Résumés
Résumé
Problématique et objectif : La consommation des substances en contexte sexuel – aussi connu sous le nom de chemsex – a surtout été documentée chez les hommes gais, bisexuels ou ayant des relations sexuelles avec d’autres hommes (gbHARSAH), avec de rares études incluant des hommes hétérosexuels. Par ailleurs, les motivations associées au chemsex demeurent sous-documentées, nonobstant l’orientation sexuelle primaire rapportée. Cette étude qualitative exploratoire visait à décrire les motivations associées à la pratique du chemsex chez les hommes et à explorer les possibles différences selon leur orientation sexuelle primaire.
Méthodologie : Onze hommes cisgenre (>18ans) rapportant avoir consommé en contexte sexuel au moins une des substances associées au chemsex (méthamphétamine, cocaïne, kétamine, MDMA ou GHB) dans la dernière année ont participé à un entretien semi-directif. Une analyse thématique a été réalisée en utilisant la théorie de l’autodétermination (Ryan et Deci, 2000) pour organiser et conceptualiser les thèmes émergents relatifs aux motivations intrinsèques et extrinsèques associées à la pratique du chemsex.
Résultats : Les motivations extrinsèques rapportées faisaient référence à (1) l’influence de normes sociosexuelles intériorisées ou (2) des partenaires sexuels dans l’initiation ou le maintien de la pratique du chemsex. Les motivations intrinsèques incluaient le désir (1) d’améliorer la performance sexuelle et des sensations physiques ; (2) de réduire les inhibitions lors d’interactions sexo-relationnelles ; (3) de favoriser la connexion émotionnelle au.x partenaire.s ; (4) d’atténuer l’impact d’émotions ou d’événement douloureux ou alors (5) de combler un besoin lié à une dépendance aux substances.
Discussion : Nos résultats relèvent les facettes multiples du chemsex en matière de facteurs individuels, relationnels ou culturels influençant sa pratique, de même que le caractère heuristique du modèle de l’autodétermination pour distinguer les profils d’utilisateurs relativement à leurs motivations et leur orientation sexuelle primaire.
Mots-clés :
- chemsex,
- motivations,
- hommes,
- orientation sexuelle,
- méthodologie qualitative
Abstract
Background and objective: Sexualized drug use, also known as chemsex, has been documented mostly among gay, bisexual, or men who have sex with men (gbMSM), with rare studies including heterosexual men. Furthermore, motivations associated with chemsex are under-documented, regardless of reported primary sexual orientation. The aims of this study were to describe the motivations associated with chemsex among men and explore possible differences by primary sexual orientation.
Methods: Semi-structured interviews were conducted with 11 cis men ( 18years) reporting sexual drug used of at least one substance related to chemsex (methamphetamine, cocaine, ketamine, MDMA, or GHB). A thematic analysis was conducted using self-determination theory (Ryan et Deci, 2000) to conceptualize emerging themes related to intrinsic and extrinsic motivations associated with chemsex practice.
Results: Extrinsic motivations reported referred to (1) the influence of internalized socio-sexual norms or (2) sexual partners in initiating or maintaining chemsex practice. Intrinsic motivations included the desire to (1) enhance sexual performance and physical sensations, (2) reduce inhibitions during sex-related interactions, (3) foster emotional connection to partners, (4) cope with painful emotions or events, or (5) fulfill a need related to substance dependence.
Discussion: Our results highlight the multiple facets of chemsex in terms of individual, relational or cultural factors influencing its practice, as well as the relevance of the self-determination model to distinguish user profiles with respect to their motivations and primary sexual orientation.
Keywords:
- Chemsex,
- motivations,
- men,
- sexual orientation,
- qualitative methods
Resumen
Problemática y objetivo: El consumo de sustancias en el contexto sexual, también conocido como sexdopaje o chemsex, se ha documentado principalmente en hombres gais, bisexuales o que tienen relaciones sexuales con otros hombres (gbHARSAH), con raros estudios que incluyen hombres heterosexuales. Por otra parte, las motivaciones asociadas al sexdopaje siguen estando muy poco documentadas, a pesar de la orientación sexual primaria documentada. Este estudio cualitativo exploratorio tuvo como objetivo describir las motivaciones asociadas a la práctica del sexdopaje en los hombres y explorar las posibles diferencias según su orientación social primaria.
Metodología: Once hombres cisgénero (mayores de 18 años) que habían consumido durante el último año por lo menos una de las sustancias relacionadas con el sexdopaje (metanfetamina, cocaína, ketamina, MDMA o GHB) participaron en una entrevista semidirigida. Se realizó un análisis temático utilizando la teoría de la autodeterminación (Ryan y Deci, 2000) para organizar y conceptualizar los temas emergentes relativos a las motivaciones intrínsecas y extrínsecas asociadas con la práctica del sexdopaje.
Resultados: Las motivaciones extrínsecas comunicadas se referían a lo siguiente: 1) la influencia de las normas socio-sexuales interiorizadas o 2) parejas sexuales en la iniciación o el mantenimiento de la práctica del sexdopaje. Las motivaciones intrínsecas incluían el deseo de: 1) mejorar el rendimiento sexual y las sensaciones físicas; 2) reducir las inhibiciones durante las interacciones sexo-relacionales; 3) favorecer la conexión emocional de las parejas; 4) atenuar el impacto de emociones o acontecimientos dolorosos o 5) satisfacer una necesidad relacionada con la dependencia de sustancias.
Discusión: Nuestros resultados señalan las múltiples facetas del sexdopaje con respecto a factores individuales, relacionales o culturales que influyen en su práctica, así como el carácter heurístico del modelo de autodeterminación para distinguir los perfiles de los usuarios en relación con sus motivaciones y su orientación sexual primaria.
Palabras clave:
- sexdopaje (chemsex),
- motivaciones,
- hombres,
- orientación sexual,
- metodología cualitativa
Parties annexes
Bibliographie
- Ahmed, A. K., Weatherburn, P., Reid, D., Hickson, F., Torres-Rueda, S., Steinberg, P. et Bourne, A. (2016). Social norms related to combining drugs and sex («chemsex») among gay men in South London. International Journal of Drug Policy, 38, 29-35. https://doi.org/10.1016/j.drugpo.2016.10.007
- Amaro, R. (2016). Taking Chances for Love? Reflections on Love, Risk, and Harm Reduction in a Gay Slamming Subculture. Contemporary Drug Problems, 43(3), 216-227. https://doi.org/10.1177/0091450916658295
- Bachelor, A., et Joshi, P. (1986). La méthode phénoménologique de recherche en psychologie : guide pratique : Presses Université Laval.
- Blais, M., Otis, J., Lambert, G., Cox, J., Haig, T. et Groupe de recherche Spot (2018). Consommation de substances en contexte sexuel chez des hommes gbHSH de Montréal : 2009-2016. Drogues, santé et société, 17(2), 76–94. https://doi.org/10.7202/1062117ar
- Bourne, A., Reid, D., Hickson, F., Torres-Rueda, S., Steinberg, P. et Weatherburn, P. (2015). «Chemsex» and harm reduction need among gay men in South London. International Journal Drug Policy, 26(12), 1171-1176. https://doi.org/10.1016/j.drugpo.2015.07.013
- Braun, V. et Clarke, V. (2012). Thematic analysis. In APA handbook of research methods in psychology, Vol 2: Research designs: Quantitative, qualitative, neuropsychological, and biological. (p. 57-71).
- Chartier, M., Araneta, A., Duca, L., McGlynn, LM., Gore-Felton, C., Goldblum, P., Koopman, C.(2009). Personal values and meaning in the use of methamphetamine among HIV-positive men who have sex with men. Qualitative Health Research 19(4):504-18. https://doi.org/10.1177/1049732309333018
- Cheng, W. S., Garfein, R. S., Semple, S. J., Strathdee, S. A., Zians, J. K. et Patterson, T. L. (2009). Differences in sexual risk behaviors among male and female HIV-seronegative heterosexual methamphetamine users. The American Journal of Drug Alcohol Abuse, 35(5), 295-300. https://doi.org/10.1080/00952990902968585
- Cheng, W. S., Garfein, R. S., Semple, S. J., Strathdee, S. A., Zians, J. K. et Patterson, T. L. (2010). Binge use and sex and drug use behaviors among HIV(-), heterosexual methamphetamine users in San Diego. Substance Use & Misuse, 45(1-2), 116-133. https://doi.org/10.3109/10826080902869620
- Deimel, D., Stover, H., Hosselbarth, S., Dichtl, A., Graf, N. et Gebhardt, V. (2016). Drug use and health behaviour among German men who have sex with men: Results of a qualitative, multi-centre study. Harm Reduction Journal, 13(1), 36. https://doi.org/10.1186/s12954-016-0125-y
- Drysdale, K. (2021). ‘Scene’ as a critical framing device: Extending analysis of chemsex cultures. Sexualities. https://doi.org/10.1177/1363460721995467
- Edmundson, C., Heinsbroek, E., Glass, R., Hope, V., Mohammed, H., White, M. et Desai, M. (2018). Sexualised drug use in the United Kingdom (UK): A review of the literature. International Journal of Drug Policy, 55, 131-148. https://doi.org/10.1016/j.drugpo.2018.02.002
- Florêncio, J. (2021). Chemsex cultures : Subcultural reproduction and queer survival. Sexualities. https://doi.org/10.1177/1363460720986922
- Flores-Aranda, J., Bertrand, K. et Roy, É. (2018). Trajectoires addictives et vécu homosexuel. Drogues, santé et société, 17(2), 28–52. https://doi.org/10.7202/1062115ar
- Goyette, M., Flores-Aranda, J., Bertrand, K., Pronovost, F., Aubut, V., Ortiz, R. et Saint-Jacques, M. (2018). Links SU-Sex: development of a screening tool for health-risk sexual behaviours related to substance use among men who have sex with men. Sexual health, 15(2), 160-166. https://doi.org/10.1071/SH17134
- Javaid, A. (2018). The interconnectedness of chemsex, drugs, sexual promiscuity and sexual violence. Irish Journal of Sociology, 26(2), 183–207. https://doi.org/10.1177/0791603518773703
- Khaw, C., Zablotska-Manos, I. et Boyd, M. A. (2020). Men who have sex with men and chemsex: a clinic-based cross-sectional study in South Australia. Sexuality research and social policy, 1-9. https://doi.org/10.1007/s13178-020-00505-2
- Knight, R., Karamouzian, M., Carson, A., Edward, J., Carrieri, P., Shoveller, J., Fairbairn, N., Wood, E. et Fast, D. (2019). Interventions to address substance use and sexual risk among gay, bisexual and other men who have sex with men who use methamphetamine: A systematic review. Drug Alcohol Depend, 194, 410-429. https://doi.org/10.1016/j.drugalcdep.2018.09.023
- Lafortune, D., Blais, M., Miller, G., Dion, L., Lalonde, F. et Dargis, L. (2021). Psychological and Interpersonal Factors Associated with Sexualized Drug Use Among Men Who Have Sex with Men: A Mixed-Methods Systematic Review. Archives of Sexual Behaviors, 50(2), 427-460. https://doi.org/10.1007/s10508-020-01741-8
- Lawn, W., Aldridge, A., Xia, R. et Winstock, A. R. (2019). Substance-Linked Sex in Heterosexual, Homosexual, and Bisexual Men and Women: An Online, Cross-Sectional «Global Drug Survey» Report. Journal of Sexual Medicine, 16(5), 721-732. https://doi.org/10.1016/j.jsxm.2019.02.018
- Lea, T., Hammoud, M., Bourne, A., Maher, L., Jin, F., Haire, B., Bath, N., Grierson, J., et Prestage, G. (2019). Attitudes and Perceived Social Norms toward Drug Use among Gay and Bisexual Men in Australia. Substance Use & Misuse, 54(6), 944-954. https://doi.org/10.1080/10826084.2018.1552302
- Ma, R. et Perera, S. (2016). Safer ‘chemsex’: GPs’ role in harm reduction for emerging forms of recreational drug use. British Journal of General Practice, 66(642), 4-5. https://doi.org/10.3399/bjgp16X683029
- Maxwell, S., Shahmanesh, M. et Gafos, M. (2019). Chemsex behaviours among men who have sex with men: a systematic review of the literature. International Journal of Drug Policy, 63, 74-89. https://doi.org/10.1016/j.drugpo.2018.11.014
- McCready, K. C. et Halkitis, P. N. (2008). HIV serostatus disclosure to sexual partners among HIV-positive methamphetamine-using gay, bisexual, and other men who have sex with men. AIDS education and prevention : official publication of the International Society for AIDS Education, 20(1), 15–29. https://doi.org/10.1521/aeap.2008.20.1.15
- McKetin, R., Lubman, D. I., Baker, A., Dawe, S., Ross, J., Mattick, R. P. et Degenhardt, L. (2018). The relationship between methamphetamine use and heterosexual behaviour: evidence from a prospective longitudinal study. Addiction, 113(7), 1276-1285. https://doi.org/10.1111/add.14181
- Melendez-Torres, G. J., Bonell, C., Hickson, F., Bourne, A., Reid, D. et Weatherburn, P. (2016). Predictors of crystal methamphetamine use in a community-based sample of UK men who have sex with men. International Journal of Drug Policy, 36, 43-46. https://doi.org/10.1016/j.drugpo.2016.06.010
- Meyer, I. H. (1995). Minority Stress and Mental Health in Gay Men. Journal of Health and Social Behavior, 36(1), 38–56. https://doi.org/10.2307/2137286
- Milhet, M., Shah, J., Madesclaire, T. et Gaissad, L. (2019). Chemsex experiences: narratives of pleasure. Drugs and Alcohol Today, 19(1), 11-22. https://doi.org/10.1108/DAT-09-2018-0043
- Miltz, A. R., Rodger, A. J., Sewell, J., Gilson, R., Allan, S., Scott, C., Sadiq, T., Farazmand, P., McDonnell, J., Speakman, A., Sherr, L., Phillips, A. N., Johnson, A. M., Collins, S., Lampe, F. C., Aurah, et Groups, A. S. (2021). Recreational drug use and use of drugs associated with chemsex among HIV-negative and HIV-positive heterosexual men and women attending sexual health and HIV clinics in England. Int J Drug Policy, 91, 103101. https://doi.org/10.1016/j.drugpo.2020.103101
- Møller, K., et Hakim, J. (2021). Critical chemsex studies: Interrogating cultures of sexualized drug use beyond the risk paradigm. Sexualities, 0(0). https://doi.org/10.1177/13634607211026223
- Pollard, A., Nadarzynski, T. et Llewellyn, C. (2018). Syndemics of stigma, minority-stress, maladaptive coping, risk environments and littoral spaces among men who have sex with men using chemsex. Culture, Health & Sexuality, 20(4), 411-427. https://doi.org/10.1080/13691058.2017.1350751
- Pufall, E. L., Kall, M., Shahmanesh, M., Nardone, A., Gilson, R., Delpech, V., Ward,H. (2018). Sexualized drug use (‘chemsex’) and high-risk sexual behaviours in HIV-positive men who have sex with men. HIV Medicine, 19(4), 261-270. https://doi.org/10.1111/hiv.12574
- Race, K., Murphy, D., Pienaar, K., et Lea, T. (2021). Injecting as a sexual practice: Cultural formations of ‘slamsex’. Sexualities.https://doi.org/10.1177/1363460720986924
- Ryan, R. M. et Deci, E. L. (2000). Intrinsic and extrinsic motivations: classic definitions and new directions. Contemporary Educational Psychology, 25(1), 54-67. https://doi.org/10.1006/ceps.1999.1020
- Savoie-Zajc, L. (2006). Comment peut-on construire un échantillonnage scientifiquement valide. Recherches qualitatives, 5, 99-111.
- Savoie-Zajc, L. (2016). L’entrevue semi-dirigée. Dans B. Gauthier et I. Bourgeois (dir.) Recherche sociale de la problématique à la collecte des données (6e édition, p. 337-360). Presses du l’Université du Québec.
- Sewell, J., Cambiano, V., Speakman, A., Lampe, F. C., Phillips, A., Stuart, D.,Gilson,R., Asboe, D., Nwokolo, N., Clarke,A., Rodger, A. J. (2019). Changes in chemsex and sexual behaviour over time, among a cohort of MSM in London and Brighton: Findings from the AURAH2 study. International Journal of Drug Policy, 68, 54-61. https://doi.org/10.1016/j.drugpo.2019.03.021
- Stuart, D. (2019). Chemsex: origins of the word, a history of the phenomenon and a respect to the culture. Drugs and Alcohol Today. https://doi.org/10.1108/DAT-10-2018-0058
- Tracy, S. J. (2010). Qualitative Quality: Eight “Big-Tent” Criteria for Excellent Qualitative Research. Qualitative Inquiry, 16(10), 837-851. https://doi.org/10.1177/1077800410383121
- Voisin, D. R., Hotton, A. L. et Schneider, J. A. (2017). The relationship between life stressors and drug and sexual behaviors among a population-based sample of young Black men who have sex with men in Chicago. AIDS Care, 29(5), 545–551. https://doi.org/10.1080/09540121.2016.1224303.
- Weatherburn, P., Hickson, F., Reid, D., Torres-Rueda, S. et Bourne, A. (2017). Motivations and values associated with combining sex and illicit drugs (‘chemsex’) among gay men in South London: findings from a qualitative study. Sexually Transmittes Infections, 93(3), 203-206. http://dx.doi.org/10.1136/sextrans-2016-0526951136/sextrans-2016-052695
10.7202/1062117ar