Digital chemsex support and care: The potential of just-in-time adaptive interventions

International Journal of Drug Policy, Volume 85, November 2020

https://doi.org/10.1016/j.drugpo.2020.102927

T. Platteau, C. Herrijgers, J. de Wit

Abstract

Chemsex among gay, bisexual and other men who have sex with men (GBMSM) has received increasing attention as a public health concern in recent years. Chemsex can affect a variety of aspects of the lives of GBMSM and contribute to physical, social and emotional health burden. Starting from a continuum perspective of chemsex, rather than a binary view of problematic vs. non-problematic use, we argue that men engaging in chemsex at different points in their chemsex journey may benefit from tailored and personalized support to cope with the various and evolving challenges and concerns that may be related to their chemsex behavior. To date, interactive digital communication technologies are not much used to provide support and care for GBMSM engaging in chemsex, neither for community-based support and care nor by health services. This suggests potential for missed opportunities, as GBMSM are generally avid users of these technologies for social connections and hookups, including in relation to chemsex. Recent research has provided emerging evidence of the potential effects of so-called just in time adaptive interventions (JITAI) to provide effective support and care for a variety of health issues. JITAI hold much promise for the provision of appropriate, tailored support and care for GBMSM at different points in the chemsex journey. Co-designing JITAI with potential users and other stakeholders (co-design) is key to success. At the Institute for Tropical Medicine, in Antwerp (Belgium), we initiated the Chemified project to develop an innovative digital chemsex support and care tool for GBMSM. This project illustrates how current understanding of chemsex as a journey can be integrated with a JITAI approach and make use of co-design principles to advance the available support and care for GBMSM engaging in chemsex.

 

 

People identifying as LGBTIQ and alcohol, tobacco & other drugs in Australia

Australian Institute of Health and Welfare, last updated

Key Findings:

  • People identifying as lesbian, gay or bisexual have relatively high rates of substance use. However, there is a lack of comprehensive data available on the associated harms for this population group.
  • Almost one in 5 (18.7%) people identifying as homosexual or bisexual reported daily tobacco smoking in 2016, comapred with 12% of heterosexual people.
  • Over a quarter (25.8%) of people identifying as homosexual or bisexual reported drinking at levels exceeding lifetime risk guidelines in 2016, compared with 17.2% of heterosexual people.
  • In 2016, 42% of people identifying as homosexual or bisexual reported drinking at levels exceeding single occasion risk guidelines, compared with 26% of heterosexual people.
  • In 2016, 41.7% of people identifying as homosexual or bisexual recently used any illicit drug, compared with 14.5% of heterosexual people.

More information is available in the People identifying as lesbian, gay, bisexual, transgender, intersex or queer (LGBTIQ) fact sheet (PDF)

Australian Burden of Disease Study: Illicit Drug Use, Intimate Partner Violence, Unsafe Sex

 Australian Institute of Health and Welfare, Last updated: 

Burden of disease is a measure of the years of healthy life lost from living with, or dying from disease and injury. A portion of this burden is preventable, being due to modifiable risk factors. This report provides information on the deaths and burden of disease due to risk factors included in the Australian Burden of Disease Study 2015. 

New analyses of the key drivers of change over time in the burden of disease due to selected risk factors have recently been added to these data visualisations (August 2020).

The following excerpts may be of interest:

Or you can see all the data here

 

 

Accessing pharmacotherapy (opioid replacement therapy) during COVID-19

Alcohol and Drug Foundation (Australia), April 27th 2020

There are now new challenges for people who access opioid replacement therapy (ORT) due to the COVID-19 (coronavirus) pandemic. Many may be experiencing anxiety and fear due to COVID-19 and trying to reduce and mitigate these feelings is vital.

In most cases, people who are on ORT are required to visit their health clinic or pharmacy on a daily basis. This can be more difficult for people right now, due to restrictions on movement and the social distancing regulations imposed to curtail COVID-19.

 

Stigma towards people who inject drugs and sex workers prevalent, according to new Australian study

Centre for Social Research in Health, UNSW, July 2020

Priority groups at risk of blood borne viruses and sexually transmissible infections are still likely to experience negative behaviour from the general public and in healthcare settings according to a recent report from the Stigma Indicators Monitoring Project.

86% of the general public sampled self-reported that they would behave negatively towards people who inject drugs to some extent, as did 56% of healthcare workers and 55% of healthcare students. Additionally, 64% of the general public, and 36% and 31% of healthcare workers and students respectively, self-reported likely negative behaviour (to some extent) towards sex workers.

 

 

COVID-19 and Harm Reduction Programme Implementation: Sharing Experiences in Practice (Webinar)

Médecins du Monde Harm Reduction, April 2020

The COVID-19 pandemic is having a profound effect on the provision of health services across the globe and is further magnifying the existing barriers faced by people who use drugs in accessing harm reduction services. Programmes have had to adapt, and efforts are being made to enhance accessibility and ensure the continuity of harm reduction services in a context that is changing daily.

But what does this look like in reality, and what practical measures can be put in place to ensure that people who use drugs continue to have access to the services and support that they need?

The aim of this webinar is to facilitate an interactive discussion and share experiences on how to maintain and adapt harm reduction services during the COVID-19 pandemic.

Speakers will discuss:

• The impact of COVID-19 on the lives of people who use drugs and their use of services

• Community mobilisation and advocacy by people who use drugs

• Examples of how harm reduction programmes such as OST and NSP are continued in some countries

Organisers: Médecins du Monde, International Network of People Who Use Drugs, Harm Reduction International, European Network of People Who Use Drugs, the United Nations Office on Drugs and Crime and the World Health Organization.