What does coronavirus (COVID-19) mean in regard to chemsex? David Stuart.

Author – David Stuart. 

The great majority of us human beings here on planet Earth will contract coronavirus (COVID-19) this year. People who engage in chemsex are even more likely to, because in many cases (not all) chemsex includes lots of transmission possibilities within those chemsex scenarios; it also often (not always) involves higher numbers of new partners over two to three day periods. For the great majority of us, the symptoms will pass and we’ll be fine.
So despite the fear and alarm associated with this pandemic, we really shouldn’t be frightened of that inevitability.

However, there is a minority of people among our chemsex communities who will develop more complicated symptoms when they contract COVID-19; and for a certain number of those, the symptoms will be fatal.

So. We all have a responsibility to protect that minority – vigilantly – from catching COVID-19; from us, from our communities.

That means doing our best to avoid that minority of people when we are potentially infectious.
Given the amount of COVID-19 peaking within our communities this year, it would be unwise and very unkind to hook up with/have chemsex with a COVID-19-vulnerable person;
– especially if we have had other partners in the previous days/weeks
– especially if we have not been vigilant about hand-washing, face touching in the previous days/weeks
– especially if we have been close to anyone with symptoms of cough or high temperature in the previous days/weeks
– especially if we have been around any confirmed cases of COVID-19 in the previous days/weeks
– especially if we have a new persistent cough, shortness of breath or a high temperature (self-isolate for 7 days in this case)

Who are the people most likely to develop the more dangerous complications from COVID-19?
– elderly people, over 70
– people with cancer
– people with high blood pressure
– people with problematic diabetes
– people with chronic kidney disease

– people with chronic heart disease
– people with chronic lung disease
– people with respiratory problems
– people with compromised immune systems.


COVID-19 is very new, so there is not a lot of evidence to give absolute reassurances on the following.

COVID-19 affects our respiratory tract mostly; the stronger our immune systems are, the better we can fight it. The HIV virus weakens the immune system if left untreated for too long. This time can vary person to person.

(For the information below, I consulted an HIV specialist, who I thank dearly.)

– Nearly all people living with HIV and on treatment with undetectable viral loads have strong immune systems, so COVID-19 would not necessarily pose a higher risk to them than anyone else. Take comfort in this; be reassured. (The British HIV Association recommends that HIV positive patients make sure they’re up to date with their annual flu vaccination and the pneumonia vaccination; both are common at this time of year, both are preventable; avoiding those illnesses will reduce the burden on our health services and hospitals during this COVID-19 pandemic.)

– It’s possible that people living with diagnosed HIV, but who are not taking any HIV medicines, or people who have only recently started treatment might be at greater risk of developing the more complicated symptoms of COVID-19; but this isn’t known for sure. Talk to your doctor or HIV healthcare team as soon as possible about this. They’ll be able to answer this more exactly.

– If people have HIV but do not know it, their immune system might have been damaged, putting them at risk of developing infections and other illnesses. It’s possible that they might not be able to fight off infections like COVID-19 as people who don’t have HIV, or people with HIV who are taking treatment. Therefore, if you haven’t tested recently (or ever), it is a good idea to have a test so that if it’s positive, you can start treatment as soon as possible.

– For some people, going for an HIV test is a scary thing; but it really shouldn’t be. HIV medicines work brilliantly and the protection they give to your immune system should make it easier to fight infections like COVID-19. Now is a very good time to get tested for HIV. While you are there; ask about condoms, ask about PEP; ask what “undetectable” means, and ask about availability of PrEP. These are all HIV prevention tools, and now is a really good time to avoid a new HIV infection. A new HIV infection is quickly followed by some HIV seroconversion symptoms; these symptoms vary person to person, but they could complicate a COVID-19 infection if they happened simultaneously. HIV prevention is especially important during this COVID-19 outbreak.

Being kind

Everyone has different and varying relationships to chems; they affect us all differently.
Some of us can stop chems, take a break during a dangerous period, practice excellent hygiene, wear condoms consistently, adhere to our HIV medicines perfectly, take our PrEP perfectly.
For many of us others, those things can be difficult.

Drug cravings can be overpowering. Mental health can fluctuate.
The desire to self-care can be out of our reach sometimes, during some seasons of poor wellbeing.
Sometimes when things are bad, the lost ability to self care can be accompanied by an apathy in regard to caring for others
Choosing to take a break, or to practise meticulously safe chemsex during this COVID-19 pandemic is not something we can all accomplish. And as a community, we need to be kind, understanding and intelligently aware of this. And patient and flexible and generous. Cruelty, lack of empathy, and unkindness make epidemics worse.

Many people participating in chemsex may be run down, depressed, off their HIV medicines for a period of time.
Many people participating in chemsex may be living with undiagnosed HIV; whether that’s a month or a year.
Many of our older brothers and lovers may be participating in chemsex despite the risks, because they may have less control over triggers, cravings and compulsions to use chems.
Many older COVID-19-vulnerable people may be lonely and isolated, and taking greater risks in regard to COVID-19 prevention.
For some of our older gay brothers, this is the second epidemic within their lifetime that affects their sex lives and their ability to seek connection, intimacy, pleasure; epidemic fatigue is a real thing.

This is life, this is gay life. This is addiction, this is mental health; this is fatigue, this is fluctuating seasons of wellbeing, and this is sex and horniness. This is the need for intimacy, this is the ‘Human’ in human nature. This is our primal desire for connection. This is the nature of gorgeous and sometimes vulnerable human beings.
This is chemsex too.

If you DO want to take a break from chems during this time, but don’t feel confident that you can…

Try it this way.

1. DECIDE to do it. In your heart (That makes it easier).
2. Choose a small period of time, like 1 week; say “I’m not doing Chems for the next seven days“. Say it into a mirror. Say it to a friend. Commit to it.
3. Learn how to anticipate triggers in the coming week; so you are prepared for the cravings.
4. Learn how to manage cravings.
5. Keep yourself busy & occupied. That helps. Ask friends for help keeping you busy & occupied


AFEW International asks international organisations to take immediate action

AFEW International together with other European NGO asks international organisations to take immediate action and protect prisoners from coronavirus as soon as possible.

Text of the statement 

Appeal by European NGOs involved in the field of prison health and in the defence of the right to health protection for prisoners

The signatory organisations, which are involved on a daily basis in the protection of the right to health of prisoners, are alarmed at the unpreparedness of penitentiary administrations to deal with the spread of the coronavirus on the continent and, in most countries, the lack of consideration of the specific situation of prisons in national preparedness plans and systems for dealing with public health incidents. They recall that more than 1.5 million people are detained in prison facilities on the continent on any given day and that under international treaties, States are obliged to take the necessary measures to protect the life and health of those they detain.

The deficiencies observed pose a threat not only to prisoners and staff working in the institutions but also to the general population[1]. Prisons are generally considered to be amplifiers in the spread of infectious diseases[2].

Although levels of exposure to the health crisis vary greatly from one country to another, due to the great disparities in the characteristics of prison systems and the performance of national hospital systems, it appears that, overall, the prison issue is too largely ignored at European level, even though prisons are places with a high risk of transmission. Moreover, some states are tempted to adopt measures to isolate detainees from the rest of the population, in disregard of the rights of detainees and their relatives, and at the risk of preventing the population’s adherence to health instructions given by authorities.

Consequently, taking amount of the risk factors in the prison context, the signatory NGOs intend to alert the international organisations concerned, first and foremost WHO and the Council of Europe, to the serious shortcomings observed on the ground and urge them to put pressure on governments to take special health measures and reduce significantly the prison population as soon as possible.

Once again, the national contexts are highly contrasted and the picture drawn below should not be interpreted as reflecting a uniform situation. However, in view of the urgency of the situation, it is intended to underline the seriousness of the consequences that would result from failure to manage the coronavirus disease outbreak in prison and the imperative need for international organizations to act immediately to redirect national policies in this area.

  1. Prisons represent high-risk environments for the transmission of infectious diseases

1.1 Conditions of occupancy and organization of prison facilities. Prisoners are permanently in a situation of great promiscuity, whether in cells, production workshops, yards, etc. All aspects of prison life involve the movement of prisoners in groups, in more or less large numbers. The facilities are often poorly ventilated. In many European states, this situation is aggravated by regional or national situations of prison overcrowding[3]. From this point of view, the risks of spreading of the virus in the prison systems of post-soviet countries are particularly significant: i.) the prison population there is particularly large; ii.) remand prisons are often overcrowded and organised in collective cells, while correctional institutions are mostly organised in barracks housing 80-150 convicts, if not more; iii. ) once convicted, prisoners are transported for weeks or even months to their assigned correctional institutions; these transports take place in appalling hygienic conditions and involve repeated stops along the route.

1.2 A population at high risk of communicable disease and facing serious risk factor for coronavirus severity. In particular, the notification rates of tuberculosis in European prisons are up to 30 times higher than in the general population[4]. Prison populations in Europe are aging at an unprecedented rate[5]. Several countries in Europe, especially in Eastern Europe report HIV prevalence among prisoners at rates greater than 10 %[6]

1.2 A frequently failing medical system. Although the level of development of prison medicine varies greatly, the organisation of care in prisons is never designed to deal with a crisis situation. Even more critically, especially in Eastern Europe, services are very often under-equipped, understaffed and unable to cope adequately with the ordinary burden of common diseases. Moreover, they generally suffer from a very poor linkage with the general health system, leading to significant delays. Almost everywhere, the unavailability of escorts is a recurrent problem for the transfer of patients to the hospital.

  1. WHO guidance against COVID-19 spread are hardly implemented in prison.

WHO has provided States with guidance for public health measures that can slow the transmission and spread of COVID-19[6]. Accordingly, many States have taken measures to prohibit gatherings, to close down most public places and impose quarantine on the population to ensure social distance. However, although all countries are not on an equal footing in this respect, most measures recommended by the WHO are not, for the most part, implemented in prisons[7].

2.1 The reduction of prisoners’ contact with their relatives: mostly adopted response by prison administrations. Domestic authorities have generally limited themselves to providing information about the virus and drastically limiting prisoners’ contact with the outside world[8]. Some, like France, have suppressed collective activities within the prisons. However, these measures do not appear to be of such a nature as to adequately prevent the risks of contamination, which may be caused by new entrants, extractions of prisoners to the courts, staff working in the prison, etc. These measures can have perverse effects: prisons are particularly vulnerable to fake information/myths that may circulate by word-of-mouth or online. The increasing isolation of the prison environment accentuates the impact of rumours[9].

2.2 The maintenance of recurrent situations of regrouping of people: a favourable environment for the spreading of the virus. At present, detainees are generally still faced with multiple and routine gathering situations, for roll call, work, showers, etc.. Prison staff are in daily contact with a large number of detainees, conduct body and cell searches.

2.3 Failure to implement the required prevention interventions. From this point of view also, authorities do not seem to consider the risks of internal propagation within the prison. Detainees are frequently not in a position to observe hand hygiene instructions[10]. Masks for symptomatic individuals or health staff are not available[11]. Environmental cleaning is done under usual conditions.

  1. COVID-19 case management

The laconism of the prison preparedness and response plans disseminated, or even the absence of any public information on the subject, indicates that prison medical services have not, at this stage, been prepared for an influx of COVID-19 cases. In view of the serious failures of the services concerned in the management of common pathologies in ordinary times, the lack of preparedness suggests an improvised and therefore potentially chaotic management of COVID-19 cases.

3.1 Intervention protocol and articulation with civil medicine. In most of the countries, no information was available on the intervention protocols defining the division of roles between prison medicine and civil medicine.

3.2 Capacities of penitentiary medical facilities. Apart from exceptions[12], the available information does not show any reinforcement of the medical units in terms of personnel and equipment, particularly respiratory equipment. It does not appear that guidance to health providers for COVID-19 and severe acute respiratory infections has been disseminated.

3.3 Conveyance and stay of detained patients in hospital. No increase in the number of medical personnel was reported, nor were escorts provided to transport patients with Covid-19 to civilian hospitals. No legal measures to ease the transfer and hospital stay appear to have been envisaged.

  1. Measures liable to infringe fundamental rights.

Several countries have taken, or are about to take, drastic measures to limit the prison population’s contact with the rest of the world. Some countries have decided to completely suspend family visits[13], others have imposed severe restrictions in this area. Some States have provided for compensatory measures, such as increased telephone[14] or video conferencing facilities[15].

Several UN experts[16] and the Council of Europe have urged States to avoid overreach of security measures in their response to the coronavirus outbreak. When it comes to prison, the NGO Penal Reform International has recalled the requirements of necessity and proportionality of measures limiting visiting rights in this context[17].

While limitations on contact with the outside world may be justified where they are proportionate to the risk and accompanied by adequate compensatory measures, it must be stressed that closing prisons on themselves increases the risk of ill-treatment, especially in crisis and panic situations. Limitations on visits and activities will inevitably lead to situations of great tension[18]. Prison administrations will face unprecedented pressure. If relief measures are not taken swiftly, particularly in terms of the number of detainees, they may find themselves facing situations that are very difficult to manage.

Furthermore, it is essential that NPMs retain their right of access to prisons and that detainees have the possibility of contacting them by telephone, under appropriate conditions of confidentiality.


  1. An indispensable intervention at the international level

The Signatories urge international governmental organizations to take full account of both the major health risk associated with the spread of COVID-19 in prisons and the inertia shown by States, and consequently to take measures to ensure that States act effectively and with full respect for the fundamental rights of detained persons.

5.1 Health measures of prevention, early detection and control of COVID-19. International organizations must act swiftly to get States to develop the required prevention and response plans. WHO must play its leading role in this area and provide support to authorities for preparation and response. However, the technical support approach is not enough, and WHO and the relevant United Nations and Council of Europe bodies must use all their influence to bring States to meet their international obligations to protect the life and health of detained persons.

5.2 Avoid the spread of COVID-19 by significantly reducing the prison population. Whatever measures may be taken by the prison authorities to adapt to life in detention, the configuration of the premises and the organization of the prisons do not allow for the implementation of preventive measures, and in particular of social distance. Unless there is a clear reduction in the number of detainees, the virus will spread rapidly within the facilities and the prison and medical services will be overwhelmed. The national authorities must take urgent measures to seriously reduce the number of prisoners. In this respect, Council of Europe bodies, and in particular the Committee of Ministers, the General Secretary, the Committee for the Prevention of Torture (CPT) and the Commissioner for Human Rights, which play an important role in guiding penal and prison policies, must rapidly adopt recommendations to bring states to take these decisive steps. States have at their disposal a wide range of measures that can produce rapid effects, from penal policy guidelines provided to prosecutors’ offices to exceptional measures of pardon and amnesty. It is essential that an impetus be given very quickly at European level to steer national policies in this way.

5.3 Monitor respect for fundamental rights. The mechanisms for monitoring respect for fundamental rights should take exceptional organisational measures in order to be able to fully play their role. First, the ECtHR should strengthen its capacity to deal with requests for interim measures under Rule 39. In ordinary times, these are already very often necessary in some countries, such as Russia or Ukraine, in order to obtain acts of care which are essential for the protection of life. It is likely that the number of well-founded requests will increase significantly. Moreover, for legal or practical reasons, prisoners’ access to their lawyer or to NGOs will become acute. The Court should adopt practical instructions adapting the formal requirements resulting from Article 47. The other relevant bodies of the Council of Europe and the United Nations should organise the monitoring of the measures taken by states to combat the pandemic.

A PDF version of the document

On 18.03.2020

First signatories :

European Prison Litigation Network – EPLN

Eurasian Network of People who use Drugs – ENPUD

Helsinki Foundation for Human Rights (Poland)

Altro Diritto (Italy)

PromoLex (Republic of Moldova)

Antigone (Italy)

Belgian Bar (French and German speakers bars) – Avocats.be (Belgium)

Kharkiv Human Rights Protection Group – KHPG (Ukraine)

Ukrainian Human Rights Institute (Ukraine)

Bulgarian Helsinki Committee (Bulgaria)

Public Verdict Foundation (Russia)

Russia Behind Bars (Russia)

Ban Public (France)

Observatoire International des Prisons – Section Française (France)

Prison Archive/Strafvollzugsarchiv e.V. (Germany)

Legal Basis (Russia)

Agora International Human Rights Group (Russia)

Zona Prava (Russia)

Association for Human Rights of Andalusia (Spain)

Iridia – Center for the Defense of Human Rights (Spain)

Centre de la protection internationale (France/Russia)

Siberia Without Torture (Russia)

Man and the Law (Russia)

Ural Human Rights Group (Russia)

Civil Activists (Russia)

Tatort Zukunft (Germany)

Kosova Rehabilitation Centre for Torture Victims – KRCT (Kosovo)

Avocats sans Frontières – ASF (Belgium)

La Ligue des Droits de l’Homme – Section belge (Belgium)

Alliance of Ukrainian Unity (Ukraine)

HPLGBT (Ukraine)

«New Life » (Russia)

«All-Ukrainian League «Lеgalife» (Ukraine)

Zahid Chance (Ukraine)

Initiative Group PULS (Moldova)

Citizen N. (Russia)

Forum PUD (Russia)

Ukrainian Helsinki Human Rights Union (Ukraine)

AFEW International (Netherlands) 

[1] WHO, Prison and Health, Genève, 2014
[2] The Lancet, HIV and related infections in prisoners, Sep 10, 2016 Volume 388Number 10049p1025-1128, e2-e3
[3] Prison population brief. See also CoE, White Paper on Prison Overcrowding, CM(2016)121-add3
[4] WHO Europe, Good practices in the prevention and care of tuberculosis and drug-resistant tuberculosis in correctional facilities (2018)
[5] For instance, a report by Public Health England (PHE) showed that the proportion of people in prison aged 50 or older has increased by 150 per cent between 2002 and 2017.
[6] https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance
[7] In France, the National Preventive Mechanism stated on 16 March that the safety of persons in remand detention centres was no longer guaranteed and that the administration will therefore fail in its obligation to protect the persons under its control if it does not take the necessary measures as a matter of urgency. It called for a reduction in the prison population by encouraging prison exits and limiting entries.
[8] In addition to visitations restrictions, the Irish Prison Service planned on a number of contingency measures to reduce the number of people in custody in a controlled manner.
[9] In Italy the lack of medical information and miscommunication resulted in panic and false myth.
[10] For instance, hydroalcoholic gel is prohibited for detainees.
[11] In Italy, according to the NGO l’Altro Diritto, ombudsmen have expressed high concerns for the lack of masks, gloves or sanitizer. In Belgium, the guidelines for the management of suspected or actual cases of contamination recall the shortage of means of protection (masks, disinfectant gel) and recommend their use only when necessary.
[12] In Moldova, the texts dated 12 March foresee the supply of equipment stocks (protective masks, multifunctional electronic thermometers, etc.), medicines, biodistructive preparations, etc.;
[13] Including Belgium, Spain, Italy, France, Russia, Ukraine, Moldova, Bulgaria
[14] Belgium has granted a 20 euro telephony credit to all detainees.
[15] On 8 and 9 March, the Italian authorities authorised wide access to video calls to offset the effects of the suspension of visits. However, these instructions were unevenly applied, contributing to the outbreak of trouble.
[16] COVID-19: States should not abuse emergency measures to suppress human rights – UN experts, GENEVA (16 March 2020)
[17] Penal Reform International, Coronavirus: Healthcare and human rights of people in prison, briefing paper, 16 March 2020.
[18] Riots or protests have been taking place in 27 prisons throughout Italy. In this context, 13 prisoners died on 7 March 2020.

COVID-19. Comprehensive Harm Reduction Tips for People who Use Drugs

The following tips were developed to inform the global community of drug users on important harm reduction tips to practice during the current COVID-19 (“coronavirus”) pandemic. 

1) DON’T SHARE pipes, bongs, vapes or joints, nasal tubes (for inhaling/snorting), and all injecting equipment (including sterilized water)

2) If you’ve got the money, try to STOCK UP on your drugs of choice before things deteriorate much further

3) If you are a client of drug substitution programs (ie: methadone maintenance/tapering, heroin, Suboxone/Bup, stimulants, marijuana etc.), and particularly if you have a pre-existing condition that makes you more vulnerable to infection, ask your doctor if you can GET A 3 MONTH TAKE-HOME PRESCRIPTION (meaning you don’t have to go to the pharmacy to get new doses after your first collection). Also, ask if you can skip doctor appointments and urine testing for at least the next three months.

4) If you have an opiate habit and are currently using the illegal drug trade to obtain your drugs, BE PREPARED TO GO THROUGH INVOLUNTARY WITHDRAWAL if your dealer(s) gets sick. Have backup plans that include increasing the number of dealers you can score off of, getting medical help (i.e. drug substitution programs) and make sure you have all the necessary medications, food and drinks (especially protein-based and electrolyte boosting liquids) you will need to detox off opiates (similar steps can be taken by those with habits to other drug types)

and get enough to last you at least 3 – 4 weeks (longer if you are high risk for infection and if programs can manage it)

6) WIPE DOWN drug packages/wraps with alcohol-based cleansers after your dealer drops them off or once you’ve picked them up (a minimum 60% alcohol concentration has been shown to effectively kill the virus). If your dealers are in the habit of carrying dope in their mouths ask them if they can change this habit during this outbreak – if they won’t, be careful handling the packages and do the cleaning as advised above. Remember that anti-bacterial washes don’t kill viruses but can be better than nothing, especially if they contain alcohol

7) AVOID PUTTING DRUG BAGS/WRAPS IN YOUR MOUTH, VAGINA OR ANUS. If you must carry it in your body, clean vigorously with an alcohol-based cleanser both before and after you take it out, and if carried in your mouth use an alcohol-based mouthwash afterwards

8) WASH YOUR HANDS with soap and hot water vigorously for at least 20 seconds (but longer if you can) every time you come into contact with others, after handling money and after you get your drugs packages. Paper towels are preferred for drying hands, or at least use a clean towel

9) PREPARE YOUR DRUGS YOURSELF and ensure that you don’t handle or touch other people’s equipment/drugs and don’t let them touch yours

10) If you have symptoms or think you’re getting sick, AVOID GOING TO YOUR LOCAL HR PROGRAMS – HAVE THEM DELIVER TO YOU and tell them you are unwell so they can take the necessary precautions for their safety

11) Be prepared for the POSSIBILITY OF NEEDLE EXCHANGES AND DRUG TREATMENT PROGRAMS CLOSING DOWN (and possibly drug detoxes) and follow steps 2, 3, 4 and 5 to reduce any problems related to running out of supplies or equipment

Remember that people with compromised immune systems, lung diseases and other pre-existing conditions are more at risk of contracting COVID19 and help keep them safe by keeping yourself safe – follow these and other harm reduction tips to help you achieve this goal.