Chemsex Fuels STIs, Reigniting Debate on Who Pays for the Damage

Chemsenschem: 48 Hours of Partying, Back to School on Monday

"You start on Friday and finish at 3 AM on Monday; by 7 AM, you have to get up for work." This is the account of L., a 40-year-old high school teacher with HIV, in a report published by La Voz de Galicia on November 26, 2023, detailing drug and sens parties among men in Vigo. It's not an isolated incident. This pattern is now appearing in clinics, carrying a healthcare cost that no one wants to openly acknowledge.

The numbers are unambiguous. Between 2019 and 2021, two out of every three HIV infections in Galicia (63%) occurred among men who have sens with men, according to Sergas data. Heterosenshetero sens is a distant second. The bicho doesn't discriminate, but the patient profile has changed: almost no one gets infected by sharing needles anymore. Now, transmission occurs via dating apps, messages like 'chill, there are four of us,' and weekends that bleed into the week.

The Case of the Teacher Who Works After 48 Hours of Partying

What elevates this issue to a major problem isn't the practice itself, but who engages in it. A teacher with a 7 AM job, HIV, and a weekend of intense substance use before facing students is the detail that sparks controversy. Some public discourse sarcastically summarizes it as: quality public education.

The report itself describes the sequence plainly. After his positive diagnosis, V. took "great care" for a month. The trinc month, he returned to the sessions, with the only precaution being to avoid those lasting more than a day. He admits, "The dependence isn't caused by sens, it's caused by the substance"; the urge is driven by the drug.

The Healthcare Bill No One Wants to Face

The list of associated pathologies is long and costly. Testing and treatment for chlamydia and gonorrhea of the rectum, penis, and throat, hepatitis A and B, HIV, genital herpes, syphilis, human bicho, monkeypox, depression, and anxiety, as well as hemorrhoids, fissures, fistulas, rectal cancer, or inflammatory bowel disease. A full breakdown of the cost of each test and treatment in public healthcare reveals a surprising figure, one that few dare to calculate publicly.

Simultaneously, a pharmacological paradox emerges. With PrEP (HIV preventive medication) widely available and the clinical understanding that an undetectable positive individual does not transmit, cases are not decreasing. They are multiplying. Someone cynically remarked: the pill prevents transmission, yet HIV cases are increasing.

Victim or Responsible Party? The Core of the Controversy

Here, consensus breaks down. Some argue that calling someone a "victim" who uses drugs excessively and engages in unprotected sens over entire weekends whitewashes an individual choice: if there's money for illegal drugs, there should be for legal consequences. Countering this is the argument that addiction is not a choice, and treating public health as punishment is more expensive than prevention.

A third, quieter perspective reminds us that these behaviors do not define an entire community and that most men who have sens with men do not participate in these sessions. In the meantime, the discourse is poisoned by insults directed at the community and references to fentanyl, xylazine, and nitazenes circulating in the United States. Noise that drowns out what's important.

What the Case Leaves Unresolved

The report doesn't resolve anything, and therein lies its value. There's no total figure for the healthcare cost, no clear protocol for affected teachers, and no answer to the fundamental question: should the healthcare system treat addiction the same as chronic illness? With the guideline of "undetectable equals untransmittable" upheld by specialists, infections continue to rise. No one has yet explained why both are true simultaneously.