Chemsex and its risk factors associated with human immunodeficiency virus among men who have sex with men in Hong Kong

The Effect of a Brief Video-Based Intervention to Improve AIDS Prevention in Older Men: Randomized Controlled Trial

Background

The AIDS epidemic among older people is becoming more serious. Evidence-based, acceptable, and effective preventive interventions are urgently needed. Video-based interventions have become an innovative way to change behaviors, and we have developed a brief video-based intervention named Sunset Without AIDS.

Objective

In this study, we tested the effectiveness of a brief video-based intervention targeting older men's understanding of AIDS prevention.

Methods

A randomized controlled trial was conducted from June 20 to July 3, 2023. In total, 100 older men were randomly divided into the intervention group (n=50) and the control group (n=50) using the envelope extraction method. The intervention group was shown the Sunset Without AIDS video; the control group viewed a standard AIDS education video. A questionnaire was used to measure the effect of Sunset Without AIDS after 2 interventions. AIDS-related high-risk behaviors were followed up 1 and 3 months after the intervention. The difference was statistically significant at P≤.05.

Results

After 2 interventions, the total awareness rates (%) of AIDS-related knowledge in the intervention and control groups were 84% (42/50) and 66% (33/50), respectively (P=.04). The mean stigma attitude scores of the 2 groups were 2.53 (SD 0.45) and 2.58 (SD 0.49), respectively (P=.55), but there was a statistically significant difference in the first dimension (fear of infection) between the 2 groups (P<.001). The mean positive scores of attitudes of AIDS-related high-risk behaviors of the 2 groups were 83.33 (SD 21.56) and 75.67 (SD 26.77), respectively (P=.58). In addition, 82% reported that they were satisfied with the educational content within the Sunset Without AIDS video. At 1- and 3-month follow-ups conducted after the intervention, participants in the 2 groups did not report AIDS-related high-risk behaviors. After watching the 2 videos, more people accepted and were satisfied with Sunset Without AIDS.

Conclusions

Sunset Without AIDS could improve the ability of older men in China to follow best practices for AIDS prevention and provide a certain basis for the innovation of AIDS education in the older adult population.

"A way to liberate myself": A qualitative study of perceived benefits and risks of chemsex among gay, bisexual, and other men who have sex with men in Almaty, Kazakhstan

BACKGROUND

In Kazakhstan, the HIV epidemic has a significant impact on marginalized groups such as gay, bisexual and other men who have sex with men (GBMSM), exacerbated by homophobic attitudes (in society) and (resulting) minority stress. This stress often leads to coping behaviors such as chemsex - the use of synthetic stimulants to enhance sexual experiences. Our study explores the motivations and perceived risks associated with chemsex among GBMSM in Almaty.

METHODS

We conducted semi-structured in-depth interviews with 21 chemsex participants self-identified as GBMSM in Almaty, Kazakhstan. Participants were recruited through community-based organizations to ensure a diverse sample in terms of age and ethnicity. Thematic analysis was used to identify key themes related to motivations and risks.

RESULTS

Participants practiced chemsex to seek liberation from societal norms and personal inhibitions, increase sexual pleasure, and escape daily stressors. Chemsex sessions provided intensified sexual experiences, emotional comfort, and social connections, challenging constraints on sexual behavior. Participants recognized significant risks, including mental and physical health issues, social stigma, and violence victimisation. Despite these risks, the desire for the perceived benefits of chemsex, particularly feelings of freedom and happiness, underscored its appeal.

CONCLUSIONS

The study reveals a complex dynamic in which chemsex serves as a coping mechanism for minority stress, a source of sexual liberation, and a social connector for GBMSM in Kazakhstan, while also posing significant health risks. These findings emphasize the need for targeted harm reduction strategies, mental health support, and community-building efforts that are responsive to the experiences and needs of GBMSM who engage in chemsex.

Application of the Delphi Method for Content Validity Analysis of a Questionnaire to Determine the Risk Factors of the Chemsex

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.

Substance use in sexual minority youth: prevalence in an urban cohort

BACKGROUND

Little comparative data on substance use (SU) between sexual minority youth (SMY) and heterosexual youth (HET) is available. This study compares the prevalence of SU in an urban cohort between SMY and HET and evaluates demographic and psychosocial predictors of SU.

METHODS

Data came from a prospective-longitudinal cohort study in an urban setting (N = 1297). SU and psychosocial variables such as internalizing symptoms, self-control, sensation-seeking, bullying-victimization, subjective stress, leisure activities, and peer influences were assessed with self-reports at age 17 and 20. SU was stratified by sex and sexual attraction, and the groups were compared using regression models, with demographic and psychosocial variables included as covariates.

RESULTS

SMY- and HET-youth displayed differences in a number of psychosocial variables. Overall, SMY- and HET-youth differed in their 12-months prevalence of SU: At age 17, SMY-females had significantly higher rates of SU than HET-females for cannabis (aOR = 2.14, p = 0.04), ecstasy/MDMA (aOR = 4.29, p = 0.01), and hallucinogens (aOR = 5.59, p = 0.02). At age 20, SMY-females had significantly higher rates of SU than HET-females for tobacco (aOR = 2.06, p = 0.03), cannabis (aOR = 2.24, p = 0.004), ecstasy/MDMA (aOR = 3.93, p < 0.001), stimulants (aOR = 3.45, p = 0.002), and hallucinogens (aOR = 6.65, p < 0.001). SMY-males reported significantly lower rates for tobacco and cannabis than HET-males at age 17. At age 20, they reported significantly higher rates for the use of ecstasy/MDMA (aOR = 2.30, p = 0.04) and hallucinogens (aOR = 2.43, p = 0.03).

CONCLUSIONS

Given that psychosocial variables were significant covariates of SMY-status and SU, our results underline the importance of accounting for these when explaining differences in SU between adolescents. While differentiation by sex is established in most studies, such standardized comparisons are lacking with regards to sexual identities. But knowledge about SU of SMY is critical for designing effective interventions. This is especially true for SMY-females: Thus, SU in SMY-females early in life needs to be explored more thoroughly and addressed with adequate prevention measures.

Impacts of psychological wellbeing with HIV/AIDS and cancer among sexual and gender minorities: A systematic review and meta-analysis

Background

The agony and economic strain of cancer and HIV/AIDS therapies severely impact patients' psychological wellbeing. Meanwhile, sexual minorities experience discrimination and mental illness. LGBT individuals with cancer and HIV/AIDS play two roles. It is important to understand and examine this groups mental wellbeing.

Objective

The purpose of this study is to synthesize current studies on the impact of HIV/AIDS and cancer on LGBT patients' psychological wellbeing.

Methods

This research uses a systematic literature review at first and later stage a meta-analysis was run on the same review. In this study, data from Google academic and Web of Science has been used to filter literature. PRISMA 2020 Flow Diagram seeks research on LGBT cancer and HIV/AIDS patients. The above sites yielded 370 related papers, some of which were removed due to age or inaccuracy. Finally, meta-analyses was done on 27 HIV/AIDS and 33 cancer patients's analyse.

Results

The research included 9,898 LGBT cancer sufferers with AIDS and 14,465 cancer sufferers with HIV/AIDS. Using meta-analysis, we discovered the gap in psychological wellbeing scores between HIV/AIDS LGBT and non-LGBT groups ranged from -10.86 to 15.63. The overall score disparity between the HIV/AIDS LGBT and non-LGBT groups was 1.270 (95% CI = 0.990-1.560, Z = 86.58, P < 0.1). The disparity in psychological wellbeing scores between cancer LGBT group and general group varies from -8.77 to 20.94 in the 34 papers examined in this study. Overall, the psychological wellbeing score disparity between the cancer LGBT subset and the general group was 12.48 (95% CI was 10.05-14.92, Test Z-value was 268.40, P-value was <0.1).

Conclusion

Inflammation and fibrosis in HIV/AIDS and cancer sufferers adversely affect their psychological wellbeing.

Health and Social Inclusion: The Impact of Psychological Well-Being and Suicide Attempts Among Older Men Who Have Sex With Men

Older adults' mental health and suicidal tendencies have garnered much attention because of their vulnerability. Few studies have examined the impact of psychological well-being and suicide attempts among older men who have sex with men (OMSM). This study examines the levels of depression and suicidal tendencies among OMSM, factors impacting their mental health, and their likelihood of committing suicide. Descriptive statistics are used to analyze the correlation between depression and suicidal tendencies among OMSM in the United States. We constructed a regression model using relevant data, and scales were selected based on a literature review. The validity and relevance of the control variables were considered. Depression and suicidal tendencies were dependent variables. Data were obtained from the U.S. General Social Survey and analyzed with an ordinary least squares model. There were significant differences between MSM and general groups in depression and suicidal tendency scores (t = 67.084, 58.193, p < .01). Compared with general groups, MSM scored significantly higher on depression and suicidal tendencies. The regression analysis revealed that sex with men was associated with depression and suicidal tendencies (p < .01) among older men. This indicates that OMSM generally have higher levels of depression and suicidal tendencies than the general population. Finally, in the intermediary test, the level of depression had a significant mediating effect on the relationship between homosexuality and suicidal tendencies (p < .01). This suggests that depression intervention can help reduce suicidal tendencies among OMSM.