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Talking about hepatitis C with immigrants and newcomers to Canada. Sharing the voices of people with lived experience on World Hepatitis Day. Some gay, bisexual and other men who have sex with men gbMSM use drugs specifically to facilitate or enhance sexual encounters.
This phenomenon is commonly called party and play PnP. In this article we discuss the drugs most commonly used for PnP in Canada, how common PnP is in Canada, the risks of PnP related to sexually transmitted and blood-borne infections STBBIsand how service providers can provide support for men who PnP in their communities. PnP is the use of certain drugs by some gbMSM before or during sex specifically to facilitate, sustain or enhance sexual encounters.
Participation in PnP has been made easier by the use of online dating sites and hook-up apps that allow gbMSM to quickly locate men interested in PnP in their area. The drugs most commonly associated with PnP in Canada are crystal methamphetamine crystal methgamma-hydroxybutyrate GHB and ketamine. These drugs are used because they increase sexual arousal and performance, while encouraging disinhibition. The effects of crystal meth can last up to 24 hours, although doses are usually repeated every few hours to enhance energy or to remain high. The effects of crystal meth include euphoria experiencing intense pleasure or excitementincreased energy, enhanced confidence, impulsivity, reduced experience of pain, intense sexual stimulation and lowered inhibitions.
It has relaxant effects so can make receptive anal sex easier or more pleasurable. This means they may not be able to meaningfully consent to sex. Ketamine K, Special K, cereal is an anaesthetic. It can be snorted, injected into muscle, swallowed, or smoked mixed with tobacco or cannabis. The effects of ketamine last between 40 and 90 minutes after it is snorted and up to three hours after it is swallowed or injected.
How often doses are repeated depends on the way it is taken. Ketamine numbs physical pain. In small doses it can give a minor energy boost. Moderate doses can induce feelings of relaxation and disconnection or disassociation from the body. Ketamine increases the desire for sex but makes it harder to keep an erection.
Erectile dysfunction drugs such as Viagra are used by some men to counter the effects of crystal meth or ketamine, which may make it difficult to get or keep an erection. Mixing different drugs can be dangerous as it can lead to drug interactions or potential overdose. For example, mixing poppers and Viagra can cause a drop in blood pressure, which can lead to fainting, a stroke or a heart attack. However, because of the varying ways the questions in these studies were asked and analyzed there is no clear estimate of participation in PnP.
Participants were not specifically asked if they had used drugs for PnP. In a sub-analysis of Ontario respondents, of 2, 4. This study looked at factors associated with PnP in Ontario. ificantly more:. The Momentum study, an ongoing prospective cohort study of the health, sexual behaviour and substance use patterns of gay and bisexual men in Vancouver, asked men about their drug use in the six months 11 : The men were not specifically asked about drug use in the context of PnP. Research suggests that some gbMSM are open to exploring activities during PnP that they have no intention of engaging in when sober.
Given that the use of drugs during PnP sessions can reduce inhibitions, increase sexual adventurism and extend sex sessions, it can also increase the likelihood of participation in activities that can cause damage to the rectal lining.
Men injecting crystal meth may also pass HIV or hepatitis C if they share injecting equipment.
Although men who PnP may be aware of the risks of injecting, they may not be as vigilant as usual when they share equipment during extended PnP sessions. A systematic review of sexualized drug use among gbMSM found an increased prevalence of gonorrhea and chlamydia, especially in men who used crystal meth. There is some evidence that men who have experienced depression or anxiety at some point in their lives may be more likely to take part in PnP.
PnP is also linked to other drug use and addiction issues. For example, crystal meth can be highly addictive, especially if it is smoked or injected. Lack of dopamine means a person may have difficulty feeling happy or good about themselves. This may make them want to take more crystal meth to feel better about themselves. Most traditional drug and harm reduction services are not well equipped to deal with PnP-related issues.
Some men who PnP may have limited knowledge of needle and syringe programs, risk reduction strategies and available drug supports. Sexual health clinics and other community settings with large s of gbMSM clients are ideally placed to develop programs to help men dealing with potential problems related to PnP. Men are likely to feel more comfortable talking about their sexualized drug use as part of a sexual health check-up than by visiting a harm reduction service, as long as they receive non-judgmental support.
It is important to mention that not all men who PnP experience negative effects from their drug use. Some men take part in PnP sessions occasionally, use it to enhance the kind of sex they want and are able to include it as part of their life with no or limited harms. However, some men may have a more complicated relationship with the drugs they use and the sex they have. In Februarythe clinic introduced a program to support gbMSM who report using drugs in a sexual context. By the end of DecembergbMSM had agreed to single or multiple interventions to help address their sexualized drug use.
Here are a few examples:. MAX also produces safer partying kits, which contain harm reduction equipment for men who PnP, including condoms and lube, gloves, injecting kits, snorting kits and a meth pipe. This six-week program uses motivational interviewing, cognitive behavioural therapy and other approaches to help gbMSM make positive changes in the way they use drugs.
An outreach worker is available to facilitate sessions to discuss risk reduction and answer sex- and drug-related questions at parties. Kontak also runs Crystal Meth and Sex workshops and offers one-on-one counselling sessions. This campaign provides sex-positive information on drugs and harm reduction for gbMSM who are involved in PnP and who may want to make changes related to their substance use during sex. The packs contain colour-coded drug equipment such as syringes and spoons to reduce the chance of people sharing equipment while partying, as well as condoms, lube and latex gloves.
Service providers have an important role to play in reaching out and understanding the issues related to PnP in their communities. Toronto Vibe — safer drug use information for gbMSM who party. Condoms for the prevention of HIV transmission. Oral pre-exposure prophylaxis PrEP. Post-exposure prophylaxis PEP. Can daily use of cannabis help to reduce the frequency of injecting opioids? Study uncovers health issues and concerns of some aging HIV-positive people.
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Jump to Jump to Content. Search the site. Hepatitis C Subscriptions Become a Member. Current Issue Back Issues Subscribe. Spring Print. What is PnP? How common is PnP in Canada? ificantly more: HIV-positive men Compared with gbMSM who do not participate in PnP, HIV-negative gbMSM who do participate in PnP are more likely to: participate in condomless anal sex with one or more partners 13 participate in more frequent receptive anal sex 14 participate in condomless anal sex with HIV-positive or unknown-status partners 13 participate in receptive condomless anal sex with an unknown-status partner 13 report having 11 or more new sexual partners in the past year 13 participate in group sex 13 Research suggests that some gbMSM are open to exploring activities during PnP that they have no intention of engaging in when sober.
Where should PnP programs be developed? What can service providers do to support guys who party? Start a community discussion: There is a lot of stigma around PnP and a reluctance to speak openly about it, so it may be hidden in many communities.
Start an open, non-judgmental dialogue with men who PnP in your community to get a better idea of the issues around PnP: How big is the PnP community? What drugs are being used? What language do people who take part in PnP use? What challenges are they facing? What supports do they need? Where are men meeting to PnP? Provide culturally informed or context-specific counselling and support: If they are offered a space to talk, men who PnP may be able to talk more openly about any problems they may be experiencing and will be less likely to withdraw into social networks that include only other men who PnP.
Provide accurate information: Men who PnP may need information on safer sex including safer fisting practices if appropriate and safer drug use and how to limit harms associated with using drugs in a sexual environment. They may also need access to accurate information about various drugs, their effects, drug interactions, and other risks associated with taking them. Men who want to reduce or discontinue their drug use will need information to help with their decision and on how and where they can access support and treatment.
While someone is under the influence of drugs during PnP it can be hard to gauge if they are agreeing to an activity, especially if they are so high they may not know exactly what is going on. It is important for men to pay attention to the body language and level of consciousness of their partners during sex to ensure they are still enjoying the activity and have the ability to continue to consent to it.
Remain sex positive: Any discussion of PnP in the gbMSM community must be open and accepting of diverse sexual interests and behaviours. Men who PnP need to be supported as they define what works for them, without judgment on the kind of sex they are having. It can be difficult for men who have been involved in the PnP scene to have satisfying sex lives without drugs.Drugs and fuck personals
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