New Project Tackles Health Needs of Soweto MSM Engaged in Chemsex


A new project has been launched to improve the well-being of men who have sex with men (MSM) that engage in chemsex, a group that’s typically marginalised and stigmatised.

The initiative is a partnership between South Africa’s OUT LGBT Well-being (OUT) and the Elton John AIDS Foundation (EJAF).

Chemsex, the practice of using drugs to enhance sexual experiences, poses a considerable health risk among MSM, who are already at an elevated risk of HIV. OUT, which offers sexual health services to gay, bisexual and other MSM, found an HIV prevalence of 20% among 1,662 Johannesburg MSM who engage in chemsex tested over a 12-month period.

In addition to an increased risk of HIV infection, OUT also found that MSM who engage in chemsex are more difficult to retain in HIV treatment programmes.

The 16-month pilot project will focus on MSM who engage in chemsex in Soweto and will provide a comprehensive package of care tailored to their needs. This programme is groundbreaking in its approach within South Africa, aiming to deliver a holistic model of care that integrates biomedical, behavioural, and structural interventions.

Promoting Health and Reducing Stigma

The initiative will enhance the detection of HIV, improve retention of those diagnosed with HIV on antiretroviral therapy (ART), and support their overall health and social outcomes with medical, social and mental health services.

OUT will also promote harm reduction practices in the context of chemsex and foster social cohesion within this community. Additionally, the organisation will work to reduce stigma around MSM who engage in chemsex, provide sensitisation training to service providers and influence policy to recognise and support the needs of this group.

By adopting a non-judgmental, person-centred model, the initiative seeks to address the complex interplay of factors affecting this community, including mental health issues, stigma, and access to health services.

“MSM who engage in chemsex are marginalised by moralistic and judgmental attitudes, criminalisation, and a general lack of awareness about their needs,” said Dawie Nel, the Executive Director of OUT in a statement.

“They may also struggle with internalised stigma, making it difficult for them to be open about their substance use with health care providers. Our focus is not to judge but to reduce harm, uphold human rights, and ensure that MSM who engage in chemsex have access to compassionate, stigma-free and effective health services.”

A Long-Term Vision For a Sustainable Model

The programme’s approach is grounded in evidence-based practices and informed by an understanding of the needs and challenges of MSM who engage in chemsex. The initiative is designed with a long-term vision to create a sustainable model that can be adapted and scaled to other settings.

“By taking a comprehensive and integrated approach to address the multifaceted needs of MSM who engage in chemsex, OUT LGBT Well-being is dedicated to improving health, reducing stigma, and fostering a fairer and more equitable society in South Africa,” added Nel.

“We are proud to partner with OUT to support their invaluable efforts to challenge stigma and blame for a very vulnerable community,” commented Anne Aslett, EJAF CEO.

“The Foundation has supported life-saving work for men, women and children in South Africa and is deeply committed to ensuring no one gets left behind in the national HIV response. We firmly believe that this latest investment, to delivering tailored, non-judgemental, life-saving services where they are needed will make significant strides towards fostering optimal health and wellbeing for all in the country.”

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