By Timour Azhari
BEIRUT, July 7 (Openly) - Lebanese drag performer Aniss Ezzeddine had been drug-free for seven months. But when a massive chemical explosion wrecked his hometown Beirut, all he wanted was to get high.
Ezzeddine bought some crystal meth, desperate to blot out the thought that he could have died if he had been on time for a meeting in a neighbourhood that was decimated by the blast - including friends' homes and venues where he had performed.
"I needed to let off steam after seeing friends killed and injured," the 25-year-old, who wears a red sequined dress with waist-length blonde hair when performing as Anissa Krana, told the Thomson Reuters Foundation.
"I had been very proud to be clean, but when the explosion happened, I got back on drugs immediately."
The blast that rocked the port last August, blamed on a huge quantity of poorly stored chemicals, killed more than 200 people, wounded thousands and left countless more with the hidden scars of trauma.
It wiped out bars, clubs and cafes that were a lifeline for the LGBT+ community in Beirut, which is one of the most liberal cities in the Middle East although people having "sexual intercourse against nature" face up to a year in jail.
One year on, health officials are warning of a spike in risky behaviour including drug use, sex work and "chemsex" - where mainly gay and bisexual men take drugs such as crystal meth or GHB to enhance sex, often unprotected.
Ezzeddine estimated that chronic drug use has increased from less than half to about two-thirds of his LGBT+ community since the blast, which has deepened Lebanon's political and economic collapse, along with the coronavirus pandemic.
"Most of these people hooked on drugs don't care about anything anymore," said Ezzeddine, adding that he had lost friends when they "got sucked into the chemsex community".
"They know it's affecting them in a bad way but they say, 'Give me a different solution to fix my life. I'm stuck with no work, no life, a family that fights me and a state that is against me."
At least 70% of LGBT+ people in Lebanon have lost jobs in the last year and 75% have seen their mental health deteriorate significantly, according to a June survey by the British charity Oxfam.
"People need more drugs to cope with all the craziness and get through the weekend," said Ismael Maatouk of the National AIDS Control Program, who has worked with the LGBT+ community for eight years.
"They try to escape reality and one of the side effects is lack of control of sexual behaviour," said Maatouk, a Sexually Transmitted Infections specialist, noting others in the community had turned to sex work to make ends meet.
Alcohol and drug use are known to trigger risky sexual practices and sexual health experts say the lack of sex education in Lebanon makes the problem worse.
A survey by Beirut's Marsa Sexual Health Center, which works with LGBT+ clients, found that consistent condom use was much higher among men who received sex education from reliable sources, such as school, university or health care workers.
But only 19% of men said they had been given such information.
As in Europe, chemsex parties in Lebanon risk re-fuelling epidemics of HIV among gay men, with apps like Grindr used to seek out drug-heightened and often anonymous and unprotected sex, according to AIDS experts.
HIV rates have risen to well over 12% among gay and bisexual men in Lebanon, said Mostafa El Nakib, director of the National AIDS Control Program.
"The community has to take steps to decrease the rate of new infection, which is driven largely by risky behaviour and unsafe sexual practises – otherwise, it will be a disaster," he said.
Men who have sex with men have a higher risk of HIV infection, particularly when their sexual activities are criminalised and stigmatised, making it difficult to access medical advice, testing and treatment.
While about 65% of Lebanon's roughly 3,000 HIV positive people are taking anti-retroviral drugs to stay healthy, drugs to prevent HIV infection are not widely available.
The daily pills, known as pre-exposure prophylaxis (PrEP), have led to dramatic falls in HIV transmission rates among gay and bisexual men in the United States and Australia.
"PrEP needs to be introduced as soon as possible," said Ayman Assi, president of the Marsa Sexual Health Center.
"It's the only way to prevent new infections."
A pilot, launched by the National AIDS Control Program in February 2020, providing PrEP to 250 men who have sex with men, was slowed by repeated COVID-19 lockdowns and saw a lukewarm reception among the LGBT+ community.
"The main issue we had is uptake - people would stop taking the drugs or do it inconsistently," said Maatouk of the National AIDS Control Program, putting the mixed results down to the novelty of the treatment in Lebanon.
"They need time to become familiar with this new prevention method."
(Reporting by Timour Azhari @timourazhari Editing by Maya Gebeily and Katy Migiro. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers the lives of people around the world who struggle to live freely or fairly. Visit http://news.trust.org)
Openly is an initiative of the Thomson Reuters Foundation dedicated to impartial coverage of LGBT+ issues from around the world.
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