid to hold your loved one’s hand in public, skipping office banter to avoid divulging with whom you share your life, choosing the long way home to side-step potentially hostile ground, or enduring ridicule every time you show your personal identification.

How British moral attitudes have changed in the last 30 years

This analysis by the Policy Institute at King’s College London, based on polling by Ipsos MORI reveals how the British public’s views on moral issues have become increasingly liberal over the last 30 years, with society today far more tolerant of illegal drug use, homosexuality, abortion, depictions of violence and many aspects of sex in popular culture, and many other issues and activities. However, views on some behaviours haven’t changed or have even hardened, including on extra-marital affairs and rejection of capital punishment. The 1989 survey was published in the book We British, by Eric Jacobs and Sir Robert Worcester.

The wordings of the statements have been kept consistent to ensure comparable trends, even where concepts and language have moved on. Most of the 2019 survey results here have been conducted using the same design as the original study: face to face interviews in respondents’ own homes, to be representative of the whole population aged 15 and above. Two of the 2019 questions were asked on an online study, of a representative sample of the population aged 16 75: these comparisons should therefore be seen as indicative but still useful, given the very large changes in attitudes seen.

London Assembly: Supporting mental health for all

Report states: prevalence of mental ill-health is significantly higher in LGBT+ communities, disabled people, Deaf people, and those with experience of the criminal justice system. And the issue is compounded by services that do not understand and meet their specific needs.

LGBT+ is mentiomned on pages 5, 7 (recommendation 2), 11, 13, 16, 21, 22, 24, 31, 34, 38, 40, 42, 43, 45, 47.

Culture for All Londoners

Alongside the Mayor’s other strategies and plans, this draft Culture Strategy (March 2018) outlines an ambitious programme to sustain a city that works hard, and plays hard, for everyone. A city that is built on the principle of culture for all Londoners. It is themed around four priorities:

• Love London – more people experiencing and creating culture on their doorstep
• Culture and Good Growth – supporting, saving and sustaining cultural places and spaces
• Creative Londoners – investing in a diverse creative workforce for the future
• World City – maintaining a global powerhouse in a post-Brexit world

LGBT+ is mentioned on pages 17, 43, 51, 75, 77, 141, 171.

LGBT Action Plan 2018

LGBT Action Plan resulting following the 2017 Government national survey of LGBT people – open to anyone who identified as having a minority sexual orientation, gender identity or had variations in sex characteristics. It asked questions about people’s experiences of living in the UK and in accessing public services. We asked questions about education, healthcare, personal safety and employment. The survey received more than 108,000 responses, making it the largest national survey of its kind anywhere in the world. The LGBT Action Plan contains 75 actions for this term of Parliament crossing all Government departments.

However one sees this as a step in the right direction, it hasn’t escaped our notice (at MEN R US) that the Action Plan has been launched while the Government is still shagging the Democratic Unionist Party (DUP) … one of the most anti-LGBT organisations in the country and consistent in its objections to LGBT rights. For example, while the Action Plan is unequivocal in wanting to ban gay conversion therapy, it’s something  DUP members have publicly advocated for in the past.

National LGBT Survey 2017

The Government Equalities Office launched a national LGBT survey in July 2017 to develop a better understanding of the lived experiences of lesbian, gay, bisexual and transgender people, and people who identify as having any other minority sexual orientation or gender identity, or as intersex.

The survey was open for 12 weeks and received 108,100 valid responses through an anonymous online questionnaire that collected the experiences and views of individuals who self-identified as having a minority sexual orientation or gender identity, or as intersex, and were aged 16 or above and living in the UK.

Summary

• LGBT respondents are less satisfied with their life than the general UK population (rating satisfaction 6.5 on average out of 10 compared with 7.7). Trans respondents had particularly low scores (around 5.4 out of 10).
• More than two thirds of LGBT respondents said they avoid holding hands with a same-sex partner for fear of a negative reaction from others.
• At least two in five respondents had experienced an incident because they were LGBT, such as verbal harassment or physical violence, in the 12 months preceding the survey. However, more than nine in ten of the most serious incidents went unreported, often because respondents thought ‘it happens all the time’.
  2% of respondents had undergone conversion or reparative therapy in an attempt to ‘cure’ them of being LGBT, and a further 5% had been offered it.
• 24% of respondents had accessed mental health services in the 12 months preceding the survey.

Human Rights Campaign (US)

The Human Rights Campaign and the Human Rights Campaign Foundation together serve as America’s largest civil rights organization working to achieve LGBTQ equality. HRC advocates for LGBTQ equality and educates the public about LGBTQ issues.

The HRC Foundation improves the lives of LGBTQ people by working to increase understanding and encourage the adoption of LGBTQ-inclusive policies and practices. Actress Sally Field speaks at HRC’s 16th Annual National Dinner and explains why she loves and supports her gay son Sam Greisman:

Hate crime England and Wales, 2015-2016

Home Office

Information on the number of hate crimes from police recorded data in England and Wales from April 2015 to March 2016. The bulletin covers the extent and trends in hate crime for all forces, with additional analysis based upon more detailed data supplied by 24 police forces on the types of offences associated with hate crime. Hate crime is defined as ‘any criminal offence which is perceived, by the victim or any other person, to be motivated by hostility or prejudice towards someone based on a personal characteristic.’

There are five centrally monitored strands of hate crime: race or ethnicity, religion or beliefs, sexual orientation, disability, and transgender identity.

The publication includes information on racist incidents in England and Wales recorded by the police from April 2015 to March 2016. A ‘racist incident’ is any incident, including any crime, which is perceived by the victim or any other person to be motivated by a hostility or prejudice based on a person’s race or perceived race. This release includes an Annex on racially and religiously aggravated offences around the European Union (EU) referendum.

• Hate crime, England and Wales, 2015 to 2016
• Hate crime, England and Wales, 2015 to 2016: data tables
• Hate crime, England and Wales, 2015 to 2016: appendix tables

Hate crime report | GALOP

Hate crime report 2019 | GALOP

This research shows that our journey toward LGBT+ equality is far from over. Despite most people in this UK poll voicing support for LGBT+ people, a significant proportion still think we are dangerous, immoral or that we can be ‘cured’. More importantly, it offers a sobering reminder that progress achieved in recent decades can easily be reversed. Young people polled tended to hold more negative views toward LGBT+ people than other age groups. This alarming finding warns of a generational pivot ahead and a bumpy road for those of us committed to challenging anti-LGBT+ violence and abuse.

In this study, a representative sample of 1,617 people from across the UK answered questions on their beliefs about LGBT+ people. The key findings are:

• More than 4 in 5 people said that LGBT+ people should be free to live as they wish. 1 in 20 said that LGBT+ people should not have this freedom
• 1 in 5 people said being LGBT+ was ‘immoral or against their beliefs’. This rose to 1 in 4 among 18-24 year olds, higher than other age groups
• 1 in 10 people thought that LGBT+ people were ‘dangerous’ to other people
• 1 in 10 people said that being LGBT+ could be ‘cured’
• Around 3 in 5 people responded very positively about having LGBT+ people as neighbours. 1 in 5 people showed reluctance to the idea of LGB+ neighbours, and more than 1 in 4 to trans neighbours
• 3 in 5 respondents said that they were comfortable with trans people using the public restrooms that they use
• 5 in 10 people agreed that hate crime has higher impact than other types of crime, and that LGBT+ people modify their behaviour in public to avoid being targeted. However, only 4 in 10 thought that violence against LGBT+ people is a problem in the UK.

Hate Crime report 2016 | GALOP

This report presents evidence about the needs and priorities of LGBT communities in relation to hate crime. It includes analysis of an on-line community survey of 467 LGBT people, which asked about experiences of hate crime and interactions with services. It also analyses interviews and written submissions from 18 individuals who have either experienced hate crime, or are professionals working on this issue. Despite progress on this issue, the results presented here suggest that homophobia, biphobia and transphobia remain a significant part of LGBT peoples’ lives. Additionally, it found that individuals face considerable barriers to accessing assistance in terms of policy, practice and legislation.

Experiences of hate crime

• 4 in 5 LGBT people had experienced hate crime
• A quarter had experienced violent hate crime
• A third experienced on-line hate crime
• A tenth experienced sexual violence as part of a hate crime

National LGB&T Partnership

The National LGB&T (lesbian, gay, bisexual and trans) Partnership, a member of the Department of Health, NHS England, and Public Health England’s Health and Care Voluntary Sector Strategic Partner Programme, is an England-wide group of LGB&T voluntary and community service delivery organisations that are committed to reducing health inequalities and challenging homophobia, biphobia and transphobia within public services.

The National LGB&T Partnership members positively influence the policy, practice and actions of Government and statutory bodies and ensure that health inequalities experienced by LGB&T people are kept high on the Government’s agenda and that best use is made of the experience and expertise found within the LGB&T voluntary and community sector.

Inequality: IFS Deaton Review

This report introduces the IFS Deaton Review, setting out some key background facts, questions and puzzles that will be addressed over the next five years.
Discussion of inequalities increasingly defines economic and political debate. Concerns abound that the poor are being left behind by the rich, the young by the old, the regions by the metropolis, the unskilled by the highly educated. Inequalities exist not just in income and living standards, but in wealth, health, family environments, life chances and political influence.

Health and Social Care and LGBT Communities

“We have found that too few health and social care providers are actively thinking about LGBT people when they plan their services and that senior leaders are not doing enough to ensure that LGBT-inclusion is hardwired into commissioning strategies. This problem filters all the way down to training, where medics of the future are not taught how to provide LGBT-inclusive treatment. While few people set out to discriminate, training currently sends the message that sexual orientation and gender identity are not relevant to providing “person-centred care”. We have heard that for many witnesses that it is, in fact, essential. At the moment, there seems to be neither the leadership necessary to ensure services are designed to be LGBT-inclusive nor swift enough improvements among staff on the ground.” Summary, pg 3

Public Health England action plan 2015-16

Public Health England (PHE)

Public Health England’s evidence and action plan to address the health and well-being inequalities affecting gay, bisexual and other men who have sex with men:

• Promoting the health and well-being of gay, bisexual and other men who have sex with men: action plan (2015-16)
• Black and minority ethnic men who have sex with men: project evaluation and systematic review (May 2016)
• Promoting the health and well-being of gay, bisexual and other men who have sex with men: initial findings
• Promoting the health and well-being of gay, bisexual and other men who have sex with men: summary document

Substance misuse services for men who have sex with men involved in chemsex

Briefing for commissioners and providers of drug and alcohol services highlights issues relating to men who have sexual contact with other men (MSM)a involved in chemsex. It contains background information, recent data, prompts for local areas and services, and case studies.

National representative data on the health of lesbian, gay and bisexual adults in England published for the first time

A first-of-its-kind report has been published today by NHS Digital on the health outcomes and health behaviours of lesbian, gay and bisexual (LGB) adults. The data is based on a representative sample of adults aged 16 and over who participated in the Health Survey for England (HSE) between 2011–2018. Breakdowns by age, ethnicity and sex are also covered in the report.

LGBTQ* UK COVID-19 Lockdown 18-35 Experiences

Preliminary results from the LGBTQ* UK COVID-19 Lockdown Experiences survey. This is the First Survey in a series of surveys and interview studies planned on LGBTQ* adults’ experiences of the coronavirus pandemic and associated restrictions. “Many of the comments on the survey, and the numerical findings detailed, reveal the difficulties faced by people in LGBTQ* communities. But we also can see strengthand resilienceas respondents wrote of their concern and caring for others who were more vulnerable both within the LGBTQ* community and beyond.” Please note preliminary results are based on n=345 replies and do not include the full sample of First Survey participants.

Preventing suicide Research

Suicide is the ninth leading cause of death in Canada, responsible for nearly 4,000 deaths each year (Navaneelan, 2012). While everyone is susceptible to the feelings of hopelessness and despair that precede suicide, for some groups suicide is a more common reality. As one striking example, rates of suicide are five times higher in indigenous communities than in non-indigenous peoples in Canada. Rates are also higher among those who are unemployed or who lack social support—from partners, close friends, or family. A common theme in the societal patterning of suicide is one of social marginalization.People who are excluded or disconnected are more likely to end their lives early.

Most significantly, these results highlight the need for national and provincial strategies to address the LGBT suicide disparities in Canada. Groundwork for such strategies can be found in existing policy documents, including the BC Provincial Health Officer’s Report on HIV among Gay and Bisexual Men. The next step is for community actors and policy-makers to work together to develop specific initiatives to address this disparity.

Preventing suicide among lesbian, gay and bisexual young people: toolkit for nurses

Toolkits to help nurses understand mental health issues in relation to LGBT sexual orientation and identity in young people.
Preventing suicide among lesbian, gay and bisexual young people: toolkit for nurses | Public Health England | Royal College of Nursing | Mar 2015

LGBT+ sex and lifestyles survey

Earlier this year, GMHC (of which MEN R US is part) promoted this piece of research for Public Health Institute, John Moores University and the preliminary findings are now in.

Facebook sponsored advertising was used to recruit LGBT+ people to take part in an online survey. Four adverts were used over 6 weeks (one MSM, one WSW, one trans, and one LGBT+ advert). Relevant LGBT+ organisations also advertised the survey on their social media accounts. A prize draw for a £50 Amazon voucher, or one of two runner-up prizes of £25 was used. The questionnaire was divided into three sections: demographics, sexual health and drug use, and psychological well-being.

A total of 4,690 participants started the survey, of which 1,110 did not complete the survey sufficiently to be included in analyses (n=3,676, completion rate of 78%). The median time taken to complete the survey was 12 minutes.

Men who have sex with men

When controlling for other factors, MSM who engaged in chemsex were more likely to live in a densely populated area (56% vs. 32%), have a larger number of condomless anal intercourse male partners, be living with HIV (20% vs. 6%), and have a low sexual self-efficacy (confidence in practicing safer sex consistently). MSM engaging in chemsex were more likely to report currently taking PrEP (30%), compared to MSM engaging in other sexualised drug use (9%), and those not engaging in any sexualised drug use (3%).

Sigma Research

Sigma Research is a social research group specialising in the behavioural and policy aspects of HIV and sexual health. It also undertakes research and development work on aspects of lesbian, gay, bisexual and transgender (LGBT) health and well-being. While this section concentrates on the Gay Men’s Sex Survey (1993-to date), Sigma’s research covers a wide range of issues affecting gay men and you are encouraged to explore their website.

Gay Men’s Sex Survey

In 1993, Sigma Research carried out an on-the-spot survey of men attending the London Lesbian and Gay Pride festival, instigating an annual survey that has grown to be the largest in the world and an institution on the UK summer gay scene. The National Gay Men’s Sex Survey (GMSS), also known as Vital Statistics, has occurred 17 times in the 24 years since and now recruits exclusively online.

The content of the survey is developed in collaboration with health promoters, within the framework of Making it Count. The questions cover a range of demographics, health indicators, sexual behaviours, HIV prevention needs, use of settings in which health promotion can occur and recognition of national interventions. The weight given to each area varies each year, and the data collected is treated as cumulative, building a detailed picture of gay men and bisexual men and HIV over time.

A blueprint for the future: sexual and reproductive health and HIV services in England

Good sexual health enables healthy relationships, planned pregnancies and prevention of disease. The LGA is calling on the Government to work with local government to commit and deliver, a sustainable, national 10 year sexual and reproductive (SRH) strategy.

Two years on: a progress review of ‘From harm to hope': A 10-year drugs plan to cut crime and save lives’

Public Sector Access, in collaboration with the LGA, has engaged with nine councils across the country to review the progress of ‘From harm to hope’. This provides a snapshot of the strides made, challenges faced and opportunities uncovered in the pursuit of creating healthier, safer communities.
Two years on: a progress review of ‘From harm to hope’: A 10-year drugs plan to cut crime and save lives’ | LGA | 6 Sep 2024

Sexual health: How councils are driving innovation through partnership working

These case studies highlight the varied ways councils are working with trusted partners to help communities access sexual and reproductive health services.
Sexual health: How councils are driving innovation through partnership working | LGA | 2 Jun 2023

Breaking point: Securing the future of sexual health services

This report comes at a time when commissioners and providers of sexual health services have been making repeated calls to the government to address the long-term funding and capacity challenges across local authority commissioned sexual health services.
Breaking point: Securing the future of sexual health services | LGA | 15 Nov 2022

Hepatitis C in England

Reports and updates. Provides recommended actions which could support the evidencing of progress towards eliminating HCV by strengthening the need to reduce incidence, increase testing and linkage into care, and reduce mortality. These should be considered within the context of the UKHSA’s ongoing programme of work to eliminate HCV as a health threat by 2030 in line with the WHO targets for HCV infection and includes collaboration with other stakeholders.

HIV Commission

How England will end new cases of HIV

“‘Ending HIV transmissions in England by 2030’ is not just a government target but has the potential to change lives for many. At the moment nearly 3,000 people a year are newly diagnosed. Achieving this goal will prevent tens of thousands of new infections and all the complications that can follow – mental health challenges, medical complications, living with stigma and discrimination. This is such a worthwhile aspiration, it requires urgent government action.

To meet the ambition to end new HIV transmissions in England by 2030, the government should reaffirm this target, but also adopt the new interim milestone recommended by this commission to see an 80% reduction by 2025. This will ensure we are on track. We should seek to build on positive progress made to date and ensure that the government commit to England being the first country to achieve a goal that will change so many lives.”

All-Party Parliamentary Group (APPG) Inquiry HIV and COVID 19

Executive summary

While the world struggles to deal with COVID-19, the ongoing HIV epidemic continues to present huge challenges for people, communities and governments worldwide.

The overwhelming evidence that HIV services in the poorest parts of the world are suffering mass disruption is extremely concerning and if not addressed, could lead to two decades of progress being eroded in a single year, and deaths from AIDS-related causes could overtake deaths from COVID-19.

The current pandemic is now unfortunately being used as an excuse by some governments to target specific vulnerable groups. This is a major human rights concerning itself and will only make testing, treatment and prevention of both HIV and COVID-19 more difficult. It is vital that the UK government actively ensures that the COVID-19responses that it supports have a strong human rights component and that they do not erode or violate human rights.

State of the Nation: Sexually Transmitted Infections in England

“We are at a pivotal moment in the response to sexually transmitted infections (STIs) in England. The choice is clear: either we all step up and take firm action or we sit back and continue to see STIs spiral out of control and the threat of drug resistance increase. Everyone from national government to local community organisations has a part to play in this.For too long there has been insufficient focus and action centred on STIs and broader sexual health.

With this report we are trying to make a start in rectifying this. This state of the nation report seeks to shine a spotlight on STIs. We do not set out all of the answers – in fact we raise many more questions than we find answers to. But we’re aiming to start a conversation and highlight important issues – from inequalities and the communities who are disproportionately affected by STIs, to the need for sufficient funding for sexual health services and the important steps that are now needed to train and support sexual health champions.”

The Missing Link: HIV and mental health

Stigma ruins lives. It can make us feel isolated, ashamed and worthless. It can stop us from building relationships or accessing work. It can prevent us from seeking help or treatment. It can deny us the opportunity to live our lives to the full.

As this report demonstrates, stigma continues to have a pervasive impact on the lives of people living with HIV, many of whom will also have a mental health problem. It’s hard enough to be living with a long-term health condition and experiencing a mental health problem, without having to face the judgement, shame and isolation that often surround them. Therefore, as Mind, we welcome the APPG’s focus on trying to understand the experiences of people living with both HIV and mental health problems.

Future of HIV services in England

The King’s Fund

Undertaken by the King’s Fund, this research aimed to make recommendations to those responsible at local and national levels for planning and delivering HIV services on how best to develop those services over the next 5–10 years. It included a review of existing literature and data, and interviews with national stakeholders. We then looked in detail at four geographical areas as case studies of how HIV services currently operate and the issues they face. This included finding out about patients’ experiences, through focus groups and interviews with people living with HIV. We held five focus groups and interviewed around 100 individuals, including direct input from 38 people living with HIV. Through the project’s advisory group and membership of our research team, we involved people living with HIV in all aspects of the study. We selected case study areas to give a diverse range of settings, including urban and rural areas, areas with high and low HIV prevalence, and a wide geographical spread (north and south of the country, and London).

London Chemsex Conference

The impetus by GMHC to organise a London Chemsex Conference stemmed from a lack of harm reduction for GBMSM and the wider LGBT+ community, the persistent rise of problematic drug use, addiction and complex harms, and the need for a more joined-up/ coordinated whole system approach for the Capital. 67 delegates attended this in-person multi-agency event on 7 June 2024 at Camden Town Hall.
London Chemsex Conference

Chemsex Support by London Borough (FOI)

To better understand the provision of chemsex support, treatment, and harm reduction in Greater London for LGBT+ people, the Gay Men’s Health Collective (GMHC) sent a FOI request to 32 London Boroughs asking to know how much funding has been earmarked, allocated or spent, specifically for LGBTQ+ people, gay men and other men who have sex with men in relation to 1) chemsex treatment and 2) harm reduction (2022-23, 2023-24, 2024-25). By way of an exploratory exercise, Boroughs were graded from A to G.
Chemsex Support by London Borough (FOI)

Reducing Drug Deaths in London

Drug-related deaths have been rising for the past eight years. Latest available statistics show that drug use deaths in England and Wales are at their highest level since records began, with 296 deaths in London and 2,996 deaths across England and Wales during 2020 alone.

This tragic trend, which disproportionately affects people living in deprived areas, has led to growing calls for policies and practices which focus on harm reduction methods to try to reduce the harm that people do to themselves or others from their drug use.

The report investigation focused on the benefits and risks of three harm reduction interventions and explored their potential for reducing drug-related deaths in London.

Chemsex Today - around the world

Chemsex has been a growing trend in many parts of the world over the past few decades, particularly in urban areas.
Despite its global reach and prevalence, there remains little information on chemsex.

This lack of knowledge is partly due to the stigma and taboo surrounding substance use and sex as in many cultures, substance
use and sexual behaviour are highly stigmatized and criminalized, making it challenging to research chemsex.

Additionally, because of the diversity of cultures and languages around the world, it can be challenging to develop research
instruments that are culturally sensitive and accessible to all individuals.

In response to this gap in knowledge, ReShape decided to conduct a study on chemsex to ensure that we have a global view of the phenomenon. The study aimed to provide a comprehensive and inclusive view of chemsex that considers the diversity of cultures and languages worldwide. The study was designed to be accessible to everyone, regardless of language or cultural background.

The problematic chemsex journey: a resource for prevention and harm reduction

Purpose
Chemsex is a phenomenon that has gained increasing attention in recent years. The purpose of this paper is to differentiate chemsex from other sexualized substance use, and clarify differences between recreational and problematic chemsex use. Despite plentiful publications, little has been published on underlying determinants that predispose individuals to chemsex, and their process toward problematic chemsex use.

Design/methodology/approach
During the second European Chemsex Forum, people who engage in chemsex, community organizers, researchers, clinicians, therapists, social workers and (peer) counselors discussed potential pathways to problematic chemsex. In this manuscript, we translate findings from these discussions into a framework to understand the initiation and process toward problematic chemsex.

Findings
Six stages (loneliness and emptiness, search for connection, sexual connection, chemsex connection, problematic chemsex and severe health impact) and a set of factors facilitating the transition from one stage to the next have been identified.

Originality/value
It is hoped that this “Journey towards problematic chemsex use” will stimulate reflection and debate, with the ultimate goal of improving prevention and care for people engaging in chemsex.

Authors: Tom Platteau, Roger Pebody, Nia Dunbar, Tim Lebacq and Ben Collins (2018)

Survey findings to better understand mainstream service chemsex support provision in Greater London

MENRUS.CO.UK volunteers check and update drug and alcohol and chemsex service listings regularly due, in part, to the frequency with which contracts are renewed (resulting in Internet ‘breadcrumbs’ for both old and new services) and inaccurate details on local authority websites.

In 2021, volunteers noticed a sustained uptick in mainstream drug services in Greater London stating the provision of chemsex support (of some description). In August 2021, MENRUS.CO.UK undertook a short survey to get a better understanding of this provision.

The survey findings will inform the accuracy of our listings and the information MEN R US provides and the findings have been shared with drug services in Greater London working in the drug and alcohol, and chemsex fields.

From harm to hope: a 10 year drugs plan to cut crime and save lives

UK Government 10-year plan “to combat illegal drugs sets out how we are doing more than ever to cut off the supply of drugs by criminal gangs and give people with a drug addiction a route to a productive and drug-free life. Underpinned by record investment of over £3 billion in the next three years, we will reduce drug-related crime, death, harm and overall drug use. National and local partners will focus on delivering three strategic priorities.” Executive Summary

GMHC’s response

Though GMHC has expertise in safer drug use and chemsex harm reduction within the context of gay and bisexual men and men who have sex with men, we defer to our friends at Release, the national centre of expertise on drugs and drugs law, and its response to this plan.

Review of drugs

In February 2019, the Home Secretary appointed Professor Dame Carol Black to undertake an independent review of drugs. This was to inform the government’s thinking on what more can be done to tackle the harm that drugs cause.

Part 1
Dame Carol’s response to phase one of the commission provides a detailed analysis of the challenges posed by drug supply and demand, including the ways in which drugs fuel serious violence.
Review of drugs part one: evidence relating to drug use, supply and effects, including current trends and future risks | Dame Carol Black | Feb 2020

Part 2
The following evidence section presents an overview of the trends in the prevalence of drug use and the associated harms, as well as the treatment response. It also includes information on how these harms are very much associated with deprivation and often concentrated in the poorest areas of the country.
Review of drugs part two: prevention, treatment and recovery: annexes | Dame Carol Black | Jul 2021

 Annex C: costs and benefits of the review recommendations to improve the coverage and quality of treatment, prevention and recovery, Part 2, pg 30.

Summary:

The following presents an overview of the costs and benefits of a proposed 5-year plan to respond to the recommendations in this review. The plan outlined will:

• improve the quality and capacity of the treatment system for both adults and young people
• increase the workforce numbers as well as training and skills, and bring in more qualified health professionals, particularly from mental health backgrounds
• increase the uptake and provision of residential and inpatient detoxification treatment
• ensure that there are well-resourced recovery communities in every area
• increase the provision of harm reduction interventions such as naloxone and needle and syringe exchange programmes
• increase the provision of employment support, housing support, and support for offenders
• create an innovation fund to help tackle recreational use

An assessment of the harms of gamma-hydroxybutyric acid (GHB), gamma-butyrolactone (GBL), and closely related compounds

In January 2020 the Home Secretary commissioned the Advisory Council on the Misuse of Drugs (ACMD) to review the evidence for the classification of gamma-hydroxybutyric acid (GHB), gamma-butyrolactone (GBL) and related compounds under the Misuse of Drugs Act 1971 (MDA), and the scheduling of these compounds under the Misuse of Drugs Regulations 2001 (MDR).

This report reviews the evidence of harms of GHB and related compounds that have emerged since the ACMD’s last significant assessment of the risks of GHB and its prodrugs, GBL and 1,4-butanediol (1,4-BD) in [ACMD, 2008a].

The ACMD recommends that GHB, GBL and 1,4-BD be moved to Class B of the MDA (pg. 53, Recommendation 3). 

The aim is to enable the ACMD to assess the level of harms associated with these compounds and to make recommendations to mitigate these harms – including (but not limited to) recommendations on the most appropriate classification and scheduling of these compounds under the MDA and MDR respectively.

MEN R US Comment: In our opinion, to include FRANK, Antidote, Crew (only)  as “current sources of available information” is lazy (pg. 58, Information and support); and term ‘harm reduction’ is not mentioned once in the report.

UK drug council knows GHB crackdown targets queer people, recommends it anyway

“Spurred by media panic around a so-called “chemsex crimewave,” the United Kingdom’s independent drug policy advisors are recommending that people involved with the highly stigmatized depressant gamma-hydroxybutyrate and related substances (GHB-RS) be subject to harsher criminal penalties.

But the Advisory Council on the Misuse of Drugs (ACMD) did not make its recommendation to escalate punitive responses unanimously. An unspecified number of ACMD experts on the Technical Committee, which deliberated GHB-RS’s change in classification under the Misuse of Drugs Act 1971, objected. They warned that intensifying criminalization will only inflict, not reduce, harm—particularly for queer and trans people.

The ACMD was commissioned by UK Home Secretary Priti Patel to investigate GHB-RS at the beginning of 2020—shortly after the conviction of, and ensuing media fixation on, a gay man of color for committing large-scale sexual violence that was allegedly facilitated by GHB-RS. On November 20, the ACMD published its assessment of the harms of GHB-RS and its recommendations in response.”

Review of GHB Deaths (2011-15)

A comprehensive and thorough review into 58 deaths from Gamma-hydroxybutyrate (GHB) poisoning across London between June 2011 and October 2015 was carried out following the murders committed by Stephen Port.

The results of the extensive reviews were presented at two case closure panels that included senior officers and independent advisors from the LGBT+ Independent Advisory Group. The panel were satisfied the reviews did not identify that any death was a homicide. The review concluded with a final report in 2019.

Organisational learning was identified and this has been accepted and action taken to improve our service and investigative approach. This is alongside the issues identified following the offences committed by Stephen Port and the action taken since then to learn and improve. A toolkit and a checklist document have been created to provide guidance for front-line officers and investigating officers on how to best respond to allegations of drug facilitated sexual assault or sexual assault following chemsex. We have also developed a chemsex ‘flag’ on our crime reporting systems to make it easier to identify such offences.

European Chemsex Forum

3rd European Chemsex Forum, Paris, 14-16 November 2019

Address key chemsex issues including sexual health and sexual pleasure; harm reduction and risk-taking; shame, crime, personal safety, peer support and online support. Feature a wide range of emerging structured, community-based local responses from both higher capacity and lower capacity locales. Focus attention on key under-represented populations including migrants, sex workers, trans and non-binary people. Focus attention on key regions, including Eastern Europe, Central Asia and the Middle East and  North Africa. Screen Micheal Rice’s documentary, parTy boi: black diamonds in ice castles, followed by a session on marginalisation. Have improved simultaneous translation with most sessions into French, Russian and English.

2nd European Chemsex Forum, Berlin, 22-24 March 2018

The 2nd European Chemsex Forum called for concrete actions at the local level to provide strategic resources to chemsex responders. The aim of the Forum was to develop a platform to engage in international, cross-sector, multi-disciplinary dialogue around chemsex-defined by the use of specific drugs (“chems”) in a sexual context … and facilitate coordinated responses to chemsex issues in locales where chemsex related harm is a problem, regardless of its size and impact.

European Chemsex Forum, London, 6-8 April 2016

The European ChemSex Forum was a preliminary intelligence gathering and networking event aiming to provide a platform to engage in international, cross-sector, multi-disciplinary dialogue and discussions around ChemSex – defined by the use of specific drugs (“Chems”) in a sexual context by Men who have Sex with Men (MSM), Transgender people and any other population disproportionately affected by HIV, hepatitis C and other sexually transmitted infections. The Forum was hosted by 56 Dean Street, GMFA, ReShape, International HIV Partnerships (IHP) and Professional Briefings, with the support of Gilead, ViiV Healthcare, Abbvie and AIDES and endorsed by the European AIDS Treatment Group, HIV in Europe and AIDS Action Europe. This meeting report synthesises and summarises the proceedings and outcomes of the European ChemSex Forum and has been prepared by the organising committee in consultation with key partners.

European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the leading authority on illicit drugs in the European Union. The Lisbon-based agency provides independent, scientific evidence and analysis on all aspects of this constantly changing threat to individual lives and wider society. Its work contributes to EU and national policies to protect Europe’s citizens from drug-related harms.

The agency does not make policy or recommendations. Its expertise helps to ensure that the decisions of EU and national policymakers, professionals and practitioners are based on objective and verified facts, not ideology or moral and value judgements. It frequently identifies important drug-related threats, helping EU countries be better prepared to handle them.

Review of Drugs 2020

The content in this evidence pack was commissioned by Dame Carol Black as part of the Review of Drugs, to provide detailed data on the illicit drug market, its associated harms and the interventions currently in place to tackle and respond to these harms. Public Health England analysts were commissioned to provide the content for chapters 1, 6, 8, 9, Home Office analysts were commissioned to provide the content for chapters 2, 3, 4, 5 and 7, while the other chapters were jointly produced.

Substance misuse services for men who have sex with men involved in chemsex

This briefing for commissioners and providers of drug and alcohol services highlights issues relating to men who have sexual contact with other men (MSM) involved in chemsex. It contains background information, recent data, prompts for local areas and services, and case studies.

Public Health England was replaced by UK Health Security Agency and Office for Health Improvement and Disparities. Even so, this remains a helpful and instructive briefing document.

Chemsex: Understanding risk behaviours

In order to better meet the needs of service users involved in these activities, primarily to ensure reduction of harms in relation to drug use, sexual health and stigma, SDF sought funding to carry out research both with drug users themselves and with the staff supporting them. This report details the information gathered and highlights key issues around drugs used and sexual health issues, related harms and consequences, and information needs. It also gives recommendations with regards to the type of training which should be available for staff who support people involved in chemsex, transactional sex and IPED use. SDF-SHBBV-Research-Report-Chemsex-Transactional-Sex-IPEDs Text

Gay men’s chemsex survival stories

Findings indicated that 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 both for understanding why chemsex pathways may prove attractive, but also why they may be so difficult to leave.

Drugs and Alcohol Today: Chemsex Edition

A message from the guest editor of this special “Chemsex” edition of Drugs and Alcohol Today | Marcus Day

“Despite a growing number of deaths by overdose or rising incidence of HIV, the wider gay community largely ignored the contribution that illicit drugs, largely synthetic stimulants consumed orally, intranasally or anally but rarely injected, had to morbidity and mortality in their community.

Harm reduction was originally focussed on the prevention of HIV and other blood borne diseases acquired through injecting drug use. The focus of interventions was street based and focussed on people who injected opioids. Despite there being LBGT people represented in harm reduction, there was a prevailing culture of heteronormativity that was a barrier to accessing services for some.

Two challenges needed to be overcome in applying a harm reduction lens to chemsex. First, chemsex is largely a non-injecting drug scene and the World Health Organisation has yet to enunciate the HIV risks associated with non-injecting stimulant use. Second has been the denial and stigmatisation of men participating in chemsex by their gay peers. The first made men who were using drugs through non-injecting routes invisible, while the second created a barrier to accessing services, either with gay men’s health services that often has a palatable aversion to drug use, or traditional heteronormative harm reduction services.

Finding no appropriate services that addressed a growing epidemic of death and disease, chemsex activists took example from the 1980s AIDS epidemic and the community response that addressed a need ignored by the medical and political establishments. The result: a community spurred on to action reminiscent of the actions of the early pre-ART days of the “AIDS crises”.”

A message from the guest editor of this special “Chemsex” edition of Drugs and Alcohol Today | Marcus Day | Drugs and Alcohol Today/ Emerald Insight | Apr 2019

Chemsex experiences narratives of pleasure | Maitena Milhet, Jalpa Shah, Tim Madesclaire, and Laurent Gaissad

“The purpose of this paper is to understand the dynamics of pleasure related to chemsex from the perspective of French gay men and other men who have sex with men (MSM). Recognising that participants in chemsex are social actors, the authors diverge from the prominent “pathology paradigm” used in public health.

In-depth interviews were conducted with gay men and other MSM engaging in chemsex via snowball sampling (n=33). The authors explored the definitions of pleasure and the role of stimulants, sexual activity, smartphones and partners in chemsex pleasures.

Chemsex pleasures encompass multiple dimensions that go far beyond bodily pleasures, such as love or romantic relationships, socializing with significant others and sexual discovery through disinhibition. Narratives of pleasure were also, simultaneously, stories of suffering and distress. This dissonance can pose challenges to the participants in chemsex, their entourages and care providers.”

Chemsex experiences narratives of pleasure | Maitena Milhet, Jalpa Shah, Tim Madesclaire, and Laurent Gaissad | Drugs and Alcohol Today/ Emerald Insight | Apr 2019

Chemsex origins of the word, a history of the phenomenon and a respect to the culture | David Stuart

“The purpose of this paper is to clarify the origins, use and meaning of the term “chemsex”.

The term chemsex has a definition and a purpose that promotes culturally competent care for a marginalized group of vulnerable people. This is a qualitative, personal, point-of-view piece which may be of value in broadening understandings and responses amongst public health and academic activities.

The findings can be used to develop a sense of community and support amongst men who have sex with men in a chemsex setting, and to provide some background and context for professionals working in this field.”

Chemsex origins of the word, a history of the phenomenon and a respect to the culture | David Stuart | Drugs and Alcohol Today/ Emerald Insight | Apr 2019

The problematic chemsex journey a resource for prevention and harm reduction | Tom Platteau, Roger Pebody, Nia Dunbar, Tim Lebacq, and Ben Collins

“Chemsex is a phenomenon that has gained increasing attention in recent years. The purpose of this paper is to differentiate chemsex from other sexualized substance use, and clarify differences between recreational and problematic chemsex use. Despite plentiful publications, little has been published on underlying determinants that predispose individuals to chemsex, and their process toward problematic chemsex use.

During the second European Chemsex Forum, people who engage in chemsex, community organizers, researchers, clinicians, therapists, social workers and (peer) counselors discussed potential pathways to problematic chemsex. In this manuscript, we translate findings from these discussions into a framework to understand the initiation and process toward problematic chemsex.

Six stages (loneliness and emptiness, search for connection, sexual connection, chemsex connection, problematic chemsex and severe health impact) and a set of factors facilitating the transition from one stage to the next have been identified.”

The problematic chemsex journey a resource for prevention and harm reduction | Tom Platteau, Roger Pebody, Nia Dunbar, Tim Lebacq, and Ben Collins | Drugs and Alcohol Today/ Emerald Insight | Apr 2019

The psychological roots of chemsex and how understanding the full picture can help us create meaningful support | Katie Evans

“The purpose of this paper is to explore the larger picture of chemsex in a hope to understand how to best work with clients therapeutically. The paper’s aim is to acknowledge not just the risk and “negative” aspects but also what might be gained by men engaging in chems use. How can the chemsex space act as a container for emotions and experiences?

This is a paper based upon cases from within the author’s private practice plus anonymous interviews with men. It comes from a sex positive therapy approach and explores ideas formed within the author’s work as a practitioner.

The findings within this paper showed just how complex an issue chemsex is with many layers to it. The author also found that the most important aspect to bear in mind is that this is a very human issue, with aspects many can relate to such as intimacy, self-esteem, desire for connection and dealing with difficult emotions. By seeing what part it plays in the life of men involved then it is possible to can understand how seductive it could be.”

The psychological roots of chemsex and how understanding the full picture can help us create meaningful support | Katie Evans | Drugs and Alcohol Today/ Emerald Insight | Apr 2019

Too painful to think about chemsex and trauma | Stephen Morris

“Whilst chemsex is a relatively new phenomenon, trauma is not. Freud borrowed the word from physical medicine, where it was used to describe tissue damage, and applied it, for the first time, as a metaphor to a psychological process by which the protective functioning of the mind can too be pierced and wounded by events. The chemsex environment hosts a myriad of potentially traumatising scenarios and experiences, though perhaps disguised as exhilaration or excitement. The paper aims to discuss these issues.

These experiences piled on top of childhood experiences of being “less than” for being gay, can be responsible for widespread undiagnosed post-traumatic stress disorder (PTSD) among those who engage in chemsex. This paper explores this possibility and offers solutions.”

Too painful to think about chemsex and trauma | Stephen Morris | Drugs and Alcohol Today/ Emerald Insight | Apr 2019

What is sober sex and how to achieve it | Remziye Kunelaki

“The purpose of this paper is to provide the first definition of sober sex and recommendations for health care professionals who work therapeutically with patients who struggle with intimacy after experiencing chemsex. The recommendations are based on the clinical experience of a psychosexual therapist working with men having sex with men (MSM) in a Sexual Health clinic in central London. The paper concludes that having a clear definition of sober sex and specific tools, such as healthy masturbation exercise, could prove helpful for health professionals who work with this cohort of patients.”

What is sober sex and how to achieve it | Remziye Kunelaki | Drugs and Alcohol Today/ Emerald Insight | Apr 2019

Yes, has no meaning if you can’t say no consent and crime in the chemsex context | Stephen Morris

“The title of this paper is a statement made by a man at the end of his treatment following conviction for several sexual offences. It is powerful in conveying a simple and accurate meaning of consent. Legally, consent is not complicated and can be simply defined as: permission for something to happen or agreement to do something. The context of consent, however, is complicated and complex none more so than when it becomes an issue within chemsex. If we are to gain a full appreciation of consent-related complexity, we must also gain an understanding of the wider picture concerning chemsex and crime. The purpose of this paper is to provide that wider picture. With the exception of breaching of drug-related law, not all men who engage in chemsex are committing offences but, as we are discovering, a not insignificant percentage are and this needs to be cause for concern.”

Yes, has no meaning if you can’t say no consent and crime in the chemsex context | Stephen Morris | Drugs and Alcohol Today/ Emerald Insight | Apr 2019

Drug-related deaths in England: local authorities and how they are responding

Drug-related deaths (DRDs) are at their highest level since records began in 1993 with 3,756 DRDs in England and Wales last year, 53% of which related to opiate use. Almost a third of all deaths from overdose in 2016 in Europe happened in the UK.

This constitutes a public health and humanitarian crisis which must be addressed urgently. DRDs are now an indicator in the Public Health Outcomes Framework (PHOF) in England.

The Harm Reduction Group wrote to the 40 local authorities with worse than benchmarked DRD rates, asking how they were responding to DRDs in their area. 35 local authorities responded.

Chemsex: support for LGBT families and friends

Resource providing helpful information for the families, friends and LGBT partners of people engaged in chemsex. Supporting a loved one whose chemsex involvement you are concerned about can be difficult and may put a lot of practical, financial and emotional pressures on family members, friends and partners. This resource will help you with how to support yourself and your loved one and provides practical and emotional advice and information on services that are available. The resource is aimed both at people who are familiar with chemsex as well as those to whom it is a new concept.

Global State of Harm Reduction

The 2018 Global State of Harm Reduction is the 6th edition of this report, and the most comprehensive ever thanks to a coordinated effort of over 100 harm reduction practitioners, academics, advocates and activists from around the world. It finds that, since the last report in 2016, the global harm reduction response has effectively stalled (view press release here). Overdose, HIV and hepatitis C crises continue, among myriad health and social problems related to drug use and drug policy, yet many countries are neglecting them.

Chemsex is mentioned on page 69.

Drug Strategy 2017

Home Office

The word ‘chemsex’ is mentioned four times in a short paragraph, part a 52-page strategy document:

“Chemsex is a term for the use of drugs before or during planned sexual activity to sustain, enhance, disinhibit or facilitate the experience. Chemsex commonly involves crystal methamphetamine, GHB/GBL and mephedrone, and sometimes injecting these drugs (also known as slamming). Chemsex carries serious physical and mental health risks including the spread of blood-borne infections and viruses. PHE will support local areas to meet these needs by promoting and publishing guidance on effective practice, including targeted interventions and close collaboration between sexual health services and other relevant services including community groups.”

Some argue the fact that the harms of chemsex are mentioned at all is a win, and while Public Health England has done work on the issue, it just seems like small change against the turmoil of recent years including research last year (2016) reporting a 119% increase in deaths associated with GHB/GBL in London with most linked to chemsex. That’s about 1 gay man dying every 12 days in the capital.

It’s disappointing there’s no mention of gay men and men who have sex with men, or a wider LGBT focus, at all. This was included in the 2010 Strategy (with a note that treatment services should consider the needs of LGBT groups). The importance of services speaking directly to specific communities is widely recognised, particularly when addressing problematic chemsex drug use, discussing sexual behaviour openly and addressing the multiple stigmas that accompany drug use, HIV, gay sex and sexual identity. Bottom line: we at MEN R US think the strategy is a missed opportunity though the short paragraph does provide some opportunity to refer back to the strategy when pushing for better services for chemsex users.

Response to the 2017 Drug Strategy by the English Harm Reduction Group

The Government has now published the 2017 Drug Strategy. We express great concern at the lack of focus on harm reduction – an evidence-based response that protects people and ultimately saves lives – at a time when drug-related deaths are the highest on record.

• Heroin and morphine deaths rose by 109 percent in the England and Wales between 2012 and 2016ii, when the evidence is overwhelming that harm reduction initiatives can reduce them. Initiatives such as opioid substitution treatment (OST) and needle and syringe programmes are only mentioned fleetingly within the Strategy, and others such as drug consumption rooms and heroin assisted therapy (HAT) are completely absent.
• It is appalling that the Government acknowledges in the strategy that the rise in drug-related deaths is ‘dramatic and tragic’, but proposes no concrete action plan to reduce them. For example, the strategy comments on the importance of naloxone to prevent overdose deaths but proposes no national systematic approach to naloxone provision, nor any new funding for this vital intervention. It is shocking that whilst drug-related deaths have outstripped both road traffic fatalitiesiii and deaths from blood borne virusesiv,v, there is no coordinated response from central government.
• This erosion of services continues against a backdrop of funding for all drug services being continuously reduced. Public health spending has reduced by more than 5% since 2013vi, and according to analysis a further £22 million in cuts are to made for drug treatment by the end of 2017/18vii. Without funding drug services will not be able to function effectively.
• The Government has dismissed decriminalisation of drug possession offences as being simplistic. Yet the World Health Organisation and a multitude of United Nations agencies have called for the end of criminal sanctions for possession and use of drugs in recognition that criminalisation creates barriers to those needing treatment and increases health harms.

People who use drugs are often vulnerable and marginalised. This new Drug Strategy simply does not begin to support them and reduce drug-related deaths. We call on the Government to implement the recommendations of the Advisory Council on the Misuse of Drugs to tackle opiate related deaths, these include: optimal OST prescribing; easier access to naloxone; a national HAT programme; and that drug consumption rooms are implemented where there is needviii. The Government must also ensure a minimum level of care by requiring local authorities to provide drug treatment and harm reduction services by law.

Signatories: Professor David Nutt, Drug Science; Niamh Eastwood, Release; Deborah Gold, National AIDS Trust; John Jolly, Blenheim CDP; Fionnuala Murphy, Harm Reduction International; Kate Halliday, SMMGP; Jamie Bridge, International Drug Policy Consortium; Chris Ford, IDHDP

Response to the 2017 Drug Strategy | English Harm Reduction Group

Drug misuse 2013-14

Home Office

Examines  the  extent  and  trends  in  illicit drug  use  among  a  nationally  representative sample  of  16  to  59  year  olds  resident  in  households  in  England  and  Wales,  and  is  based  on  results from the 2013/14 Crime Survey for England and Wales (CSEW).

Covers the following topics: extent  and  trends  in  illicit  drug  use  among  adults,  including  separate  analysis of young adults (16 to 24 year olds); frequency of illicit drug use in the last year; illicit drug use by personal, household and area characteristics and lifestyle factors; and estimates of illicit drug use by ethnicity and sexual orientation.

Prepared by staff in Home Office Statistics under the National Statistics Code of Practice and can be downloaded from both the UK Statistics Authority website and the Home Office pages of the GOV.UK website:

Out of your mind

London Friend

‘Out of your mind’ is a report by London Friend examining how drug and alcohol treatment services can be improved for lesbian, gay, bisexual and trans (LGBT) people. The report aims to encourage commissioners and providers of drug and alcohol treatment services to be more mindful of the support needs of LGBT people when planning and delivering services.

Higher levels of both drug and alcohol use have been reported within LGBT populations, although these groups report being less likely to engage in traditional substance misuse services, citing lack of understanding of the substance use and cultural needs amongst the barriers. ‘Out of your mind’ investigates ways in which this imbalance might be addressed, ensuring that LGBT people have access to high quality, responsive, and inclusive treatment and support services.

Neptune

Novel Psychoactive Treatment UK Network

NEPTUNE has been developed to improve clinical practice in the management of harms resulting from the use of club drugs and novel psychoactive substances. It is aimed at clinicians working in a range of frontline settings, including drug treatment and recovery services, emergency departments, sexual health services, primary care and mental health services.

Part of the Picture

The Lesbian & Gay Foundation (LGF) | University of Central Lancashire (UCLan)

The Part of the Picture (POTP) research project was a five-year partnership between The Lesbian & Gay Foundation (LGF) and the University of Central Lancashire (UCLan), funded by the Big Lottery Fund’s research programme between 2009-2014. POTP had three main aims:

• The establishment of an England-wide database of lesbian, gay and bisexual (LGB) people’s drug and alcohol use
• The use of the database to directly inform local and national policy and practice in addressing the drug and alcohol use of LGB people
• An improved knowledge and understanding of the needs of LGB drug and alcohol users amongst drug and alcohol agencies, through dissemination of the research findings

The study found evidence of significant problematic substance use among the LGB community:

• Across all age groups LGB people are much more likely to use drugs than the general population
• Problematic patterns of drinking are much more common among LGB people
• LGB people demonstrate a higher likelihood of being substance dependent and show high levels of substance dependency
• Those scoring as substance dependent are more likely to seek help, although from informal sources rather than specialist services
• A third of respondents who scored as substance dependent would not seek information, advice or treatment, even if they were worried about their drug or alcohol use
• LGB people may be more vulnerable to developing dependent and problematic relationships with drugs and alcohol
• Significant barriers exist to seeking information, advice or help among LGB people

A suite of reports present the study’s findings and detail the methodology and sample. Briefing sheet (downloads) set out recommendations for commissioners and policy makers, GPs, drug and alcohol service providers, researchers, and the LGBT voluntary and community sector to tackle this significant public health issue.

About

You might be surprised how often MENRUS.CO.UK * gets requests participants for research and studies.

If they are relevant to gay men’s health and well-being, we usually include them on the website under one of the six key sections. Over time, it’s all got a bit messy so we have decided to put them here where you can browse them at your leisure.

However, a condition is that the researchers send us a copy of the findings (which they are always happy to do). And, just in case you’re wondering: we are not affiliated with or have any associations with organisations undertaking this research; we’re just forwarding their requests for participants and letting you decide.

* part of the Gay Men’s Health Collective

Research and studies

LGBTQ* UK COVID-19 lockdown 18-35 and 36-60 experiences online survey

Thank you for considering taking part in this survey. Before you decide to participate, it is important for you to understand why the research is being done and what it will involve. Please read the following information carefully and take the time you need to decide whether or not you want to take part. (Please do discuss it with others if you wish). A member of the research team can be contacted if there is anything that is not clear or if you would like more information.

This survey is aiming to explore the varied effects of the UK COVID-19 lockdown on the well-being and experiences of LGBTQ* people aged 18-35 and 36-60 years. The survey is open to anyone aged 18-60 years old who identifies as part of the wide LGBTQ+ community and who is living in the UK currently. You are very welcome to participate in this survey whether you took part in our previous LGBTQ* UK COVID-19 Lockdown 18-35 Experiences online survey or not.

You can find the first study results HERE.

Dr Fiona Tasker, Reader in Psychology
Pronouns: she her hers  Email
Marie Houghton | Pronouns: she her hers Email
Graduate Research Assistant LGBTQ* COVID-19 & Lockdown UK Experiences Project
Dept of Psychological Sciences, Birkbeck, University of London, Malet Street, Bloomsbury, London WC1E 7HX

Does the relationship with the perpetrator of sexual harassment matter? The impact of sexual harassment experiences on mental wellbeing study

This study is part of a Doctoral dissertation, exploring the impact of experiences of sexual harassment and the relationship with self-blame and help-seeking intentions on subsequent negative outcomes. This research project is under the supervisor of Melanie Douglas.

The aim of our study is to examine how the source of sexual harassment experiences (e.g. from an intimate partner, family, friend etc) can impact mental health, and how cognitive factors effect these outcomes. Previous research has revealed significant mental and physical health consequences following sexual harassment (Black et al., 2011), with self-blame impacting emotional and psychological distress, including negative health outcomes (Filipas & Ullman., 2006). Further, women are more likely to blame the perpetrator of sexual harassment, in comparison to men, predominantly when they were less acquainted with them (Frazier, 2003).

Researcher: Siobhan Walmsley Email
Researcher Supervisor: Dr Melanie Douglas Email
School of Psychological and Social Sciences, York St John University, Lord Mayors Walk, York YO31 7EX

Mapping chemsex services in Greater London

MENRUS.CO.UK – part of the Gay Men’s Health Collective (GMHC) – is carrying out this survey to get a better understanding of chemsex support provision in Greater London, and whether LGBT+ people are accessing mainstream drug services. From August 2021, we are contacting over 70 drug services including Care Grow Live (CGL), Turning Point, Westminster Drug Project (WDP), Humankind, and NHS Services. Survey findings will be available from February 2022.

Start here ...

Welcome

This survey is for drug services in Greater London only. It has 12 questions, mostly tick boxes, and takes 5-ish minutes. The final survey report will not identify individual services and any quotes used will be anonymised. Should you have any queries, email admin@gmhc.co.uk or phone 07791 867885 (Mon-Fri, 10-3).

(1) Does your service have chemsex clients who identify on the LGBT+ spectrum? Tick all that apply. ^*

(1) Does your service have chemsex clients who identify on the LGBT+ spectrum? Tick all that apply. ^*

Gay and bisexual men

Men who have sex with men (who do not identify as gay or bisexual)

Lesbian

Trans

Intersex

Do not know/ have this information

No

(2) How do LGBT+ clients learn about your service? Tick all that apply.^*

(2) How do LGBT+ clients learn about your service? Tick all that apply.^*

Referred by another agency or organisation

Self referral

Word-of-mouth

Do not know/ have this information

(3a) How are LGBT+ clients supported? Tick all that apply.^*

(3a) How are LGBT+ clients supported? Tick all that apply.^*

Through the service as a whole

Through the service with specialist chemsex support (within the service)

Through the service with specialist chemsex support (with external expertise)

Other

(3b) Please say more if you have ticked Other (3a):

(3b) Please say more if you have ticked Other (3a):

(3c) Which drugs are clients more or less likely to present within the terms problematic use? ^*

(3c) Which drugs are clients more or less likely to present within the terms problematic use? ^*

1 Least likely

2

3

4

5 Most likely

Crystal meth

GBL/ GHB

Mephedrone

Ketamine

(4) Does the service include 'outward signs' that it is inclusive of the LGBT+ community? Tick all that apply.^*

(4) Does the service include 'outward signs' that it is inclusive of the LGBT+ community? Tick all that apply.^*

LGBT+ related poster (eg: in the waiting area)

LGBT+ literature

A rainbow sticker in the window

Some staff wear a rainbow lanyard with their ID

This is an unnecessary question

(5) To the best of your knowledge, how comfortable are staff discussing (gay) sex within the context of chemsex with clients? ^*

(5) To the best of your knowledge, how comfortable are staff discussing (gay) sex within the context of chemsex with clients? ^*

Uncomfortable

1

2

3

4

5

Very comfortable

(6) What is the service’s policy in relation to working with people who disclose that they have committed offences (other than drug related offences) in the chemsex context? Tick all that apply. ^*

(6) What is the service’s policy in relation to working with people who disclose that they have committed offences (other than drug related offences) in the chemsex context? Tick all that apply. ^*

There is a policy to which our service adheres

There is no policy of which I am aware

Tell me more

(7) Some gay men say they do not access or return to mainsteam drug services because they feel they are not understood. A common comment is "They get the drugs bit but not the sex or being gay". How might you respond to this?^*

(7) Some gay men say they do not access or return to mainsteam drug services because they feel they are not understood. A common comment is "They get the drugs bit but not the sex or being gay". How might you respond to this?^*

(8a) How would you describe the service’s relationship with sexual health services when chemsex clients are referred?

(8a) How would you describe the service’s relationship with sexual health services when chemsex clients are referred?

Challenging

1

2

3

4

5

Positive

(8b) How would you describe the service’s relationship with mental health services when chemsex clients are referred?

(8b) How would you describe the service’s relationship with mental health services when chemsex clients are referred?

1

2

3

4

5

(9a) How has the demand for chemsex support trended between 2019 and 2021 in relation to your service?^*

(9a) How has the demand for chemsex support trended between 2019 and 2021 in relation to your service?^*

Downwards

1

2

3

4

5

Upwards

(9b) If you wish, say something here about the service's LGBT+ clients within the context of the COVID pandemic.

(9b) If you wish, say something here about the service's LGBT+ clients within the context of the COVID pandemic.

(10) Please say here if any of the service's staff have received training and/ or education in relation to chemsex.^*

(10) Please say here if any of the service's staff have received training and/ or education in relation to chemsex.^*

(11a) In which London Borough your service is located and what is its name?^*

(11a) In which London Borough your service is located and what is its name?^*

(11b) Under its DRUGS section, MENRUS.CO.UK lists all drug, alcohol and chemsex services in Greater London. You can also view by scanning scan the QR code. Services with expertise in chemsex are listed with a lifebuoy icon. Say here if you believe your service should include a lifebuoy?

(11b) Under its DRUGS section, MENRUS.CO.UK lists all drug, alcohol and chemsex services in Greater London. You can also view by scanning scan the QR code. Services with expertise in chemsex are listed with a lifebuoy icon. Say here if you believe your service should include a lifebuoy?

(12) Are aware of the following (tick all that apply). ^*

(12) Are aware of the following (tick all that apply). ^*

MENRUS.CO.UK | Gay men's health and wellbeing (inc. harm reduction/ safer chemsex)

PIP PAC | Safer Chemsex Packs

"Safer Chemsex" booklet (A5, 32 pages)

"Your Rights on Arrest" and Legal Help booklet (A6, 12 pages)

"Hook-Up Safer" booklet (A6, 8 pages)

"HIV/ HCV/ STI Risk-O-Meter" leaflet (A6, 4 pages)

"Sex Calories Counted" leaflet (A6 leaflet, 4 pages)

None of the above

(12a) Please make any further comments here, including your name/ email address here if you have a query or would like copies of our literature.

(12a) Please make any further comments here, including your name/ email address here if you have a query or would like copies of our literature.

(12b) Please include a name/ email address if you would like to receive a copy of the survey findings in February 2022 (est).

(12b) Please include a name/ email address if you would like to receive a copy of the survey findings in February 2022 (est).