The counselors’ perspective on the use of methamphetamine in a sexual context among men who have sex with men
Abstract
Background
The use of methamphetamine in sexual contexts (chemsex) among men who have sex with men (MSM) concerns stakeholders. This population is confronted to a complex syndemic between substance use and sexual health. Therefore, there is a need to develop integrated and collaborative interventions. The understanding of the counsellors’ perspective is necessary to improve the adequacy of services and to develop harm reduction interventions for MSM who use methamphetamine.This study aims to understand the actual services offered to MSM and the counselors’ needs.
Methodology
Counselors offering services in substance use and sexual health to MSM were recruited by community organizations. One focus group was conducted with counselors (n=10) in Montreal (Canada). Based on audio-record, a thematic analysis was realized on their services and their needs.
Results
Sexual health is the transversal theme discussed by the participants. However, some found the link between sexual health and substance use not clear. They perceived that MSM who use methamphetamine would need more information about their substance use and that they should be less involved in their sexual activities. For the others, asking MSM to stop having sexuality while using methamphetamine doesn’t seem a good solution. Currently, few services exist and the one that exist aren’t well known. Therefore, counselors are confronted to provide out field interventions and refer to services that even doesn’t correspond to MSM needs.
Conclusion
The results of this study suggest that it is essential to think about the development of new services or more integrated interventions that would address sexuality and substance use. In order to develop tools and intervention strategies that meet needs of MSM, specific training should be developed. Consistent with a syndemic approach, an intervention based on harm reduction seems to be a good way to support MSM who use methamphetamine.