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Abstract

Critical scholarship on chemsex, the sexualised use of substances such as mephedrone, alpha-PVP, and GHB/GBL, has analysed the practice through frameworks of neoliberal restructuring and homonormativity, frameworks presupposing political formations in which certain sexual minorities achieved conditional social inclusion. These frameworks travel poorly to contexts where no such formation exists. This study examines chemsex in Kazakhstan, where sexual non-conformity is formally legal but socially persecuted, and where the Soviet-era narcological registry transforms healthcare into an apparatus of surveillance, collapsing the distinction between patient and criminal.

Drawing on Interpretative Phenomenological Analysis (IPA) of in-depth interviews with seven men at the most risk of HIV practising chemsex in Almaty, this study extends the concept of structural edgework to demonstrate that the same practice constitutes qualitatively different phenomena depending on the practitioner's position within intersecting structures of ethnicity, class, self-acceptance, and institutional access. Three superordinate themes trace an arc from the conditions constituting the edge participants sought to cross, through the embodied phenomenology of crossing it, to the erosion of control as the boundary shifted beneath them. The same substance generated self-recovery, self-dissolution, relational restoration, and self-suspension across different participants; chemsex ranged from bounded recreation to existential survival.

The central finding is a structural gradient along which voluntariness, phenomenological character, function, and consequence compounded rather than varying independently. Participants with the greatest pharmacological expertise experienced the most severe consequences, directly challenging intervention models premised on information provision. The single successful stabilisation occurred through environmental change, non-coercive shelter, therapy, and consistent human contact, rather than through knowledge acquisition or individual resolve. These findings reframe chemsex by shifting analytical focus from individual motivations to structurally distributed positions, with implications for differentiated harm reduction in contexts where institutional hostility forecloses conventional pathways to care.