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.

 

 

Changing Epidemiology of Gonorrhea in Adelaide, South Australia

Ellis SL, Tsourtos G, Waddell R, Woodman R, Miller ER.

Changing Epidemiology of Gonorrhea in Adelaide, South Australia.

Sex Transm Dis. 2020 Jun;47(6):402-408. doi: 10.1097/OLQ.0000000000001162.

Abstract

Background: Gonorrhea is a significant public health concern. The changing epidemiology of gonorrhea in Australia has highlighted the need for detailed examination of surveillance data to determine population groups at greatest risk for infection.

Methods: We analyzed deidentified gonorrhea notification data for the years 2012 to 2017, in Adelaide (N = 3680), calculating age-adjusted notification and antibiotic resistance rates. Age, gender, year, sexual orientation, and socioeconomic status were assessed for associations with gonorrhea notifications using negative binomial, log binomial and spatial autoregressive models. Maps were generated to examine spatial localization of gonorrhea rates in Adelaide.

Results: Gonorrhea notification rates in Adelaide increased annually, with a 153% adjusted increase in rates from 2012 to 2017, localized to specific areas and inversely associated with income levels. The increase in rates in 2016 and 2017 was associated with young heterosexuals from low income areas. Azithromycin-resistant notifications increased significantly in 2016 in young heterosexuals. Reinfections were significantly more likely in men who have sex with men than other population groups.

Conclusions: This study demonstrates the changing epidemiology of gonorrhea in Adelaide from a largely men who have sex with men profile toward an increase in young heterosexual gonorrhea. This could be seen as a harbinger for future increases in heterosexually transmitted HIV and other sexually transmitted infections in Australia.

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Disparities in characteristics in accessing public Australian sexual health services between Medicare‐eligible and Medicare‐ineligible MSM

Disparities in characteristics in accessing public Australian sexual health services between Medicare‐eligible and Medicare‐ineligible men who have sex with men

Australian and New Zealand Journal of Public Health

Anysha M. Walia, Christopher K. Fairley, Catriona S. Bradshaw, Marcus Y. Chen, Eric P.F. Chow

First published: 31 August 2020
https://doi.org/10.1111/1753-6405.13029
Abstract:

Objectives: Accessible health services are a key element of effective human immunodeficiency virus (HIV) and sexually transmitted infection (STI) control. This study aimed to examine whether there were any differences in accessing sexual health services between Medicare‐eligible and Medicare‐ineligible men who have sex with men (MSM) in Melbourne, Australia.

Methods: We conducted a retrospective, cross‐sectional study of MSM attending Melbourne Sexual Health Centre between 2016 and 2019. Demographic characteristics, sexual practices, HIV testing practices and STI diagnoses were compared between Medicare‐eligible and Medicare‐ineligible MSM.

Results: We included 5,085 Medicare‐eligible and 2,786 Medicare‐ineligible MSM. Condomless anal sex in the past 12 months was more common in Medicare‐eligible compared to Medicare‐ineligible MSM (74.4% vs. 64.9%; p<0.001) although the number of partners did not differ between groups. There was no difference in prior HIV testing practices between Medicare‐eligible and Medicare‐ineligible MSM (76.1% vs. 77.7%; p=0.122). Medicare‐ineligible MSM were more likely to have anorectal chlamydia compared to Medicare‐eligible MSM (10.6% vs. 8.5%; p=0.004).

Conclusions: Medicare‐ineligible MSM have less condomless sex but a higher rate of anorectal chlamydia, suggesting they might have limited access to STI testing or may be less willing to disclose high‐risk behaviour.

Implications for public health: Scaling up access to HIV and STI testings for Medicare‐ineligible MSM is essential.

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)

How sexual assault survivors can feel in control during cervical screenings

ABC Life By Kellie Scott / 12th August 2020
Kate* avoids cervical screenings.The 34-year-old from Sydney is a survivor of sexual assault and finds the physical examination re-traumatising.

Kate’s experience is not unique.

One in five Australian women has experienced sexual violence since the age of 15. And research shows those who have experienced sexual abuse, either as adults or children, are less likely to attend regular cervical screening.

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