Injecting Drugs 

• Sharing a needle or syringe to inject any substance (including steroids, hormones or silicone) puts you at risk of HIV and other infections found in the blood, like hepatitis C. You’re at risk whether you’re injecting under the skin only or directly into your bloodstream.

• Sharing needles and syringes is not the only risk. Sharing water to clean injecting equipment, reusing containers to dissolve drugs, and reusing filters can also transmit HIV.

• To reduce HIV risk, avoid shared needles and other injecting equipment, use a new or disinfected container, clean water and a new filter each time you prepare drugs.

 

How do you get HIV from injecting drugs?

During an injection, some blood goes into the needle and syringe. A needle and syringe that someone living with HIV has used can contain blood with the virus in it after the injection. If you then use the same injecting equipment, you are likely to inject HIV-infected blood directly into your bloodstream.

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Can I get HIV from any type of injecting?

Sharing a needle or syringe for any use, including injecting drugs under the skin (skin popping), steroids, hormones or silicone, can put you at risk of HIV and other infections found in the blood like hepatitis C.

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You can get HIV from injecting into a vein (intravenous injecting). You can also get HIV from injecting into the fat under the skin (subcutaneous injecting) and injecting directly into a muscle (intramuscular injection).

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There are many ways you could get HIV from injecting drugs and the equipment used to inject drugs, including:

• preparing drugs with syringes that contain infected blood

• sharing water used to flush blood out of a needle and syringe

• reusing bottle caps, spoons, or other containers (‘cookers’) to dissolve drugs into water and to heat drug solutions

• reusing filters - normally small pieces of cotton or cigarette filters – used to filter out particles that could block the needle during an injection

• unsafe disposal of used needles or syringes.

 

If I use drugs, how can I reduce my risk of HIV?

If you inject drugs, avoid sharing needles, syringes or other injecting equipment like spoons or swabs, as this exposes you to HIV and other viruses found in the blood like hepatitis C.

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In some countries, used needles can be exchanged for clean ones at pharmacies and needle exchanges. If you take heroin and share needles, you could consider joining a methadone or buprenorphine programme to reduce your risk of HIV. These opioid substitutes are swallowed as a liquid, reducing your risk of HIV as well as helping you to manage your drug addiction. A doctor or healthcare professional can advise you about the availability of needle exchanges and methadone/buprenorphine programmes in your area.

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There are other things you can do to reduce your risk of HIV from injecting drugs:

• use sterile water to prepare drugs (for example, boiled water)

• use a new or disinfected container (‘cooker’) and a new filter (‘cotton’) each time you prepare drugs

• before you inject, clean the area of your body you’re going to inject into with a new alcohol swab

• safely dispose of needles and syringes after one use so you don’t use them again, and other people aren’t at risk of accidental exposure.

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Chemsex

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Chemsex (also known as chemfun, party and play or PNP) involves using one or more drugs to enhance sex; it can last for many hours at a time, and often with multiple sexual partners.

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• Chemsex involves using one or more (specific) drugs to enhance sex.

• Taking drugs to deliberately enhance sex is a different kind of recreational drug use, and has specific sexual health risks.

• The three main drugs used for chemsex are GHB, mephedrone and crystal meth. Each one has very different mental and physical effects. 

• Participating in chemsex is never 100% safe, but there are precautions you can take to stay safe and protect yourself from HIV. 

• If you’ve had chemsex and are worried you’ve put yourself at risk of HIV, get advice from a sexual health professional or visit an accident & emergency department as soon as you can. 

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What is Chemsex? 

Chemsex is a term that describes the sex that gay men have when using certain drugs. It can involve groups (including larger party settings), couples or lone masturbation. It’s important to remember that straight people often use drugs and alcohol for sex too, and though it may not come under the chemsex definition, there can be sexual health (and other) risks for them too. 

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Taking drugs for chemsex is different to drinking alcohol or taking drugs recreationally. This is because the associated drugs, or “chems”, which are used to deliberately enhance sexual experiences also induce a different kind of sexual disinhibition among users.

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Usually people do it to alter the physical sensations they have during sex (increased pleasure and ability to have sex for longer), or to change their psychological experiences (increasing their confidence or removing inhibitions).

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Which drugs are used for Chemsex?

There are three popular drugs used during chemsex: 

• gammahydroxybutyrate/gammabutyrolactone (also known as GHB/GBL, G or Gina) 

• mephedrone (meph or meow)

• crystal methamphetamine (crystal meth)

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They are sometimes taken on their own or together with alcohol or other drugs (such as cocaine or ecstasy).

 

The risks of Chemsex?

Chemsex drugs are mind-altering substances, so if you mix them with sex you’re increasing your risk of HIV and sexually transmitted infections (STIs) in a number of different ways:

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• with less physical inhibitions you’re less likely to use condoms, even if you intend to beforehand

• you may not remember what activities you’ve taken part in and whether you used condoms

• if you’re involved in a long session, you might forget to take your pre-exposure prophylaxis (PrEP) medication, increasing your vulnerability to HIV if you’re not using condoms

• if you’re living with HIV, you might forget to take your HIV medication, which helps to keep you undetectable and uninfectious to your partners

• you may have sex with a number of people, who may or may not be HIV positive, increasing your chances of exposure to HIV

• you may have more forceful sex than you’re used to, because of the anaesthetic effects of drugs like GHB. The thin lining of the anus can be easily damaged or torn through forceful, unlubricated anal sex, increasing the risk of HIV infection and other STIs, including hepatitis C

• you can 'lose time' as a result of long lasting sex sessions – this may affect your chances of preventing HIV transmission with emergency post-exposure prophylaxis treatment (PEP), which needs to be taken within 72 hours of infection to be effective

• if you inject mephedrone or crystal meth with shared needles (otherwise known as slamming), you’re increasing your risk of both HIV and hepatitis C infection

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The potency of drugs like GHB also affects your wider health and safety. GHB increases your chances of ‘passing out’, leaving you more vulnerable to sexual assault. Whatever the circumstances, and whatever drugs you may have taken prior to sexual activity, remember that sexual assault is never acceptable and is never your fault. 

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The combination of chems and lack of sleep can also create a short-lived psychosis, during which people can feel paranoid, frightened, or believe they are being persecuted by others. These episodes can sometimes involve very convincing beliefs or hallucinations.

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Lethargy or crashing is also common after a drug session (also known as a comedown), as well as psychological dependence or, with the overconsumption of substances, an overdose which can be fatal.