To shed light on sexualized drug use among men who have sex with men (MSM) and transgender women (TGW) and to understand the socio-sexual context of this practice in Asia and the Pacific, APCOM commissioned a scoping review of locally informed qualitative research under the technical guidance of Drs Angela Kelly-Hanku and Jamee Newland of the University of New South Wales (Australia) and financial support of the UNAIDS Regional Office for Asia and the Pacific.  The objective of APCOM’s scoping review, titled “A qualitative scoping review of sexualised drug use (including Chemsex) of men who have sex with men and transgender women in Asia”, was to inform effective HIV, harm reduction and programmatic responses in the region, and to guide future qualitative research in the Asia and the Pacific.

SDU is not a new phenomenon and in Asia is receiving attention as the practice is further documented and explored, with SDU prevalence ranging between 3.6% to 91.2% in the region. MSM and TGW typically aged between 18 and 29 years participated in SDU where two distinct settings in the Asia region are social and sex work settings. “This review provides a groundbreaking analysis that helps us understand the social settings in which the practice takes place and the resulting and subsequent risk to HIV,” says Midnight, APCOM Director.

Diverse social and sexual motivations for SDU are reported in the review, ranging from describing SDU as a social and sexual lubricant that increased pleasure, to beauty, status and freedom to participate in sexual fantasies. In different contexts, SDU is used to build individual and community identities and establish relationships or as a coping mechanism for those who had experienced stigma, rejection, and/or who described feelings of lost social and sexual worth. Common across SDU settings reported in this review are themes of privacy, anonymity and secrecy, a finding hardly surprising in an environment where death penalties, incarceration and enforced treatment occurs with respect to drug supply, and peer and family exclusion due to sexuality and criminalisation of same sex relationships.