Sexual health: HIV, STIs, chemsex and practices
Sourced articles (Santé publique France, AIDES, WHO) to protect yourself, get tested and get treated, without judgement. (54 articles)
Emergency
- HIV exposure (broken condom, unprotected sex): PEP works best within 4 h and no later than 48 h → emergency department or sexual health clinic.
- Collapse, loss of consciousness, overdose (GHB, mixing drugs): call 112 (15 in France), put the person in the recovery position, never leave them alone.
- In France: Sida Info Service 0 800 840 800 (free, anonymous) · Drogues Info Service 0 800 23 13 13 · AIDES chemsex line (WhatsApp) +33 7 62 93 22 29 · Victim support 116 006.
Key figures
5,100new HIV diagnoses in France in 2024, 42% of them through sex between men
≈ 9,700people live with HIV in France without knowing it (end of 2024)
+35%rise in gonorrhoea in France between 2022 and 2024
67,505people used PrEP in France in the first half of 2025
13%of men who have sex with men practised chemsex in the previous 6 months (2023)
> 1 millioncurable STIs are acquired every day worldwide
HIV: prevention, testing, treatment
- After an HIV diagnosis — After an HIV diagnosis the priorities are simple: confirm the result, start treatment quickly, get support, and tell recent partners so they can get tested.
- HIV and STI statistics — In 2024 about 5,100 people were newly diagnosed with HIV in France, 42% through sex between men, and bacterial STIs rose sharply; worldwide, 41 million people were living with HIV at the end of 2025.
- HIV: transmission and symptoms — HIV is a virus that weakens the immune system; it is transmitted through blood, semen, pre-cum, vaginal and anal fluids, and today it is treated very effectively when diagnosed early.
- Injectable PrEP — Injectable PrEP replaces pills with a shot: cabotegravir (Apretude), one injection every two months, has been available and reimbursed in France since March 2026; lenacapavir, two injections a year, is recommended by WHO.
- Living with HIV — Living with HIV today means taking long-term antiretroviral treatment, having regular check-ups and, once the viral load is undetectable, living a normal life (and sex life) without passing on the virus.
- PEP (Post-Exposure Prophylaxis) — PEP (post-exposure prophylaxis, TPE in French) is emergency anti-HIV treatment best started within 4 hours and no later than 48 hours after exposure, then taken for one month.
- PrEP — PrEP (pre-exposure prophylaxis) is preventive treatment taken by an HIV-negative person to avoid getting HIV; in France any doctor can prescribe it and it is 100% reimbursed.
- Undetectable and U=U — "Undetectable = Untransmittable" means that an HIV-positive person whose viral load has been undetectable for more than 6 months thanks to treatment does not pass on HIV through sex.
- Viral Load (VL) — Viral load is the amount of HIV measured in the blood (in copies per millilitre); on effective treatment it becomes undetectable, which protects the person's health and prevents sexual transmission.
STIs: symptoms, testing, treatment
- Chlamydia and LGV — Chlamydia is the most common bacterial STI, often symptom-free; among men who have sex with men, some strains cause lymphogranuloma venereum (LGV), a severe anal inflammation. Both are cured with antibiotics.
- Genital herpes — Genital herpes is a viral infection (HSV-2 or HSV-1) that causes outbreaks of small painful blisters; it spreads even without visible sores, can't be cured, but is controlled with antivirals.
- Gonorrhoea (the clap) — Gonorrhoea, or the clap, is a bacterial STI that affects the urethra, anus or throat; often silent outside the penis, it is treated with an antibiotic injection, but resistance is growing.
- Hepatitis A — Hepatitis A is a viral liver infection spread by the faecal-oral route, including during rimming; it usually clears on its own but can be exhausting, and a vaccine prevents it effectively.
- Hepatitis B — Hepatitis B is a viral liver infection that spreads easily through semen, blood and sex; it can become chronic, but a vaccine gives almost 100% protection.
- Hepatitis C — Hepatitis C is a bloodborne virus; between men it spreads through practices involving bleeding (fisting, SM, shared toys) and shared chemsex equipment. There is no vaccine, but antivirals cure it in more than 95% of cases.
- HPV (papillomavirus) — HPV (human papillomavirus) is a very common virus passed on through sexual contact; it can cause genital or anal warts and, in the long run, anal and throat cancers. In France the vaccine is recommended for men who have sex with men up to age 26.
- Mpox (monkeypox) — Mpox is a viral infection causing skin and mucosal lesions, spread mainly through close skin-to-skin contact, including sex; a vaccine is recommended for men who have sex with men who have several partners.
- Mycoplasma genitalium — Mycoplasma genitalium is a sexually transmitted bacterium that can cause urethritis or proctitis; often silent, it is only tested for and treated when there are symptoms, because of its high antibiotic resistance.
- Pubic lice and scabies — Pubic lice (crabs) and scabies are skin parasites passed on through close body contact, including sex, and through bedding; they cause intense itching and are treated by also treating partners and washing linen.
- Shigella (shigellosis) — Shigellosis is an intestinal infection caused by Shigella bacteria, passed on through invisible traces of faeces, notably during rimming; it circulates among men who have sex with men, with strains increasingly resistant to antibiotics.
- STI symptoms — Discharge, burning, a sore, spots, itching, anal pain, fever or a rash after sex are possible STI signs that warrant a quick visit to a doctor; but most STIs cause no symptoms at all.
- STIs (sexually transmitted infections) — STIs are infections passed on through sex (bacteria, viruses, parasites); most go unnoticed, are easy to test for and treat, and some can be prevented by vaccines.
- Syphilis — Syphilis is a bacterial STI that often starts with a painless sore (chancre) and can then progress silently for years; it is detected with a blood test and cured with a penicillin injection.
Protection and testing
- CeGIDD — CeGIDD (free information, testing and diagnosis centres) are public clinics in France where you can get tested, treated, vaccinated and get PrEP or PEP for free, anonymously if you wish.
- Condoms and lube — Condoms (external or internal) protect against HIV and limit exposure to other STIs; put on correctly and used with water- or silicone-based lube, they rarely break.
- DoxyPEP — DoxyPEP means taking 200 mg of doxycycline within 72 hours of condomless sex to reduce the risk of syphilis and chlamydia; in France, the HAS reserves it, case by case, for MSM and trans women highly exposed to STIs.
- HIV and STI testing — Getting tested means checking, with a blood test, a swab or a rapid test, whether you have HIV or another STI; for men with several partners, the recommended rhythm is every 3 months.
- Vaccines for MSM — Four vaccines are recommended for men who have sex with men to protect against sexually transmitted infections: hepatitis A, hepatitis B, HPV (up to 26 in France) and mpox.
- Window period — The window period is the time between infection and the moment a test can detect it: 6 weeks for a lab HIV test in France, 3 months for a self-test or rapid test.
Specific practices and their risks
- Anal douching — Anal douching means rinsing the rectum with water before sex; done properly (lukewarm water, low pressure, two hours before, not too often) it is safe, but done too often or too harshly it irritates the lining and makes infections easier.
- BDSM: safety and health — BDSM and hard sex are safer with five rules: negotiated consent, a safeword, listening to your body, sobriety and a safe setting; some practices (choking, sounding, trampling) need specific precautions.
- Blood play: health risks — As soon as an SM practice draws blood (cutting, needles, a whip that breaks skin, play piercing), the risk of transmitting HIV and especially hepatitis B and C becomes real; it's reduced with sterile single-use equipment, gloves and good hygiene.
- Fisting: risks and safety — Fisting mainly exposes you to hepatitis C (via blood and shared lube), anal and rectal injuries and some STIs; individual gloves, your own lube, short nails, going slowly and staying sober greatly reduce these risks.
- Group sex: health — Group sex multiplies contacts and therefore chances of STI transmission; PrEP, vaccines, condoms within reach, individual lube and gloves, clear consent and testing afterwards let you enjoy it while reducing risk.
- Oral sex: STI risks — Oral sex carries little HIV risk, but it is one of the main routes for gonorrhoea, chlamydia, syphilis, herpes and HPV, often with no symptoms at all in the throat.
- Piss play: health risks — Piss play (watersports, golden showers) carries little risk on healthy skin; HIV isn't transmitted by urine, but STIs and infections can pass if urine gets into the mouth, anus or a wound.
- Rimming: STI risks — Rimming (anilingus) carries very little HIV risk, but exposes you to hepatitis A, shigella, gonorrhoea, chlamydia, syphilis, herpes and HPV; the hepatitis A vaccine and throat testing are the best protection.
- Scat play: health risks — Scat play (coprophilia) carries little HIV risk but a high risk of gut infections spread through faeces: hepatitis A, shigella, parasites, intestinal bacteria.
- Sex toys: hygiene and sharing — A sex toy passed from one body to another can transmit STIs and hepatitis B and C; a new condom per partner, cleaning after every use and non-porous materials reduce the risk.
Chemsex and drugs
- 3-MMC / cathinones — 3-MMC and other synthetic cathinones are stimulants widely used in chemsex; they carry a risk of rapid dependence, overdose, heart problems and a depressive comedown, and are dangerous with some HIV treatments.
- Chemsex — Chemsex means using psychoactive drugs (cathinones, GHB/GBL, methamphetamine, ketamine…) in order to have sex, often long sessions with several partners; in France 13% of sexually active men who have sex with men practised it over 6 months (2023).
- Chemsex help — If chemsex becomes hard to manage, free specialist services exist: AIDES' WhatsApp line and groups, Drogues Info Service, chemsex clinics (Le 190 in Paris), and addiction and harm-reduction centres across France.
- Crystal meth (tina) — Methamphetamine (crystal, tina, ice) is a powerful stimulant, two to five times more intense than amphetamine, with very long effects; it carries a risk of rapid dependence, serious heart and psychiatric problems, and sexual risk-taking.
- Dangerous combinations — Some combinations of drugs and medicines are particularly dangerous during sex: GHB/GBL with alcohol or sedatives (coma), poppers with Viagra (blood pressure crash), cathinones or GHB with some HIV treatments (overdose).
- G (GHB/GBL) — "G" means GHB and GBL, two depressants with almost identical effects, widely used in chemsex; the gap between the dose that works and the one that knocks you out or into a coma is small, and mixing with alcohol is the leading cause of comas.
- Harm Reduction — Harm reduction is a public health approach that starts from what people actually do, without judgement, to limit the damage: sterile equipment, dosing, PrEP, testing, support, rather than demanding abstinence.
- Ketamine — Ketamine is a dissociative anaesthetic used recreationally and during sex; it causes loss of control, accidents, heart strain and, with regular use, serious and sometimes irreversible bladder damage.
- Poppers — Poppers are inhaled volatile nitrites that cause muscle relaxation, a racing heart and a rush of heat within seconds; they're dangerous if swallowed, on skin and eyes, with alcohol and with erection drugs.
- Slam — Slamming means injecting drugs (cathinones, methamphetamine…) intravenously during sex; it's the riskiest form of chemsex for dependence, overdose, veins, and HIV and hepatitis C transmission.
Mental health, consent, violence
- After a sexual assault — After a sexual assault the priorities are getting safe, emergency care (HIV PEP within 48 hours, drug testing, STI testing), preserving evidence and getting support; reporting it to the police is possible but not required to get care.
- Consent and drug-facilitated assault — Consent is a free, informed and reversible agreement to each sexual act; someone asleep, unconscious or too impaired by alcohol or drugs can't consent, and drugging someone without their knowledge to have sex with them is drug-facilitated assault, a crime.
- Gay and bi mental health — In France, gay and bisexual men report more than twice as many depressive episodes and suicidal thoughts as straight men; a large part of that gap is explained by violence and discrimination, and help exists.
- HIV stigma (serophobia) — HIV stigma ("serophobia" in French) means rejection, prejudice and discrimination against people living with HIV; refusing care, housing or a job because of someone's health status is illegal discrimination in France.
- Stealthing Definition — Stealthing means deliberately removing or damaging the condom during sex without the partner's agreement; it's a breach of consent that exposes the partner to HIV and STIs and calls for quick action (PEP within 48 hours, testing, the option of reporting it).
Informational article based on official sources. It does not replace medical advice: if in doubt, if you have symptoms or took a risk, see a health professional or a sexual health clinic.