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del Pozo-Herce P, Martínez-Sabater A, Chover-Sierra E, Gea-Caballero V, Satústegui-Dordá PJ, Saus-Ortega C, Tejada-Garrido CI, Sánchez-Barba M, Pérez J, Juárez-Vela R, Santolalla-Arnedo I, Baca-García E. Application of the Delphi Method for Content Validity Analysis of a Questionnaire to Determine the Risk Factors of the Chemsex. Healthcare (Basel) 2023; 11:2905. [PMID: 37958049 PMCID: PMC10649857 DOI: 10.3390/healthcare11212905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
Chemsex is understood as "the intentional use of stimulant drugs to have sex for an extended time among gay, bisexual, and other men who have sex with men". It is a public health problem because of the increased incidence of cases and because of the consequences on the physical and mental health of those who practice it. AIM This study aimed to analyze, with the help of the Delphi method, the content validity of a new instrument to assess the risk of behaviors associated with the chemsex phenomenon. METHOD First, a bank of items identified from the literature was elaborated. Secondly, 50 experts with knowledge of the chemsex phenomenon at the national level were contacted. A Delphi group was formed with them to carry out two rounds of item evaluation. The linguistic evaluation (comprehension and appropriateness) was assessed using a Likert scale from 1 to 5 for each item. Items that did not reach a mean score of 4 were eliminated. Content assessment was calculated using each item's content validity index (CVI) and Aiken's V (VdA). A minimum CVI and VdA value of 0.6 was established to include the items in the questionnaire. RESULTS A total of 114 items were identified in the literature. In the first round of Delphi evaluation, 36 experts evaluated the items. A total of 58 items were eliminated for obtaining a CVI or VdA of less than 0.6, leaving 56 items. In a second Delphi round, 30 experts re-evaluated the 56 selected items, where 4 items were eliminated for being similar, and 10 items were also eliminated for not being relevant to the topic even though they had values higher than 0.6, leaving the scale finally composed of 52 items. CONCLUSION A questionnaire has been designed to assess the risk of behaviors associated with the chemsex phenomenon. The items that make up the questionnaire have shown adequate content and linguistic validity. The Delphi method proved to be a helpful technique for the proposed objective.
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Affiliation(s)
- Pablo del Pozo-Herce
- Department of Psychiatry, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (P.d.P.-H.); (E.B.-G.)
- Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Antonio Martínez-Sabater
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 Valencia, Spain; (A.M.-S.); (E.C.-S.)
- Care Research Group (INCLIVA), Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | - Elena Chover-Sierra
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 Valencia, Spain; (A.M.-S.); (E.C.-S.)
- Internal Medicine, Consorci Hospital University of Valencia, 46014 Valencia, Spain
| | - Vicente Gea-Caballero
- Research Group Community Health and Care, International University of Valencia, 46002 Valencia, Spain;
- Faculty of Health Sciences, International University of Valencia, 46002 Valencia, Spain
| | - Pedro José Satústegui-Dordá
- SAPIENF (B53_23R) Research Group, Faculty of Health Sciences, University of Zaragoza, 50018 Zaragoza, Spain;
| | - Carles Saus-Ortega
- Nursing School La Fe, Adscript Centre, University of Valencia, 46026 Valencia, Spain;
- Research Group GREIACC, Health Research Institute La Fe, 46016 Valencia, Spain
| | - Clara Isabel Tejada-Garrido
- Research Group in Care, Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain; (C.I.T.-G.); (I.S.-A.)
| | | | - Jesús Pérez
- Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain; (M.S.-B.); (J.P.)
- Department of Psychiatry, University of Cambridge, Cambridge CB2 1TN, UK
- Prevention and Early Intervention in Mental Health (PRINT), Biomedical Institute of Salamanca, 37008 Salamanca, Spain
| | - Raúl Juárez-Vela
- Research Group in Care, Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain; (C.I.T.-G.); (I.S.-A.)
- Prevention and Early Intervention in Mental Health (PRINT), Biomedical Institute of Salamanca, 37008 Salamanca, Spain
| | - Iván Santolalla-Arnedo
- Research Group in Care, Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain; (C.I.T.-G.); (I.S.-A.)
| | - Enrique Baca-García
- Department of Psychiatry, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain; (P.d.P.-H.); (E.B.-G.)
- Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, 28040 Madrid, Spain
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Rosas Cancio-Suárez M, Ron R, Díaz-Álvarez J, Martínez-Sanz J, Serrano-Villar S, Moreno S, Sánchez-Conde M. Prevalence, characteristics, and associated risk factors of drug consumption and chemsex use among individuals attending an STI clinic (EpITs STUDY). Front Public Health 2023; 11:1285057. [PMID: 38026436 PMCID: PMC10644726 DOI: 10.3389/fpubh.2023.1285057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Sex-related drug consumption and its health-related consequences have gained relevance in the assessment of patients with sexually transmitted infections (STIs), which pose a significant challenge to public health. We aim to assess the prevalence and characteristics of drug consumption and chemsex practices, describe the associated risk factors among general individuals attending an STI clinic, and evaluate the psychological impact associated with these behaviors. We conducted an online anonymous survey offered to patients with a diagnosis of STI in a tertiary hospital in Spain. Data included sociodemographic characteristics, sexual preferences and behavior, and assessment of drug use, chemsex, and psychological and mental health symptoms. Data from 145 subjects was collected, with a higher proportion of cis-gender men (71%), and a median age of 32 years. 64 participants (44%) reported drug use in the last year, with an observed 33.8% prevalence of chemsex consumption. Drug use and chemsex were more frequent among cis-gender men, Men who have Sex with Men (MSM), people living with HIV (PLHIV), and those reporting previous group sex. Poppers and cannabis were the most frequently reported drugs, with a prevalence close to 20% for cocaine, mephedrone, extasis, and GHB. Consequences related to drug use included unpleasant physical sensations, sexual dysfunction, and impaired sexual experience after reduction or drug discontinuation. The prevalence of drug use and chemsex practices are high among patients evaluated for STIs, especially between men, MSM, and subjects practicing group sex. The study highlights the urgent need for targeted interventions on prevention and reduction of their impact on health and social well-being.
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Affiliation(s)
- Marta Rosas Cancio-Suárez
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Raquel Ron
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Jorge Díaz-Álvarez
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Javier Martínez-Sanz
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Sergio Serrano-Villar
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Santiago Moreno
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Department of Medicine, University of Alcalá de Henares, Madrid, Spain
| | - Matilde Sánchez-Conde
- Department of Infectious Diseases, Hospital Ramón y Cajal, Carretera de Colmenar, Madrid, Spain
- Ramón y Cajal Research Institute (IRYCIS), Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
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Palmer L, Maviglia F, Wickersham JA, Khati A, Kennedy O, Copenhaver NM, Uyer C, Halim MAA, Ikhtiaruddin WM, Azwa I, Gautam K, Shrestha R. Chemsex and Harm Reduction Practices Among Men Who Have Sex with Men in Malaysia: Findings from a Qualitative Study. J Psychoactive Drugs 2023:1-10. [PMID: 37610135 PMCID: PMC10884347 DOI: 10.1080/02791072.2023.2250342] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 07/10/2023] [Indexed: 08/24/2023]
Abstract
Chemsex is a form of sexualized drug use commonly practiced among MSM with psychoactive substances, such as methamphetamine. While this phenomenon has gained global attention in the past two decades, there is a dearth of empirical data to inform culturally competent interventions. The current work investigates the socio-contextual factors related to chemsex and harm reduction practices among Malaysian MSM. Between February and August 2022, we conducted six online focus group sessions with Malaysian MSM who had engaged in chemsex during the previous 6 months (N = 22). We queried participants about perceived benefits and harms, harm reduction practices, and informational needs. Most participants' first chemsex experience occurred in a casual sexual encounter, often facilitated by mobile technology. Participants reported engaging in harm reduction practices before (e.g. medication reminders), during (e.g. peer support), and after (e.g. rest) chemsex. These findings have implications for future efforts to develop and implement tailored interventions to address the specific and acute needs of Malaysian MSM engaging in chemsex.
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Affiliation(s)
- Lindsay Palmer
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Francesca Maviglia
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Jeffrey A Wickersham
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Antoine Khati
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Olivia Kennedy
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | | | - Christopher Uyer
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Mohd Akbar Ab Halim
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Mohd Ikhtiaruddin
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Iskandar Azwa
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kamal Gautam
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Roman Shrestha
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Chemsex and Psychosis: A Systematic Review. Behav Sci (Basel) 2022; 12:bs12120516. [PMID: 36546999 PMCID: PMC9774634 DOI: 10.3390/bs12120516] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Chemsex is presented as a major challenge in public health, with numerous physical and mental consequences. The general objective of this review was to analyze the relationship between the practice of chemsex and the development of psychosis. A mixed systematic review model was chosen. PubMed, PsycINFO, and Web of Science databases were searched following a predetermined search strategy. The studies were selected, and their information was extracted following a systematic method. A total of 10 articles were included. Psychotic symptoms ranged from 6.7% to 37.2%, being one of the most frequent psychiatric diagnoses. Slamsex, polydrug use and smoked methamphetamine posed up to a 3-fold increased risk of psychosis within this practice. The risk factors found were foreign or ethnic minority status, location in large cities, stress and anxiety, trauma, loneliness, sexually transmitted infections (STIs), hepatitis, and previous psychotic history. In conclusion, chemsex is associated with psychosis development; we found numerous converging risk factors and a clear mediating role of drugs. It is important, in approaching the prevention and treatment of this addiction, to take into account motivations and psychosocial circumstances.
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López de Juan Abad P, Arcos-Romero AI. Substance Use in Sexual Relationships: Association with Sexual Assertiveness and Sexual Satisfaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13645. [PMID: 36294225 PMCID: PMC9603347 DOI: 10.3390/ijerph192013645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The main objective was to examine sexual assertiveness and sexual satisfaction in people who have sex under the influence of alcohol and drugs, considering the type of substance consumed, the frequency of consumption, gender, and sexual orientation. METHODS The sample consisted of 274 adults who had sexual relationships consuming substances. A questionnaire composed of sociodemographic, sexual history and substance use items, the Sexual Assertiveness Scale and the Global Measure of Sexual Satisfaction were administered. RESULTS Gender differences were found in sexual assertiveness and in the frequency of substance use. Women reported greater sexual assertiveness and greater alcohol consumption. Men reported greater consumption of different types of substances. Furthermore, bisexual participants showed greater assertiveness and STI prevention. Homosexual participants reported a higher frequency of the consumption of poppers, mephedrone, and GBL/GHB. Sexual assertiveness was associated with sexual satisfaction. Greater consumption of some types of substances was related to sexual assertiveness, STI prevention, and sexual satisfaction. CONCLUSIONS The association found between sexual assertiveness and sexual satisfaction in a specific context of substance use in sexual relationships corroborates the important role that these psychosexual variables have in sexual health, in view of the frequency and type of drug consumed, gender, and sexual orientation.
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