Sex is chemical: an elementary analysis of metropolitan variations combining sex, drugs, and global health

Abstract

This article analyzes the social and historical construction of chemsex as a scientific, health, and political object by tracing the category's circulation between London and Brazil. The study combines a critical review of national and international literature and public health documents. We distinguish sexualized drug use, a broad descriptive category, from chemsex, understood as a recurring configuration in which substances, routes of administration, bodies, platforms, markets, sexual cultures, and prevention technologies organize the encounter. We argue that methamphetamine, mephedrone, and GHB/GBL helped stabilize the category in London circuits but do not provide a universal definition. In Brazil, cocaine may occupy or partially replace methamphetamine's structuring position in specific circuits, without implying pharmacological equivalence, within a more diverse drug ecology. The comparison shows that chemsex is both a practice and a sociomedical category transformed by markets, HIV/AIDS policies, and territorial, racial, and class inequalities. We conclude that public responses should combine rights, harm reduction, HIV and STI prevention, primary care, and mental health care without pathologizing or romanticizing participants' experiences.