The Chemsex ‘Consent Ladder’ in Male Sex Work: Perspectives of Health Providers on Derailment and Empowerment
Sexualized substance use or ‘chemsex’ is a key element in the syndemic of violence and infection in gay, bisexual, and other men who have sex with men. Chemsex is more prolific amongst men who have sex with men but is also associated with high risk behaviours that can negatively impact on health and...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-02-01
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| Series: | Social Sciences |
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| Online Access: | https://www.mdpi.com/2076-0760/10/2/69 |
| _version_ | 1797411495649214464 |
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| author | Belinda Brooks-Gordon Euan Ebbitt |
| author_facet | Belinda Brooks-Gordon Euan Ebbitt |
| author_sort | Belinda Brooks-Gordon |
| collection | DOAJ |
| description | Sexualized substance use or ‘chemsex’ is a key element in the syndemic of violence and infection in gay, bisexual, and other men who have sex with men. Chemsex is more prolific amongst men who have sex with men but is also associated with high risk behaviours that can negatively impact on health and wellbeing in heterosexual, bisexual men and women, and in homosexual women too. This qualitative study investigated perceptions and experiences of chemsex, motivations, cisgender male sex work, consent, economic exploitation, and ways to address and reduce harms. We conducted semi-structured interviews with health care providers and their clients—including sex workers and their customers (<i>n</i> = 14) between the ages of 28 and 46 years following a purposive sampling strategy. Interview topics included perceptions and experiences of chemsex use, reasons for drug use and chemsex, and proposals to address harms associated with chemsex in the UK. Interviews were audio-recorded, transcribed, coded, and analysed using Grounded Theory. The findings revealed a stepwise process of chemsex use in a ‘ladder of consent’, whereby the process starts with willing participation that is both highly pleasurable and controllable. Sexual polydrug activity often descended in rungs so that lines of consent became blurred, and even broken, resulting in physical detriment and financial exploitation. Strategies for elevation back up the consent ladder also emerged. The findings clarify the conditions of willing participation, the stepwise relationship to exploitation, and the support strategies that help re-empower individuals whose lives get taken over by chemsex, including peer-to-peer support, poly-centres, and smartphone apps to climb back up the consent ladder to improve the health, safety, and social rights of sex workers. |
| first_indexed | 2024-03-09T04:46:53Z |
| format | Article |
| id | doaj.art-67745d81c55a42bf9ed2b7fd7cf1b159 |
| institution | Directory Open Access Journal |
| issn | 2076-0760 |
| language | English |
| last_indexed | 2024-03-09T04:46:53Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Social Sciences |
| spelling | doaj.art-67745d81c55a42bf9ed2b7fd7cf1b1592023-12-03T13:15:05ZengMDPI AGSocial Sciences2076-07602021-02-011026910.3390/socsci10020069The Chemsex ‘Consent Ladder’ in Male Sex Work: Perspectives of Health Providers on Derailment and EmpowermentBelinda Brooks-Gordon0Euan Ebbitt1Department of Psychological Sciences, Birkbeck University of London, Malet Street, Bloomsbury, London WC1E 7HX, UKDepartment of Psychological Sciences, Birkbeck University of London, Malet Street, Bloomsbury, London WC1E 7HX, UKSexualized substance use or ‘chemsex’ is a key element in the syndemic of violence and infection in gay, bisexual, and other men who have sex with men. Chemsex is more prolific amongst men who have sex with men but is also associated with high risk behaviours that can negatively impact on health and wellbeing in heterosexual, bisexual men and women, and in homosexual women too. This qualitative study investigated perceptions and experiences of chemsex, motivations, cisgender male sex work, consent, economic exploitation, and ways to address and reduce harms. We conducted semi-structured interviews with health care providers and their clients—including sex workers and their customers (<i>n</i> = 14) between the ages of 28 and 46 years following a purposive sampling strategy. Interview topics included perceptions and experiences of chemsex use, reasons for drug use and chemsex, and proposals to address harms associated with chemsex in the UK. Interviews were audio-recorded, transcribed, coded, and analysed using Grounded Theory. The findings revealed a stepwise process of chemsex use in a ‘ladder of consent’, whereby the process starts with willing participation that is both highly pleasurable and controllable. Sexual polydrug activity often descended in rungs so that lines of consent became blurred, and even broken, resulting in physical detriment and financial exploitation. Strategies for elevation back up the consent ladder also emerged. The findings clarify the conditions of willing participation, the stepwise relationship to exploitation, and the support strategies that help re-empower individuals whose lives get taken over by chemsex, including peer-to-peer support, poly-centres, and smartphone apps to climb back up the consent ladder to improve the health, safety, and social rights of sex workers.https://www.mdpi.com/2076-0760/10/2/69consentchemsexsex workMSWmen who have sex with menMSM |
| spellingShingle | Belinda Brooks-Gordon Euan Ebbitt The Chemsex ‘Consent Ladder’ in Male Sex Work: Perspectives of Health Providers on Derailment and Empowerment Social Sciences consent chemsex sex work MSW men who have sex with men MSM |
| title | The Chemsex ‘Consent Ladder’ in Male Sex Work: Perspectives of Health Providers on Derailment and Empowerment |
| title_full | The Chemsex ‘Consent Ladder’ in Male Sex Work: Perspectives of Health Providers on Derailment and Empowerment |
| title_fullStr | The Chemsex ‘Consent Ladder’ in Male Sex Work: Perspectives of Health Providers on Derailment and Empowerment |
| title_full_unstemmed | The Chemsex ‘Consent Ladder’ in Male Sex Work: Perspectives of Health Providers on Derailment and Empowerment |
| title_short | The Chemsex ‘Consent Ladder’ in Male Sex Work: Perspectives of Health Providers on Derailment and Empowerment |
| title_sort | chemsex consent ladder in male sex work perspectives of health providers on derailment and empowerment |
| topic | consent chemsex sex work MSW men who have sex with men MSM |
| url | https://www.mdpi.com/2076-0760/10/2/69 |
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