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Ex-minister Imran Ahmed arrested. RU student secures GPA 3. Lost chance for a fitting farewell. The Department of Narcotics Control claimed to have busted a narcotics manufacturing laboratory and seized a consignment of two types of new drugs, including crystal methamphetamine, from the capital's Jhigatola area yesterday. The DNC team arrested Rakib Uddin, 45, in Mohammadpur area and two of his associates -- Md Jakaria, 30, and Helal Hossain alias Saddam, 32, -- in Eskaton area on Tuesday evening with pieces of yaba tablets and five grams of crystal meth. Squeezing information from the arrestees, the DNC team conducted a drive in Jhigatola and discovered the laboratory. During the daylong drive, the DNC team recovered new drugs-making machinery, hard disks and chemicals from the factory, said Khorshid. During an investigation, the DNC team learned that the owner of the six-storey building, Hasib Moammar Rashid, 32, lives in Dhanmondi with his family and went into hiding soon after the drive. The AD further said they had seized eight foreign and local debit and credit cards and sent a notification to law enforcers so that he cannot leave the country. A case would be filed against Hasib and the caretaker and his other associates would be included after verifying their involvement, Khorshid said. He could not say the actual price of the crystal meth immediately since it is new in the country. Crystal meth looks like small crystal cubes and MDMA is a tablet. Skip to main content. Back Page. Staff Correspondent. Most Viewed. Photo: Collected. Related topic:. DNC drug peddlers drugs Crystal Meth. Click to comment. Comments Comments Policy. Related News. DNC starts anti-drug campaign today 6y ago.

'Crystal meth' lab busted for 1st time

Dhaka buying MDMA pills

Global and local literature depicted the pervasiveness of chemsex among men who have sex with men MSM , yet there is limited evidence on adolescents and youth. Though literature showed their engagement in chemsex, further exploration is warranted about their socio-sexual contexts and implications. Therefore, this article explored the contexts and implications of chemsex on young and adolescent MSM. This article is extracted from qualitative research evidence, and research data are triangulated by programmatic evidence on adolescent and young MSM from two ongoing pilot interventions. The key motivational factors for engaging in chemsex were primarily rooted in the dynamics of their peer networks. Specifically, the onset of drug use is predominantly attributed to curiosity toward experimentation with methamphetamine, peer influence, propensity to lose weight, and increasing courage to approach potential sexual partners. Moreover, they continued taking drugs as it enhanced their sexual performance, thus perpetuating chemsex. Additionally, the findings revealed several sexual implications of methamphetamine, e. In essence, chemsex is considerably driven by their socio-sexual contexts, thus perpetuating sexual risk behaviors and compromising sexual health outcomes. Therefore, harm reduction interventions targeted need to be designed keeping in mind their socio-sexual dynamics and age. Sexualized drug use popularly known as chemsex has become an increasingly pervasive drug-taking practice. However, chemsex is a dynamic phenomenon which could vary geographically, culturally, and temporally Maxwell et al. Although harm reduction and other reports have revealed that chemsex has increased over the last decade Harm Reduction International, and has become the most widely used drug in Asia and the Pacific APCOM, , it remained a lingering phenomenon that has even dated back to the s, when gamma hydroxybutyrate GHB became popular in gay clubs in Western settings because of their ability to bolster sexual pleasure. Throughout the 21st century, the prominence of methamphetamine increased among the gay community, particularly MSM. Although this term was never used, it was a phenomenon that was eventually coined as chemsex for the first time since Stuart, After the first chemsex parties occurred in in London, United Kingdom, the term gradually gained widespread popularity Hakim, The prevalence of chemsex differs depending on the subgroup and also varies based on the heterogeneity in definitions assigned by different scholars Tomkins et al. However, in the context of Asia and Pacific, some additional drugs have been classified under the chemsex umbrella because of their potential to initiate and enhance sexual encounters. For example, the Asia Chemsex Platform, a regional coalition that was established in , has classified alkyl nitrates i. These drugs originate from various groups which produce a different set of physiological effects. For example, methamphetamines, ecstasy, and mephredone produce belong to the group of amphetamine-type stimulants which typically activate the sympathetic nervous system, thus inflicting sleeplessness, loss of appetite and increased sexual performance APCOM, The duration of effect can be influenced by simultaneous use of other drugs Giorgetti et al. However, the co-ingestion of ethanol and GHB may causes an adverse interaction between these two sedative drugs Busardo and Jones, The literature has also reflected that behavioral patterns and practices of chemsex are divergent based on varying cultural contexts and socio-demographic characteristics of the users, which include sexual orientation and age. In particular, the existing evidence base indicates that males having sex with males MSM are more likely to engage in chemsex compared to their heterosexual counterparts Maxwell et al. Particularly in Asia, the prevalence of these practices among MSM ranges from 3. However, there are globally acknowledged concerns about the interconnectedness between chemsex and high-risk sexual behaviors which could exacerbate the HIV and STI transmission potential of these populations by perpetuating unprotected anal intercourse, increasing the length and frequency of sexual intercourse and increasing the number of sexual partners Kenyon et al. Likewise, Tomkins et al. A systematic review reported that chemsex is associated with anxiety, depression and psychosomatic symptoms Tomkins et al. All of these complexities are tied to the broader umbrella of sexual and reproductive health and rights SRHR , therefore from the SRHR perspective, it is important to ensure that MSM-focused interventions account for issues related to chemsex. There is a growing body of literature exploring the chemsex situation among young and adolescent MSM, albeit to a limited extent compared to their adult counterparts. Similarly, latent class analysis has revealed that adolescents were more vulnerable to sexualized drug use as they are more likely to be exposed to chemsex at a young age Tan et al. In Bangladesh, there is limited research about the chemsex situation among MSM and other gender and sexually diverse populations. A recent qualitative study conducted in Dhaka, Bangladesh among MSM and transgender women locally known as hijra revealed that the participants would often engage in chemsex for various reasons, primarily enhancing their sexual performance, intensifying their sexual pleasure, augmenting their capacity to uptake more clients to generate more income, and increasing their sexual pride Khan et al. However, the same study also revealed that chemsex could perpetuate behaviors that could be detrimental to their SRHR-related outcomes, such as increasing coercive sex, enhancing group and serial sex, engaging in transactional sex with unknown clients, multiple sex partners, and condomless anal intercourse which increased their vulnerability to sexually transmitted infections STIs; Khan et al. However, further research about the risky sexual behaviors of MSM is warranted in a setting which criminalizes male-to-male sex and any other sex acts besides heteronormative sex, as per the legal framework of Bangladesh GOB, Because of the criminalization of male-to-male sex, MSM often remain hidden and hard-to-reach out of the fear of identity disclosure and potential legal repercussions. These barriers could contribute to their ability to access and utilize safer sex practices, yet there is scant knowledge about this phenomenon among this group. Therefore, the sexual risk behaviors of MSM need to be further explored within their criminalized context. Another layer of vulnerability has been added in the context of the criminalization of drug use. There is currently a paucity of global and regional evidence that explores the underlying contexts and implications of sexualized drug use among young and adolescent MSM including self-identified gay, particularly in an emerging generation that presents new sets of SRHR vulnerabilities and healthcare access challenges Halkitis and Singer, Similarly, the only available evidence in Bangladesh explores the reasons and effects of methamphetamine among older MSM, thus the terrain of youth and adolescent MSM including gay men remained unexplored. There is a current paucity of evidence about the contexts and implications of chemsex among this group in Bangladesh and many regional countries around the globe. However, as indicated by the existing global evidence, these populations may present their own set of complexities, unmet needs, and risky sexual behaviors Tan et al. Additionally, the literature has highlighted the importance of collecting in-depth empirical evidence for obtaining a nuanced and authentic understanding of the co-occurrence of drug use and sexual activity Weinhardt and Carey, ; Vosburgh et al. This will guide researchers in identifying priority areas which need to be intervened in existing and future SRHR interventions. Therefore, this article aims to explore the contexts and implications of sexualized drug use i. The findings of this article are extracted from a qualitative study that was conducted in urban Dhaka, Bangladesh to explore the patterns and key driving factors for chemsex, particularly methamphetamine use, as well as the implications of chemsex on the sexual lives of MSM and hijra Khan et al. That qualitative study consisted of 30 in-depth interviews IDIs and six focus group discussions FGDs with the target population described below , and 15 key-informant interviews KIIs with HIV intervention service providers, harm reduction specialists, and academicians. The evidence presented in the previous two articles Khan et al. Thus, there remains a paucity of information from adolescents and young adults i. Moreover, we did not have data on the self-identified gay men who belong to the urban socioeconomic background, are relatively educated, hard to reach, and generally do not seek services from the DICs due to the contexts described in the background section of this article. To foster a deeper understanding of the complexities of chemsex among the young and adolescent MSM, we revisited the data from the IDIs and FGDs of the qualitative study. While analyzing the data generated from the qualitative research study described above , some additional information was perceived necessary for encapsulating a comprehensive picture of the chemsex scenario among the young and adolescent group. To ensure this, we collated evidence from an ongoing pilot chemsex intervention that provided harm reduction services including counseling to MSM including self-identified gay men. This created opportunities for counselors and service providers to learn about their reported chemsex-related concerns which may have transcended the nature of our research data but elicited an authentic and enriched understanding of the complexities of chemsex. We had another intervention that was operated within the framework of a virtual outreach program for providing HIV prevention services to self-identified gay men. Thus, we also gathered information on chemsex from gay men who reported this while taking services through the virtual platform. In this context, we leveraged the opportunity to complement the qualitative research findings with program and service-related information through counselors and service providers from both interventions. This was done through triangulation, which is considered an integral tool for strengthening the scientific rigor of qualitative evidence Mertens and Hesse-Biber, ; Heale and Forbes, ; Patton, The triangulation approach used in this article includes data source, methodological, investigator and analytical triangulation Heale and Forbes, ; Patton, ; Noble and Heale, Specifically, the research data have been collected by sociologists, anthropologists, demographers, and public health specialists, whereas programmatic information from the participants has primarily been exchanged with counselors who are clinical psychologists , physicians, and service providers from the target group, all of who were adequately sensitized and attuned to the complexities and sensitivities of this community. This approach was posited to enhance the authenticity and trustworthiness of the data Mertens and Hesse-Biber, We attempted to reflect the diversity produced by this triangulation approach in the results section. Both the qualitative study and pilot programmatic interventions were conducted in urban Dhaka, Bangladesh among gender and sexually diverse people i. These young and adolescent MSM emerge from two main socio-demographic groups. One group emerges from lower socioeconomic groups and often partake in transactional sex in order to generate income. On the other hand, there is a group of young and adolescent men who self-identify as gay men. They typically emerge from higher socioeconomic backgrounds and reside in affluent neighborhood. Due to the fear of identity disclosure and their reluctance to associate with the former group, they do not visit the HIV prevention service centers. These DICs have also recently been providing two pilot interventions described above. These DICs are located in the north, south, west and eastern parts of urban Dhaka city. Although this paper has presented two different distinct groups of populations, there are no overlaps between these groups. The evidence presented in this paper is based on extensive literature review on chemsex-related issues, along with a variety of data collection techniques which are explained in the Table 1. From the qualitative study, data were extracted from two FGDs and seven IDIs from young and adolescent MSM aged between years old, including self-identified gay men. The depth generated from the IDIs and the overall societal insights elicited from the FGDs complemented each other to provide a comprehensive picture of the chemsex scenario. Qualitative information was derived similarly from ongoing monitoring and evaluation, service field diary notes, and day-to-day interactions between the clients and the counselor, from both of the pilot interventions. To assess their service needs and understand the overall social context, we collect information from the participants who belong to the adolescents and young groups through informal discussion. Through these discussions, we were able to understand their socio-cultural dynamics, sexual practices, drug use patterns, and other related issues experienced by these populations. We maintain a service register from which we collect quantitative information of the participants. Moreover, the service providers were expected to maintain service-related field notes which served as another valuable source of programmatic evidence in qualitative textual form. Additionally, during the ongoing monitoring and evaluation component of the intervention, we solicited their experiences and facilitate informal discussions with the participants. Firstly, the data from the qualitative study were analyzed using the conventions of thematic analysis stipulated by Braun and Clarke A small subset of transcripts was read, from which an initial set of themes were generated. Thereafter, we searched for relevant themes, reviewed and defined them and then presented these themes as findings Braun and Clarke, Decision-trails were documented accordingly and any disputes in the coding categorizations were decided by the senior author. Secondly, as triangulation entails the use of multiple data collection techniques and analytical approaches Golafshani, , we also convened the research evidence with the programmatic data and thematically categorized them based on the codes that were generated in the collaborative coding framework. Moreover, to reflect the degree of triangulation in our analysis, under several themes, we have included participant anecdotes from a diversity of sources. This approach is expected to encapsulate multiple perspectives about chemsex, regardless of the profession of the data collector, or the objective of that specific data collection technique. To ascertain scientific rigor, this triangulation initiative was also complemented by peer debriefing sessions where the service providers who collected the data and the authors exchanged their perspectives regarding the interpretation of the findings Connelly, The qualitative study already received ethical approval from the Ethical Review Committee of the Institutional Review Board of the International Centre for Diarrhoeal Diseases Research, Bangladesh before its inception. Moreover, in order to use the information extracted from the participants of these two interventions, we have attained ethical approval from the Ethical approving authority of icddr,b. Moreover, before conducting any counseling session or any informal discussions, we informed the participants that the information they reveal could be used for scientific reporting purposes, and their identities and all information would be kept fully confidential. With their verbal approval, we only collected information that is required for the interventions to be operated successfully. To ensure anonymity and confidentiality, their names were only available to the authorized counselors and physicians who work within the pilot intervention. Before presenting these data to the researchers who analyzed this data, their names were removed, thus adding another layer of informational confidentiality. Moreover, all of the interview and conversational data was de-identified and stored in a password-protected computer. The triangulation of the research and pilot programmatic evidence presented a variety of contexts of drug use, and, hence, chemsex among young and adolescent MSM, including self-identified gay men. Programmatic evidence collected from the quantitative information of the service register from the pilot interventions revealed that a total of 74 participants from both of the interventions combined fall within the age group between 18 and 24 years. In addition to the quantitative information, the participants have also been inquired about their drug use patterns during the counseling sessions. In addition, the IDIs and FGDs have revealed some insights about their drug onset and continuation behaviors and patterns. Table 3 represents the type of drugs used in a sexual context. Among the 42 participants who reported using any kind of drug, 28 responded that they used those drugs in a sexual context. Table 4 represents drug use characteristics among those who engaged in chemsex. Moreover, during the in-depth interviews and focus groups, the participants were asked about their preferred mode of administration of taking methamphetamine. All of the participants who took methamphetamine reported that they preferred inhaling. It has always been popular among our group so I do not know any other way. In addition, an informal discussion conducted with one of the participants, a university student, described how he took Yaba in the following way:. We usually inhale or snort the drug on a piece of paper or old money note. We put the Yaba tablet on the foil and then light it up until it burns. It brings out a flame and then we either inhale or puff it out snort. We consider it a complete process Participant M, 20—22 years old. Rather, their prime motivating factors for drug use were predominantly marked by the influence and dynamics of their peer networks. The programmatic and research findings, alike, depicted their social culture within their community. Many of the participants represented higher socioeconomic backgrounds i. They often congregated in exclusive, invite-only social gatherings where drugs were considered a social adhesive to an enjoyable experience with their peers. On the other hand, however, the MSM and transgender women in the lower socio-economic groups presented their own set of contextual circumstances. For example, their drug using and sexual behaviors were driven by their need to enhance their sexual behaviors either to survive in their transactional sex careers or improve their sexual performance within their intimate partnerships. Moreover, drug use was driven by their need to bolster their sexual pleasure. It is worth noting that neither of these groups used social media to initiate social contact, rather, they would meet through in-person social gatherings or, in the case of the lower socioeconomic MSM, through the service centers or cruising spots where they would commonly congregate. It is worth noting that many of the participants started experimenting with drugs out of curiosity, after witnessing the actions of their peers. While their peers did not directly pressure them on several occasions, the participants nevertheless felt the need to take these drugs after noticing that their socially prestigious peers were taking these drugs. This created a scenario where participants attached social connotations of drugs as a social symbol. After taking the drugs invoked pleasurable feelings associated with intoxication, they spiraled down a pathway of drug dependency. For example, during a counseling session with the clinical psychologist, Participant M relayed his onset of taking Yaba in the following way:. During my rag day at university, I noticed that some of my new friends and seniors were taking Yaba. Some of them are even drug dealers who sell drugs to their university juniors. I was curious about what they were taking so I felt like I had to try it out the drug as well. So, this is where my journey of taking drugs began Participant M, 20—22 years old. On the other hand, however, Participant H relayed the same motif of peer influence but described a different scenario where his friends casually coaxed him into drug use. When one of the data collectors from the self-identified gay community had a conversation with Participant H during his monitoring visit, he described his drug-using behaviors in the following way:. I noticed that my friends in my residence hall were smoking inhaling something. It looked really interesting and I was interested in trying it out. But of course, I was scared. But my friends told me that it feels so good, I should definitely try it out. And this is the beginning of my life with drugs Participant H, 20—22 years old. Within the context of their social circles, drug-taking not only served as a gateway to their peer groups, but it was also a perceived social activity that consolidated friendships. Specifically, some drug-taking activities, such as sharing lighters and drug-taking apparatus, symbolized social intimacy and fraternity. In other words, drugs were perceived as the adhesive that cemented their social circle. For example, during an in-depth interview, one of the participants mentioned:. One of the main activities in our group revolves around taking Yaba together. During this time, we also chat, gossip and joke together. Yaba is what has made our group stronger. There is something special about sharing the same lighter and pipe when taking Yaba, it makes our bond even stronger Participant X, 22—24 years old. Moreover, our findings from the informal discussions and counseling sessions for both interventions have revealed other social connotations of Yaba use, such as the catalyst for a seemingly attractive appearance. For instance, a few of the participants mentioned that they started taking Yaba as a weight loss aid. Like most other social settings, being thin was perceived as a proponent to social prestige and increased popularity within the peer network. In one particular example revealed in a counseling session for the harm reduction intervention, Participant F followed suit after one of his university roommates started pursuing this practice:. My roommate used to regularly take Yaba. I was always wondering why. He told me Yaba helped him lose weight quickly. Being an overweight person, I always felt self-conscious about how I looked. So that is what drove me to take Yaba. It was a very easy ticket to losing weight. But once I started, I became highly addicted and there was no way for me to stop Participant F, 21—23 years old. The findings, from the research interviews and programmatic informal discussions, alike, also revealed a prominent culture of informal drug peddlers who would primarily target newcomers because they believed that their naivety about drugs would easily enable them to sell lower-quality drugs at higher prices. Therefore, this alludes to the social hierarchy and motifs of seniority which interplayed within the social circles of our participants. The participants attached social meaning to these drugs, citing them as a status symbol, thus making their peers more willing to emulate them. As one of the participants mentioned:. Yaba is a symbol of wealth and style among our community. Only the rich and cool kids seem to take it. By taking this drug, you give off the impression of being smart, a risk-taker, modern, classy, adventurous, basically anything you could ever want. That is why this drug seems so appealing Participant R, 22—24 years old. The findings illuminated various contexts which have ultimately driven them toward sexualized drug use i. As described in the previous section, many of them initiated drug use as a product of their social environment, rather than the desire to enhance their sexual lives. However, their continuation of drug intake and regular practice of chemsex were often attributed to their surrounding socio-sexual contexts, which are described in this theme. In particular, this section specifically describes various events, circumstances, and perspectives which lead to chemsex. Although these parties commence with music, food, and socializing, as the parties progress through the night, alcohol and drug use predominate in the party setting. According to the majority of the participants, drugs were perceived as a precursor to a conducive environment for sexual activity. Most of the participants noted initially feeling shy and apprehensive about socializing and acquainting themselves with potential sex partners, despite reporting feeling attracted to them. Therefore, upon the suggestion of their peers and witnessing them engaging in similar acts, they resorted to taking Yaba to bolster their courage to approach their peers. Therefore, under these circumstances, they often gravitated toward drug use. As one of the participants mentioned during a counseling session in the harm reduction intervention for chemsex:. I often feel shy to approach and talk to other guys in the party even though some of them are really hot. So, I need something to help me get the courage to approach them. Because of Yaba, not only can I approach them, but I can also talk freely with them all night. This drug made me talk non-stop. Only Yaba was able to make this possible Participant T, 18—20 years old. This was also corroborated by another informal discussion that was conducted during a monitoring visit for the virtual outreach intervention. Although I cross-dress sometimes, I felt shy about letting myself loose in front of them. But Yaba helped break that barrier for me. After I took my first whiff of Yaba with them, I was finally able to make out with one of the guys Participant S, 19—21 years old. According to the research interviews, similar scenarios resonated among the young and adolescent MSM who originated from lower socioeconomic backgrounds as they wanted to confidently approach clients for sex work in order to garner additional income. However, he also highlighted that this practice carries overall risks in terms of affecting their sexual health outcomes, as it increases their inclination toward unsafe sex. As he mentioned:. Yaba increases their ability to hold a conversation and makes them more willing to socialize. Therefore, they are able to easily tackle social settings under the influence of drugs. However, these often turn into sexual encounters, which could be risky for them, as drugs affect their judgment and decision-making abilities Academician working with drugs and sexual minorities. Some participants in both the research interviews and counseling sessions stated that they started using a sexualized drug to deal with social stress associated with being sexually minor people. Many participants reported feelings of low self-confidence and esteem due to being marginalized and ostracized from their families on the grounds of mannerisms which are typically manifested by gay men of that community. As a result, they often felt alienated, thus they reported self-medicating with drugs such as Yaba. In addition to coping with social stress, methamphetamine also helped participants increase their sexual self-confidence. Before initiating sexualized drugs, a participant reported being unable to confidently communicate and negotiate with sexual partners. He stated that:. Before sex work I take Yaba methamphetamine. Without Yaba, I feel like I cannot talk and attract partners. Earlier, I did not have the confidence to talk to a partner for sex. I used to worry that my partner would say bad things to me or beat me up. But after taking Yaba, I can approach any man and talk about sex without hesitation Participant R, 22—24 years old. Many of the research and pilot intervention participants reported that it has been difficult to practice anal intercourse for a long duration because of the pain resulting from the friction, especially if they do not have lubrication on hand. Therefore, upon inspiration from their peers, they opted for taking drugs, primarily Yaba, to lessen the pain often felt during anal intercourse. As a result, this enhanced their ability to practice prolonged intercourse, thus ultimately enhancing their sexual performance. Their increased performance instilled a sense of pride, knowing that they were able to achieve a sexual conquest within their social setting, thus elevating their social status within their circle. During one of the IDIs, a participant described his predicament in the following way:. Anal sex used to be so painful before, it felt dry and every time I would go back and forth in the butt, it would just hurt. This is where Yaba has felt like a lifesaver. Now I can smoothly have sex. Also, now I feel even more satisfied because I can have sex for a long time Participant M, 20—22 years. Likewise, a participant who had an informal discussion with a data collector from his community relayed the same sentiment in the following way:. I feel like drugs helped me achieve something. During these parties, I could not have sex for a long time before but now this has changed. I was able to make another man satisfied, so I felt like I won Participant K, 22—24 years old. At the same time, they revealed that they experienced unprecedented degrees of sexual satisfaction when having sex under the influence of drugs. They did not derive the same magnitude of sexual pleasure and magnitude when having sex normally. Some participants struggled to describe their feelings and experiences with methamphetamine, whereas others briefly described their sexual experiences, feelings and sensations. Suddenly I feel like I am the king of sex kamer raja. Some of the participants also shared that other chemsex drugs, especially poppers, helped them to experience wild pleasurable sex which would not have been otherwise attainable sans the influence of drugs. These scenarios were also substantiated by a service provider in an existing SRHR intervention for MSM who relayed that the participants of their intervention would take Yaba due to similar circumstances. Specifically, they raised concerns about MSM feeling anal pain, therefore they perceived Yaba as a viable antidote, particularly for bolstering their sexual performance. Not only were drugs reported as a pathway for alleviating the social and physical barriers of anal intercourse, but they were also perceived as an aid for increasing the degree of sexual and emotional intimacy within their intercourse act. Before they regularly took drugs, the research and programmatic participants, alike, opined that it was difficult for them to achieve emotional intimacy with their sex partners, particularly if they were new, unfamiliar partners. Most of the participants reported that drugs amplified the degree of pleasure that they felt during anal intercourse. Because of this, they were able to practice prolonged anal intercourse, thus incurring a sense of emotional satisfaction from the ability to satisfy their partner. On most occasions, this has perpetuated their dependency toward drugs. As one of the participants originating from a lower socioeconomic class mentioned during a counseling session with the clinical psychologist:. But now that I am taking Yaba and other drugs, I feel a lot closer to my sex partner. Now I can have sex for a long time and feel a lot more pleasure than before Participant K, 22—24 years old. Therefore, they felt compelled to continue taking drugs. This sentiment was echoed by one of the participants in the following way:. I keep on wanting more of this drug. Once I started taking the drug, I understood why it was so special eitar moja ta bujhe gesi so now I cannot have any fun during sex without this drug. I have now become addicted Participant S, 19—21 years old! Participants also reported that sexualized drugs would stall the ejaculation that they would have achieved if they engaged in foreplay. However, some other participants reported that they can no longer have sex without sexualized drugs which are illustrated in the following IDI anecdote:. Me and my sexual partner have been having sex on Yaba for a long time. The findings also revealed that chemsex has modified their sexual behaviors, particularly in socio-sexual settings. On several occasions, drug use engendered their risky sexual behaviors, particularly because these sexual encounters did not involve condom use. These practices have the potential to elevate their likelihood of transmitting HIV and STIs, thus exacerbating their overall sexual health outcomes. This section specifically highlights the ways in which chemsex has shaped their sexual experiences and practices, primarily in relation to their social setting and the dynamics of their peer networks. This was also corroborated by the research interviews, counseling sessions and other informal discussions. Oftentimes, the participant reported the desire to enact the activities they have watched on pornographic media which often fall within the Bondage and Discipline, Dominance and Submission, Sadism and Masochism BDSM category. However, on most occasions, they reported feeling shy or apprehensive about this practice while sober, especially with unfamiliar partners. On the other hand, chemsex was perceived to alleviate that barrier. Based on the anecdotes of one of the participants from the counseling session:. I have been watching a lot of hot stuff on porn where people are spanking each other, tying each other up, etc. I really want to try that stuff out but sometimes I feel too shy to do these things. But Yaba changes me completely. I no longer feel that barrier. I tried it out with a few partners and we had a really good time Participant K, 18—20 years old! Conventionally in this population group, the top and bottom partners remain fixed in their roles. However, chemsex has increased the fluidity in their sexual roles. According to the participants, this is attributed to their increased willingness to sexually experiment. As one of the participants mentioned during his conversation with the data collector from the self-identified gay community:. I have always played the top role with my man. But now that I take drugs regularly, I find it too boring. I really want to try something new. So, this is where I started playing the bottom role Participant I, 20—22 years old. In addition, some of the participants explained that chemsex heightened their propensity to practice group sex, which was deemed as a relatively rare occurrence while sober. This situation particularly resonated with parties which involved chemsex. Some anecdotes, from both the field diaries and conversational data, alike, also revealed the recurring incident of golden showers where two sexual partners often go to the bathroom after completing their sex act. In this instance, one partner often micturates over another, and thus he considers it as a shower. In a more atypical case, a client hired a male sex worker and brought him to his residence. Thereafter, he took Yaba. Initially, he performed sex with his wife in front of the hired male sex worker, followed by a sexual encounter with the hired man. The participants described that the intake of Yaba, poppers, and other drugs have altered their state of mind to the extent that they were more likely to become violent in their sexual activities. This sub-section uncovers the motif of sexual violence in two dimensions: in terms of making them more likely to non-consensually approach a new partner; and practicing rough or coercive sex with an existing partner. As mentioned before, these social circles often constitute a seniority dynamic where the younger MSM are more likely to appease their seniors. Under the influence of drugs, senior members of the group often leverage that dynamic to approach their juniors for sex, sometimes to the extent of blackmailing or threatening them if their demands are not fulfilled. These incidents rarely involved condom use. As one of the IDI participants who were victimized by this practice mentioned:. They the seniors go mad after taking drugs. The other day, one of them approached me for having sex. I was not interested at the time, so I refused. But he would not accept no for an answer. So, he threatened me that he would tell my whole family I was gay if I did not listen to him. He seemed so angry at the time I simply could not say no. Moreover, the interview findings, as well as the field diary notes, revealed that chemsex made some of the participants sexually violent to the extent that they made rough or coercive sex a part of their existing sexual partnerships. Even if the partner was experiencing anal pain or anal bleeding from the prolonged sexual activity, the participants reported that they could not stop, as their sexual pleasure superseded every other circumstance. In one of the anecdotes, a participant mentioned:. He my sexual partner was bleeding from behind from all the rough sex, but it was impossible for me to stop even though he was crying in pain. Because of this drug, I just wanted to keep on going on and on the whole night. So, I ignored his cries and just kept on going Participant I, 20—22 years old. The majority of participants who have taken drugs before a sexual encounter reported that chemsex altered their state of mind to the extent that they were unable to make informed decisions. Rather, the consumption of Yaba and other similar drugs have intensified their sexual cravings where they immediately needed to satisfy their sexual desires at that moment. This situation was particularly applicable to parties where some participants intended to achieve at least one sexual conquest, otherwise, it would affect their reputation within their respective social circles. As one of the IDI participants mentioned:. This drug makes me sex crazy. I cannot think about anything else except sex. I do not want to be the only one without a sex partner Participant K, 18—20 years old. In the context of the aforementioned parties where sex has remained a primary staple, at that moment, they prioritized fulfilling their sexual urges. As one of the participants expressed during a counseling session with the clinical psychologist:. Who cares about condoms? At that time, the only thing that mattered to me is fulfilling that burning sexual craving that is eating me up inside. The drugs have me so crazy for sex that I do not even think about condoms. I know I should be wearing them, but what can I do Participant Z, 20—22 years old? On rare occasions, participants who took drugs for a longer time i. Therefore, this further fuelled their reluctance to use condoms because they were more willing to continue sex as opposed to safeguarding their sexual protection. In addition, some of the participants who have been taking Yaba for a long time perceived that Yaba was necessary for facilitating an erect penis, to the extent where their penis even failed to erect after taking multiple tablets of Yaba. This is one of the few qualitative articles of its kind that explores the socio-sexual contexts and implications of chemsex on adolescents and young MSM and self-identified gay men whose primary social circles lie within this community. It is worth noting that these findings consist of two denominations of youth and adolescents. One group originates from the lower socioeconomic strata whose sexual behaviors are often driven by the need to bolster their sexual performance to generate income. Whereas, another group comprises an affluent social cluster of self-identified gay men who embody a different drug-taking and sex culture. These findings primarily presented a contextualized scenario of the social attributes, nature of the sexual partnerships and social settings which have perpetuated chemsex. On the other hand, the majority of the literature has merely illuminated the relationship between drug use and risky sexual behaviors, often without exploring these crucial social contexts. Yet, in order to intervene in the sexual harms associated with chemsex, it is crucial to also understand the nuanced complexities of their socio-sexual contexts, which is also important for promoting better SRHR outcomes. Hence, these findings have bridged a pressing knowledge gap whereby we have begun to understand the circumstances shaping their sexual behaviors, especially among young and adolescent self-identified gay men who remain relatively less explored as a population group in Bangladesh and other settings. It is worth noting that their elusive nature is primarily attributed to the criminalization of both male-to-male sex and drug use explained in the introduction section which has collectively fuelled their self-stigma. Therefore, this paper highlights some contexts of drug use that are tied to the stigma associated with their criminalized status, a phenomenon that is yet to be underpinned in other literature. One of the strengths of this qualitative research was its application of various types i. This approach has allowed for ensuring the validity and trustworthiness of data collected from multiple data sources and investigators. Another unique facet of this article was its ability to unravel another culture that previously did not receive adequate research attention. For the self-identified gay group, these contexts are predominantly rooted in the culture constructed by their peer networks. Moreover, the findings have delved into how chemsex has shaped their sexual lives, in the context of their social and sexual settings. These findings have been thematically categorized into various dimensions of chemsex. While the first part describes their socio-sexual contexts, the results section then segues into an analysis of how chemsex has perpetuated various risky sexual behaviors. In Bangladesh and its surrounding region, the literature has predominantly focused on the culture of older MSM, who have their own predefined set of cultural dynamics and typically originated from lower socioeconomic backgrounds Chakrapani et al. Specifically, in partnerships, this group of MSM typically embodies traditionally masculine and feminine roles, where the latter typically wears feminine clothing, displays effeminate mannerisms, etc. On the other hand, the same masculine and feminine dispositions do not exist among the young and adolescent population groups explored in this article. Rather, their sexual dynamics are reminiscent of MSM population groups in other countries in the Asia-Pacific region and worldwide. In particular, a previous qualitative study conducted by Khan et al. While that study uncovered the motifs of enhancing sexual performance, prolonging intercourse and decreasing the friction associated with intercourse, these sexual performance-related issues did not resonate to the same extent among our participants as they were younger and more able. Moreover, Khan et al. Conversely, feminine MSM derived pride in their femininity from being able to entertain multiple consecutive partners. However, these gender roles did not exist among our participants, as there was no traditional masculine and feminine dichotomy. Moreover, the MSM groups from lower socioeconomic backgrounds often engaged in transactional sex, as one of their driving factors was their need to survive. Therefore, they considered methamphetamine as an aid to uptake more clients. However, this scenario does not resonate with our participants as they do not present the same needs. Rather, since their drug intake is not tied to financial need, the participants perceived drugs as a symbol of wealth and social prestige. In addition, our findings illuminated a seniority dynamic within the social circle, which drove newcomers into taking drugs to appease their seniors. As a result, our findings illuminated Yaba and other chemsex drugs as an adhesive for their social networks. Although the pink carpet Y cohort study based in Singapore posited that an earlier exposure age to sexual networks may perpetuate chemsex Tan et al. Thus, these findings were able to bridge that knowledge gap. Moreover, the Thailand-based study, the pink carpet Y cohort study, and other studies based beyond Bangladesh and its surrounding region have not used social media to initiate contact within their socio-sexual networks. Nevertheless, some of our findings about the contexts of chemsex are aligned with the extant regional and global literature. For example, the research conducted so far on youth and older MSM, alike, substantiated that participants engage in chemsex to enhance their performance in the sexual setting Halkitis et al. Moreover, studies in other countries such as the United Kingdom, Canada, and Thailand depicted the relationship between social influence from virtual and in-person communities and the onset of sexualized drug use Wei et al. These studies have also identified the motifs of social capital and affiliation with sexual networks Wei et al. However, other studies merely pinpointed this relationship whereas our findings described the socio-sexual contexts surrounding chemsex. Since the existing literature on young and adolescent MSM is relatively limited, there is a paucity of data on how drugs have shaped their sexual lives. However, the literature based in Bangladesh and other countries revealed that methamphetamine and other drugs have influenced their sexual lives by increasing their degree of sexual violence, decreasing their likelihood of using condoms, and increasing their propensity to practice transactional sex Guadamuz and Boonmongkon, ; Jalil et al. However, while studies that are focused on youth have highlighted that youth are more likely to gravitate toward social experimentation, the previous research did not highlight the increased degree of sexual violence that resulted from drug use. Moreover, the extant literature did not delve into issues such as coercive sex, BDSM, sexual exploitation at parties, etc. The findings of this qualitative exploration have illustrated various scenarios of chemsex that have emerged from the socio-sexual dynamics among young and adolescent MSM. However, many of these contexts and situations have perpetuated sexual risk behaviors such as engaging with multiple sex partners, practicing rough and experimental sex and forced non-consensual sex. These risky behaviors could potentially undermine the benefits of the existing interventions for these population groups, particularly the pilot chemsex intervention, in terms of safeguarding their overall SRHR health. Therefore, the socio-sexual complexities surrounding chemsex need to be intervened in the extant harm reduction interventions. Specifically, since these populations are younger, they are more likely to be influenced by their social circles Wei et al. Thus, it would be more effective to embed these complexities within counseling sessions. Moreover, evidence-based interventions could be applied for tackling the harms of chemsex among young and adolescent MSM. For instance, the literature highlighted the promising outcomes of group therapy interventions for promoting safe behaviors among young groups whose lives are closely tied to their social circles Vaughn and Howard, ; Waldron and Kaminer, ; Kaminer et al. This could be because recent research has highlighted that social ties could promote a sense of accountability and positively influence peer behaviors Tan et al. Some recommended harm reduction and therapeutic measures include psychoeducational group sessions, skill development training, support groups, and group cognitive behavioral therapy Substance Abuse Treatment: Group Therapy, One of the limitations of this article is rooted in the qualitative methods because of the lack of scope for generalizability of the findings. Rather, because of the qualitative nature of the findings, the evidence is highly contextualized within the study and programmatic settings. Even though this research has been limited to exploring the implications of chemsex on condom use, there are other paradigms of sexual health beyond the use of condoms. For example, pre-exposure prophylaxis PrEP is a scientifically proven biomedical approach for averting new HIV infections. Moreover, research has underscored the benefits of integrating chemsex harm reduction services and PrEP Maxwell et al. Another avenue for future research could include the assessment of chemsex situation among a larger group, development of an evidence-based and context-specific chemsex intervention in Bangladesh, and piloted under the implementation research to be adapted to the local context. This research approach could help elicit the key implementation opportunities and challenges in this setting, thus guiding the further redesign and refinement of the intervention. If the complexities of chemsex are not addressed in the existing sexual health intervention, chemsex could have the potential to exacerbate their physical and mental health outcomes. This could also serve as another way forward for future research. The findings of this qualitative assessment have explored the diverse socio-sexual contexts perpetuating chemsex among young and adolescent MSM and the implications on their sexual behaviors and practices. In essence, chemsex is considerably driven by the social dynamics that interplay within their peer networks. This substantially differs from the older MSM communities in Bangladesh where their propensity to practice chemsex were primarily driven by their need to increase their sexual performance and even generate income to safeguard their livelihood. Therefore, these findings have the potential to contribute insights which could be utilized to construct tailored, context-specific interventions which particularly cater to the unique complexities of these population groups. If such complexities are addressed, this has the potential to improve their sexual health and, thus, overall SRHR outcomes. The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. SI conducted the literature review, drafted and edited the manuscript, conducted the analysis, and facilitated the data collection. GS also conducted the literature review and contributed to the drafting and reviewing of the manuscript. JE facilitated the data collection and analysis and reviewed the manuscript. SK conceptualized the projects, extensively drafted and reviewed the manuscript, and managed the data collection and analysis. All authors contributed to the article and approved the submitted version. We would like to thank the participants those who provided information, the service providers of the programmatic pilot interventions for collating the programmatic data needed to develop this article. Specifically, we are grateful to both the service providers of icddr,b and its implementing partner Bandhu Social Welfare Society for their cooperation in the evidence collection process. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Akindipe, T. 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The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. Top bar navigation. About us About us. Sections Sections. About journal About journal. Article types Author guidelines Editor guidelines Publishing fees Submission checklist Contact editorial office. An uncharted territory of sexualized drug use: exploring the dynamics of chemsex among young and adolescent MSM including self-identified gay men in urban Dhaka, Bangladesh. Introduction Sexualized drug use popularly known as chemsex has become an increasingly pervasive drug-taking practice. Materials and methods 2. Premises of the qualitative evidence The findings of this article are extracted from a qualitative study that was conducted in urban Dhaka, Bangladesh to explore the patterns and key driving factors for chemsex, particularly methamphetamine use, as well as the implications of chemsex on the sexual lives of MSM and hijra Khan et al. Application of programmatic evidence in this article While analyzing the data generated from the qualitative research study described above , some additional information was perceived necessary for encapsulating a comprehensive picture of the chemsex scenario among the young and adolescent group. Participant and settings Both the qualitative study and pilot programmatic interventions were conducted in urban Dhaka, Bangladesh among gender and sexually diverse people i. Data collection techniques and approaches The evidence presented in this paper is based on extensive literature review on chemsex-related issues, along with a variety of data collection techniques which are explained in the Table 1. Table 1. Data collection methods, investigators and participant categories. Table 2. Types of drugs used by the participants. Table 3. Types of sexualized drugs used by participants. Table 4. Drug use characteristics among chemsex practitioners.

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