Yasir Ali Khan is an activist closely working on Substance use/abuse and fighting for the cause of HIV/AIDS in Pakistan for more than 10 years. He shares the situation of men who have sex with men (MSM) and drug use in Pakistan to ensure that there will be a community-led program to provide essential services for MSM who use stimulants and non-injecting drugs. He shares his work with HOPE (Have Only Positive Expectations):
With the rates of substance use, particularly addiction to crystal methamphetamine (also colloquially known as ‘ice’) and chemsex growing alarmingly in the community in Pakistan, there are major concerns about addiction, abuse, and impact on health, particularly the transmission of HIV/AIDs and other STIs that need attention. The coronavirus has had a serious impact on life in Pakistan, particularly for those identifying with marginalized communities. The lockdown has created difficulty for those earning daily wages, leaving them at the precipice of poverty and various other financial difficulties. For those members of the community that are currently living at home, the impact is devastating – not only are many finding themselves in abusive and intolerant households but being cut off from society and close friends have left them in a state of isolation that places their mental health and safety at serious risk. In this time, drug use has also increased significantly as many who rely on social support are left to their own devices in isolation. Although there are fewer instances of large parties being organized for participants to partake in group chemsex, there are still instances of substance use happening around the country that is a major cause for concern.
There is a need for resources to be gathered within the structure of community support in order to understand the use of substances and devising mechanisms for providing crucial support to people who use substances. Due to the lack of acceptance, stigma, and discrimination faced by the community in Pakistan, factors such as stress, isolation, and violence play into the development of addiction and abuse of drugs. Affirmative paths towards recovery are rarely available, leaving a majority unable to access safe healthcare and recovery facilities. The punitive approach taken by the government relies on criminalizing substance use instead of providing alternatives and methods of recovery. The policies have not been revised according to international standards for a long time thus rendering such facilities completely inaccessible, especially for marginalized and criminalized communities.
The practice of chemsex is not very different from many other countries. Arrangement of drugs, inviting friends for high fun (chemsex) is a common practice in the community. While the usage of online dating apps for hookups and forming it into a group is also an emerging factor in chemsex during the lockdown period. Chemsex can bring about the negative impact in terms of the violation, harassment, blackmailing, force enrollment in rehabs, and mental health issues:
- Isolation is a very common factor in using drugs, especially commonly used substance methamphetamine (ice).
- People are locked up during COVID-19 with friends which is also a factor that leads to chemsex parties to cope with isolation.
- Authorities seem not interested in talking about and addressing the issues of methamphetamine.
- Limited prevention support such as condoms, lubricants, syringes, and other health services during COVID-19 lockdown.
- No proper availability of PrEP in Pakistan.
- Lack of data of intersectionality between men who have sex with men and drug use.
- Stigma and discrimination associated with people who use drugs, people living with HIV, and sex between men is common, even Hepatitis C, while lack of advocacy is a major gap to address such issues.
- Hospitals are not equipped to handle such cases and those who are involved in law and enforcement agencies which cause certain issues of the user and its family & friends.
- There’s a big supply of drugs in Pakistan such as Hash, Cocaine, Poppers, Alcohol, Methadone, Crystal meth.
- Discrimination within the community exists widely.
- Mental health issues are the least priority of the government, institutions, CBOs, or any other department, that is why people face high anxiety, depression, or other mental health issues which leads the community to substance use/abuse.
- The use of methamphetamine has an impact on the thinking process that’s why most of the individuals are not aware of the risk associated with having chemsex during this pandemic of COVID-19.
- There have been cases reported of murder, violence, and harassment due to the usage of methamphetamine.
- Lack of support from CBOs and government for people who use substances especially during the COVID-19 crisis.
About HOPE: Have Only Positive Expectations (HOPE) is a registered community-based organization in Lahore, Pakistan, seeking to contribute to the wellness of SOCIESC-identifying people in Pakistan through community-based research, movement building, reporting on Human Rights violation cases and legal/financial assistance. In addition, HOPE is also providing its community with services like safe and informed access to hormones, subsidized therapy, medical referrals, and substance use/abuse support groups. Currently, HOPE has been working extensively on mental wellbeing for members of the local community. During the course of the last two years, HOPE has been providing the community with mental health resources including subsidized & free therapy with a licensed counselor, and support groups that tackle everyday issues such as substance use and living with family.
(Social Media: @HOPECommunitypk (Facebook, Instagram & Twitter).
About Yasir Ali Khan:
Yasir Ali Khan is an activist closely working on Substance use/abuse and fighting for the cause of HIV/AIDS in Pakistan for more than 10 years as a PLHIV and injecting crystal meth overdose survival and in addition, Yasir runs a page called National Network of HIV Buddy, which provides peer support to PLHIVs and Substance users. He also facilitates a support group for the SOGIESC community in collaboration with HOPE on substance use/abuse as HOPE and Individually.
Yasir Ali Khan is currently working as a Monitoring & Evaluation Officer in GreenStar Social Marketing. GSM is an implementing partner of the National Program of GFATM HIV/AIDS prevention in Pakistan as Sub-recipient.