Page 40 - IJPS-10-4

International Journal of
Population Studies Chemsex among MSM during the COVID-19 pandemic

3.5. Health disparity issues faced by men who had critical for their well-being, including HIV prevention,
sex with men engaging in chemsex practices during treatment, and care (Torres et al., 2021).
the COVID-19 pandemic In the United Kingdom, Hyndman et al. (2021) have

Health disparities among people who use drugs during highlighted that MSM face significant challenges in
the COVID-19 pandemic encompass differences in accessing health care due to societal stigma and a lack
health outcomes and access to substance use treatment of awareness among health-care providers regarding
and harm reduction services (Dunlop et al., 2020). MSM chemsex practices. This gap in understanding can prevent
engaging in chemsex are particularly vulnerable to these health-care providers from offering the necessary support
disparities, especially during lockdown phases triggered or interventions, resulting in further health disparities
by the COVID-19 outbreak. Such vulnerabilities can lead and leaving MSM without the essential treatment or
to an increased risk of sexually transmitted infections preventative care they require.
(STIs), mental health issues, substance use disorders, and The legal framework in Malaysia further complicates
challenges in accessing health-care services (Dai et al.,2023; the situation for MSM engaging in chemsex. Maviglia
Hyndman et al., 2021; Maviglia et al., 2023; Roux et al., et al. (2023) discuss how the criminalization of same-
2022). These disparities are often influenced by economic sex relationships and drug use exacerbates stigma and
inequities, environmental disadvantages, societal stigma, discrimination, placing MSM at risk of legal consequences
discrimination, and legal or social inequalities faced by in addition to societal judgment. The fear of legal
MSM (Amundsen et al., 2022). repercussions and societal discrimination severely hinders
Geographical disparities significantly influence the MSM’s access to health care, as they may avoid seeking
health outcomes of MSM engaging in chemsex. Research health services due to fear of being reported to authorities
conducted by Sousa et al. (2020) sheds light on the distinct or facing discrimination from health-care providers.
chemsex practices and knowledge gaps between Brazil and This avoidance can lead to untreated health issues and
Portugal. Brazil, for instance, reports higher occurrences perpetuate the cycle of health disparities.
of chemsex and fewer prevention efforts, attributed to a During the pandemic, lockdowns have resulted in an
prohibitionist climate. This discrepancy is concerning increased reliance on substances among MSM, particularly
as it leads to higher rates of unprotected sex, multiple noted in France by Roux et al. (2022). This rise in substance
sexual partners, and the use of psychoactive substances use, likely driven by isolation, stress, and the disruption of
during sexual encounters. The disparities in health- normal social and support networks, not only heightens
care infrastructure and the availability of sexual health the risk of addiction and health issues related to drug
services between countries such as Brazil and Portugal use but also complicates access to health-care services.
can significantly affect the accessibility to appropriate care The pandemic has intensified societal pressures and
and support for the health needs of MSM engaging in stigmatization, resulting in significant health disparities
chemsex. Portugal’s more robust health-care systems and for MSM engaging in chemsex. Card et al. (2021) provide
harm reduction interventions may offer better resources insights into the discrimination faced by this community,
for addressing the health needs of MSM compared to both within society and health-care settings, where stigma
Brazil. related to sexual orientation and substance use behaviors
The impact of societal stigma and discrimination creates substantial barriers to accessing health-care
on health-care access cannot be overstated. In Brazil, services.
Torres et al. (2021) found that drug use among MSM and Several determinants influence MSM’s ability to access
transgender/non-binary individuals during the pandemic help for substance use issues, including income levels,
was closely associated with increased stigma and barriers the frequency of substance use, and health-care provider
to accessing health care. The stigma surrounding drug awareness. Card et al. (2021) and Roux et al. (2020) note
use, especially in the context of chemsex, exacerbates that lower income and more frequent engagement in
discrimination and judgment from health-care providers, chemsex can pose additional obstacles for individuals
thus creating significant obstacles for MSM seeking health- affected by chemsex-related issues. The interplay of
care services. This stigma fosters a climate of fear among financial constraints, the intensity of substance use,
MSM, who may be concerned about legal repercussions or and provider biases leads to significant barriers to
mistreatment if they disclose their substance use to health- accessing treatment and support. These barriers are
care providers. Consequently, this fear can deter MSM further complicated by societal and health-care-related
from seeking necessary help for their drug use or related stigmatization, limiting MSM’s access to and utilization
health issues, leading to avoidance of health-care services of substance use services.

Volume 10 Issue 4 (2024) 34 https://doi.org/10.36922/ijps.2599