Case 22. Sex with Drugs: Talking About Chemsex and Harm Reduction
Download MP3With guest Dr. Jeremy Kidd, Chris reviews the case of a 27-yr-old man with HIV who reports using methamphetamine to enhance sex and has unsuppressed HIV. Is this chemsex? Is the unsuppressed viral load related? How should Chris discuss this with his patient, and what should he recommend? How should he approach the topic of harm reduction if the patient is not going to stop using chemsex?
References Cited:
References Cited:
- Kidd JD, Smiley SL, Coffin PO, et al. Sexual orientation differences among men in a randomized clinical trial of extended-release naltrexone and bupropion for methamphetamine use disorder. Drug Alcohol Depend. 2023 Sep 1;250:110899. Epub 2023 Jul 17. PMID: 37478502.
- Reback CJ. The Social Construction of a Gay Drug: Methamphetamine Use Among Gay and Bisexual Males in Los Angeles. 1997. Available online here. Accessed February 24, 2026.
- Trivedi MH, Walker R, Ling W, et al. Bupropion and Naltrexone in Methamphetamine Use Disorder. N Engl J Med. 2021 Jan 14;384(2):140-153. PMID: 33497547.
Documentaries Mentioned:
Related NYSDOH AI Guidelines and Guidance:
- Chemsex: Questions and Answers
- Substance Use Screening and Risk Assessment
- Substance Use Harm Reduction
- PrEP to Prevent HIV and Promote Sexual Health
- PEP to Prevent HIV Infection
- Doxycycline Post-Exposure Prophylaxis to Prevent Bacterial Sexually Transmitted Infections
- Guidance: Adopting a Patient-Centered Approach to Sexual Health
