Harm Reduction the Peer N Peer Way: Community Support at the Nexus of Sex and Drugs

As queer sexual cultures have evolved in the context of HIV/AIDS, so too has the relationship between sex and drugs. Earlier poz prevention strategies like condoms and serosorting have expanded to include newer paradigms of U=U, PEP, and PrEP. The drugs we use with sex have shifted as well - from the poppers, booze, pot, and LSD of the 70’s, to today’s crystal meth, GHB, ketamine, and MDMA.

Emerging from the nexus between sex and drugs is the party and play (PnP) scene, a subculture and set of practices and relationships incorporating specific drugs that facilitate, enhance, or prolong sex. PnP can be a fun, disinhibiting experience, a chance to try new things, push the limits, and have edgier, mind-blowing sex. But with new frontiers, new challenges can arise, from managing use to dealing with feelings of shame due to stigmatization and 'morning-after regrets.' This important intersection of sex, sexuality, and drug use is rarely taken into account by addictions or recovery services.

Recognizing this trend, CBRC felt that it was time to ask a question of the community-based sector: what kinds of conversations, knowledge, and perspectives would allow us to talk about drugs and drug use just as competently as we talk about sex and sexual health? To answer this question, we released an article summarizing conversations we had with PnP harm reduction leaders. This resource builds on our previous work on sexualized substance use, covering themes such as stigma, advocacy, community care, and decriminalization in the realm of PnP.

To get a sense of how these themes play out in community settings, we also spoke with Bren Dixon (they/he) and Andrew Thomas (he/him). Dixon and Thomas, in partnership with CBRC, have been adapting Peer N Peer, a community-led queer substance use and sexual health program started by the Queer and Trans Health Collective (QTHC) in Edmonton and MAX Ottawa, and have been adapting it to their respective contexts: the Sexuality Education Resource Centre (SERC) in Winnipeg and the AIDS Coalition of Nova Scotia (ACNS) in Halifax.


As Peer N Peer coordinators, Dixon and Thomas oversee small but mighty teams that deliver harm reduction supplies in their communities, including things like safer smoking/snorting/booty bumping/injection kits and safer sex kits. They also distribute resources like pamphlets and other educational materials on PnP drugs and how to use them more safely, and have been sharing information at universities and colleges, non-profit organizations, and even at clubs.

The community response to the Peer N Peer program in Manitoba has been positive, averaging about 10-15 orders of harm reduction supplies per week, as well as supplying other Two-Spirit and LGBTQIA+ resource centres. “We know that harm reduction works to keep people healthy,” Dixon says. “Harm reduction is about keeping people safe and looking after the community.”

An environmental scan conducted by SERC Manitoba earlier this year revealed that in Winnipeg and Manitoba, 2S/GBQ+ cis and trans men have a higher rate of substance use and substance use challenges, compared to the general population. Data from CBRC’s Sex Now Survey also suggest that most 2S/GBQ+ people (51%) were not actively looking to change their substance use, meaning there is an important role for harm reduction to play. Dixon shares that while it may be more straightforward to get things like injection supplies and crack kits in Winnipeg, there are still lots of assumptions about what drug users look like and where they’re located, limiting access to supplies to specific areas and communities. For this reason, offering delivery of safer sex and drug use kits directly to community members' doors allows wider access to supplies.


The PnP community is small and can be spread out, particularly in smaller cities and rural contexts, which can make it difficult at times to reach folks in person. As a result, the program goes where people who PnP go: online. The program has a presence on Grindr in both Manitoba and Halifax and has partnered with mybuzz.ca, a self-assessment alcohol and substance use questionnaire originally created by RÉZO. This questionnaire aims to help assess one's drug and alcohol use to consider the effects it might be having on folks' sex lives and sexual health, and visitors can be connected to a live chat with an outreach worker as well as links to local resources.


Like all 2S/LGBTQIA+ communities, the PnP community has intersecting needs which can be addressed by harm reduction and peer support. For instance, the first few times someone accesses the Peer N Peer program may be to get new syringes. But the more clients come in and interact with staff like Dixon and Thomas, the more they get to know and trust the services they're accessing. This can lead to opportunities to support them in a more holistic way, such as addressing housing instability or food insecurity. So what starts as handing out harm reduction supplies can lead to connecting folks to relevant and affirming services and organizations. “Addressing substance use doesn’t only address substance use,” Thomas says. “It helps connect people with other resources.” 2S/LGBTQIA+ communities often have higher rates of other health and social disparities (e.g. disordered eating, challenges with body image, mental health issues, suicidality). But, building trust and creating space for clients to discuss issues beyond substance use – especially with people who share their queer identity – can open a gateway to other services.

Another reality is that many support services are not designed to meet the unique needs of queer and trans folks. “Most programs and organizations don’t even know what PnP is,” says Thomas. This means that PnP often isn’t addressed in mainstream programming, counseling support groups, or in educational materials, which often focus solely on substance use without connecting it to queer sex and sexuality. Peer N Peer coordinators are doing important work in that regard, too, educating service providers and healthcare professionals on PnP “so that they at least know it’s a thing.” As PnP emerged from within 2S/GBTQ+ communities, it’s rarely addressed (or even known about) within spaces like recovery houses or rehabilitation facilities. This is especially true for trans folks who PnP – services doubly lack queer- and trans-specific programming, often specifying that they are for “male” and “female” clients, leaving little to no room for gender diversity.

“This is a huge component of our lives and often a big piece of why we use substances. To go to a support group, for example, and not feel comfortable discussing your sexuality is a huge barrier,” Thomas says. Adding PnP to conversations about drug use, where folks’ sexualities and sexual practices are closely tied to their substance use, can make open discussions difficult in a group setting or in 1-on-1 counseling if nobody else understands the context and significance. The Peer N Peer program meets people at the nexus of sex and drugs, and at the same time creates connections between people within 2S/LGBTQIA+ communities. “Our program provides this support as there is no judgment about the meth orgy the client was at the previous night. They can openly discuss with people who have had the experience without fear of judgment.”

For more information on CBRC’s work on sexualized substance use, please visit https://www.cbrc.net/partynplay.


Disponible en français.


About CBRC

Community-Based Research Centre (CBRC) promotes the health of people of diverse sexualities and genders through research and intervention development.
Harm Reduction the Peer N Peer Way: Community Support at the Nexus of Sex and Drugs
Harm Reduction the Peer N Peer Way: Community Support at the Nexus of Sex and Drugs
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