For many, chemsex is more than just drug use—it is often intertwined with deeper personal, social, and structural factors. In the Filipino MSM (men who have sex with men) community, chemsex may be a way to cope with loneliness, seek intimacy, or navigate the pressures of sexual and gender identity in a society that often marginalizes them. Yet, instead of being met with understanding, people who engage in chemsex are frequently subjected to blame, stigma, and discrimination. This not only isolates them but also creates significant barriers to accessing healthcare, HIV prevention, and harm reduction services.
The Philippine HIV response has made strides in prevention and treatment, but it largely overlooks the realities of sexualized drug use. Chemsex is often discussed in a way that emphasizes its risks—higher chances of HIV transmission, difficulties with antiretroviral treatment (ART) adherence, and mental health challenges—without recognizing the systemic failures that leave individuals underserved. Criminalization of drug use, fear of arrest, and moral judgment from healthcare providers drive people away from services rather than bringing them into care. When chemsex is framed solely as a personal failing rather than a public health issue, it becomes even harder for those who need help to seek it without fear.
The #ChemsexPH study showed the significant association between chemsex engagement and self-reported HIV status. From the analysis, Filipino MSM found that those who recently engaged in chemsex (in the last six months) were more than five times as likely to report living with HIV compared to those who did not engage in chemsex. Additionally, a history of sexually transmitted infections (STIs) was twice as common among MSM who reported chemsex participation, highlighting the need for integrated healthcare responses that address both drug use and sexual health. Importantly, while ART adherence was high among people living with HIV (PLHIV) in the study, recent chemsex engagement did not significantly predict non-adherence to ART. This challenges the commonly held assumption that chemsex necessarily leads to ART non-compliance and suggests that other structural factors, such as mental health and social support, may play a more crucial role in ensuring adherence.
For PLHIV who engage in chemsex, staying on ART can be a challenge. However, rather than assuming non-adherence is due to recklessness, we must acknowledge the structural and psychological barriers at play. Many who use drugs face daily struggles—unstable housing, mental health concerns, economic insecurity, and rejection from their families or communities. A healthcare system that treats them with dignity, rather than punishment, can make the difference between staying in care or falling through the cracks.
Methamphetamine, or shabu, remains the most commonly used substance in chemsex. While its effects—such as increased confidence, energy, and sexual pleasure—can be appealing, the absence of harm reduction services leaves individuals without crucial support in managing their use safely. The #ChemsexPH study highlights the importance of integrating harm reduction approaches into public health strategies to improve health outcomes and encourage healthcare engagement. By fostering a supportive environment that prioritizes care over punishment, individuals who seek help can access necessary services without fear of stigma or exclusion, ultimately promoting better health and well-being.
Harm reduction results in inclusive healthcare that is free of stigma and discrimination, providing access to peer support and health services that respect people’s dignity. Engagement in chemsex and addiction, like other health concerns, deserves medical attention and social support, not punishment. The research findings emphasize the urgent need for interventions tailored to the unique experiences of Filipino MSM engaged in chemsex, including expanding PrEP access, STI screening, mental health support, and community-led harm reduction initiatives.
By: Rod Olete
Technical Writer and #PsySE-SDN Project Lead,
Sustained Health Initiatives of the Philippines (SHIP)