Sexual Violence and Chemsex among Substance-Using Sexual and Gender Minorities in Texas

Abstract

Introduction

Chemsex is the use of methamphetamine or other substances to enhance sexual experiences, and is most often associated with sexual minority men. Within the chemsex literature, questions of sexual violence emerge due, in part, to ambiguity about what constitutes consent within sexualized environments with co-occurring substance use.

Methods

To understand the context in which sexual violence occurs, data from an online survey of sexual and gender minority Texans were analyzed using bivariate and logistic regression (N = 1273), and qualitative interviews with substance-using sexual minority men from a separate sample were thematically analyzed (N = 22).

Results

Among survey participants, 12.8% experienced a form of sexual violence (10.1% experienced intimate partner violence and 7.6% experienced sexual assault). When participants were categorized based on past year substance use and sex party attendance, 48.0% of participants who used drugs and attended sex parties (a proxy for chemsex) experienced sexual violence (41.6% experienced intimate partner violence and 41.0% experienced sexual assault). When variables statistically significant at the bivariate-level were entered into logistic regression models, participants in the chemsex category were 12.5 [95% CI: 6.9, 22.8] times more likely to experience sexual violence. Substance-using sexual minority men experiencing sexual violence describe situations in which consent is difficult to revoke and sexual exploitation is likely to occur.

Discussion

Studies which more deeply explore the relationship between sexual and relationship violence and chemsex among sexual and gender minorities are needed. Particularly, the notion of consent needs further conceptualization in the context of drug use and sex parties.

Highlights

• Measures of recent substance use and sex party attendance were combined to create a proxy measure for chemsex, which is the use of substances to enhance sexual experiences.

• Substance-using sexual and gender minorities engaging in chemsex were at increased risk of sexual violence.

• In addition to engaging in chemsex, variables associated with an increased odds of sexual violence among sexual and gender minorities were younger age, having a non-monosexual sexual identity, and receiving a mental health diagnoses.

• Studies on sexual and gender minorities engaging in chemsex should be developed to further explore sexual exploitation.

Keywords:

• intimate partner violence
• sexual assault
• substance use
• sexual behavior
• LGBT health

Acknowledgements

The authors would like to thank all study participants and the staff at the Montrose Center for supporting this study.

Declaration of interest

The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of the article.

Contributors

Wilkerson and Schick designed the study protocol. Wilkerson, Di Paola, and McCurdy undertook data analyses. Latini, Braun-Harvey, and Nieto reviewed the literature for this manuscript, and Wilkerson wrote the first draft and incorporated comments from coauthors. All authors contributed and have approved this manuscript.

Ethics

The institutional review board of The University of Texas Health Science Center at Houston (UTHealth) approved research protocols.

Additional information

Funding

Funding provided by the UTHealth School of Public Health.