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[Abstract] ‘I was struggling to feel intimate, the drugs just helped’. Chemsex and HIV-risk among men who have sex with men (MSM) in the UK: syndemics of stigma, minority-stress, maladaptive coping and risk

conference contribution
posted on 2023-06-09, 07:09 authored by Alexander Pollard, Tom Nadarzynski, Carrie LlewellynCarrie Llewellyn
Introduction: There has been a steep rise in the use of drugs during sex by some men who have sex with men (MSM), with associated increases in sexual risk for HIV and other STIs. This ‘Chemsex’ has been described, but there is a lack of theoretical perspectives applied to this particular phenomenon. We aimed to assess participants’ reasoning and conceptualisation of Chemsex and situate this within theoretical frameworks. Methods: This study presents data from telephone interviews with 15 MSM attending sexual health clinics following a risk of HIV and accessing post-exposure prophylaxis (PEP). Interviews were conducted as part of a larger interventional study, which used an adapted version of Motivational Interviewing to explore risk behaviour and support change. We used Framework analysis on interview transcripts in order to understand participants’ perspectives on the use of chemsex. Results: Participants conceptualised their chemsex and HIV risks in their psycho-social context, highlighting the influence of the psycho-socio-cultural challenges of homophobic marginalisation and the ‘gay scene’ on their behaviour. Narratives of loneliness and difficulties in forming satisfying social and sexual relationships were repeatedly identified. Discussion: Multiple influences of stigma, minority stress and maladaptive coping (including drug-use) are seen to contribute to syndemic ‘risk-environments’ in which chemsex and risk behaviours are played out. Interventions to address the harms of chemsex must recognise the complex psychosocial context of risk, and shift the responsibility for change from vulnerable individuals to a shared responsibility distributed across social, political and institutional contexts.

Funding

PEPSE; G0773; NATIONAL INSTITUTE FOR HEALTH RESEARCH; PB-PG-011021005

History

Publication status

  • Published

File Version

  • Published version

Journal

Sexually Transmitted Infections

ISSN

1368-4973

Publisher

BMJ Publishing Group

Issue

Suppl

Volume

93

Article number

A5

Event name

British Association for Sexual Health and HIV Annual Conference

Event location

Belfast

Event type

conference

Event date

18-20/6/2017

Place of publication

London

Department affiliated with

  • Primary Care and Public Health Publications

Notes

Published oral conference presentation

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2017-07-13

First Open Access (FOA) Date

2017-07-13

First Compliant Deposit (FCD) Date

2017-07-12

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