Variable riskChemsex

Chemsex: the architecture of care in encounters with substances

A practical guide to planning encounters with substances, reducing harm, and caring for the body before, during, and after.

chemsexpleasureharm-reductioncombination-preventionaftercareconsentsubstances
Also in:SpanishPortuguese (Brazil)

Chemsex: care is part of the encounter too

Chemsex describes the intentional use of psychoactive substances before or during sexual encounters to modify, intensify, or extend the experience. It is not a sexual practice in itself, but a context where pleasure, desire, relationships, substances, bodies, and decisions come together.

Information, preparation, and care can help reduce harm and support more autonomy.

The architecture of care in chemsex

Communication

Speak clearly, listen, and agree on limits, desires, substances, timing, and expectations.

Planning

Prepare the encounter, anticipate risks, review interactions, and define agreements before starting.

Knowledge

Learn about substances, dosing, routes of use, onset and duration, interactions, and combination prevention.

Ongoing care

Monitor your body, hydrate, take breaks, and ask for help when needed.

Aftercare

Take care of yourself after the encounter, check in with others, and reconnect.

1. Before the encounter

  • Define your limits, desires, and agreements.
  • Know which substances will be used.
  • Review interactions with treatment, PrEP, PEP, ART, or other medicines.
  • Tell someone you trust where you will be.
  • Prepare harm reduction supplies.

2. During the encounter

  • Keep consent ongoing and enthusiastic.
  • Hydrate and take breaks.
  • Monitor your body and your partners’ bodies.
  • Communicate how you feel.
  • Adjust practices based on agreements and how bodies are responding.

3. Substances

  • Know the dose, route of use, and expected timing.
  • Avoid unnecessary mixing.
  • Start low if you do not have experience.
  • Wait enough time before re-dosing.
  • Always check interactions in the app.

4. Combination prevention

  • Use PrEP, PEP, or ART as prescribed.
  • Use condoms and lubricant when that fits your needs and agreements.
  • Get vaccinated against hepatitis A, hepatitis B, HPV, and mpox when possible.
  • Get regular STI, HIV, and hepatitis testing.
  • Identify friendly health services and support networks.

5. Rest and well-being

  • Sleep enough before and after.
  • Eat and hydrate regularly.
  • Let your body recover.
  • Care for your mental and emotional health.
  • Ask for support if you need it.

6. Aftercare

The encounter may end, but care continues.

  • Check how you feel physically and emotionally.
  • Talk with your partners if you want to.
  • Hydrate, rest, and eat something.
  • Ask for help if something worries you.

7. When should you seek help?

Seek urgent help if there is:

  • Trouble breathing.
  • Chest pain or severe pain.
  • Seizures.
  • Loss of consciousness.
  • Extreme agitation or paranoia.
  • Suicidal thoughts.

8. Community knowledge saves lives

Sharing trustworthy information, talking without judgment, and building collective agreements are powerful ways to reduce harm, strengthen well-being, and defend rights.

Pleasure does not remove risk, but information, preparation, and care can support freer decisions and reduce harm.