Since the phenomenon became visible a good 15 years ago, community-based structures have managed to establish services in prevention, harm reduction, counseling and therapy. This pioneering phase must be followed by more in-depth research, therapy and aftercare as well as better links between care systems - this was demonstrated by the numerous contributions at the conference, including a presentation on harm reduction by Florian Vock from Aids-Hilfe Schweiz.

Rusty Souleymnaov, Professor of Social Work at the University of Manitoba, rightly described chemsex as a phenomenon with many possible interpretations: chemsex is a psychosocial issue, a subcultural practice, a reaction to discrimination and stigma, a form of play in life or an expression of desire. His study showed that it is precisely those concepts that are sexual and substance-related risks that have become inscribed in men's sexual scripts. It is precisely what is normatively forbidden, socially frowned upon and soberly unthinkable that becomes desire in the chemsex context. This perceived pleasure is therefore also a central element in rationalizing and justifying high-risk practices.

Maxime Blanchette, a social worker in Montréal, also emphasized that in addition to improving health care, intra-community aspects must also be discussed in particular: Issues of consent and sexual violence, mental health, but also social norms that have an impact on consumption. Many men have strong self-assessments and external attributions of how important substances are for belonging to the scene. However, it is a major challenge to create the urgently needed discussion spaces in the community. As professionals, we can discuss this relationship between the individual and the community in counseling and therapy - what are the motivators for consumption? What is the driving force behind living this sexuality?

This reflection work can also be done in the self-help setting. The German AIDS service organization has developed a manual and offers further training that could also be implemented in Switzerland.