Harm reduction: a practical guide for chemsex and sex

What is harm reduction?

Harm reduction is the approach championed in France by charities such as AIDES and adopted by Santé publique France: start from what people actually do, without judgement, to limit the damage. It has proven itself with drug users (sterile syringes) and in sexual health (condoms, PrEP). It isn’t encouraging drug use: it’s making sure a night out doesn’t end in A&E or with hepatitis C.

Before the session

• Sexual prevention: PrEP taken properly, or HIV treatment on track (TasP); hepatitis A and B vaccines (vaccines).
• Kit (Sexosafe): condoms, gloves, individual lube, disinfectant, sterile syringes and personal straws if needed, a measuring device for G.
• Know your drugs: get them checked, learn about effects and dangerous combinations.
• Set your limits and discuss them with partners; have an emergency number saved.
• Eat and be rested.

During

1. Measure and write down the time of each dose (AIDES: G-Track sheet, photo on your phone); at least 2 hours between G doses.
2. Never alcohol with G, no benzodiazepines.
3. Share nothing: no syringes, cotton, spoons, straws or pipes (hepatitis C, HIV).
4. Water regularly, sugary drinks at hand (Sexosafe).
5. Plenty of lube, condoms or PrEP, gloves for fisting, disinfected toys (fisting, sex toys).
6. Consent: someone asleep or very high doesn’t consent (consent).
7. Look out for each other: never leave someone who’s asleep or unwell alone.

If things go wrong

Sexosafe: for mild distress, move the person somewhere calm, reassure them, give them sugar. If they’re unconscious: recovery position and call emergency services immediately, saying what was taken.

After

• Sleep, eat, hydrate; the comedown can be rough.
• PEP within 48 hours after an HIV risk (PEP).
• Regular testing for HIV, STIs, hepatitis C.
• Take stock: if sessions pile up, talk about it (chemsex help).

Where to get free kit (France)?

At CAARUD harm-reduction centres, from AIDES (syringes, straws, GHB measuring devices), in pharmacies (injecting kits) and at some sexual health clinics. Personal straws and syringes greatly reduce the risk of hepatitis C (Drogues Info Service).