The needs of professionals working on sexualized substance use and its implications for health and social services

Background: Sexual and gender minority people who engage in sexualized substance use (SSU) require tailored and culturally sensitive interventions, but professionals are often ill-prepared to intervene with this population. The aim of this research is to identify the needs of professionals working with sexual and gender minority people who engaged in SSU and the ways to improve the quality of services and interventions they offer.

Methods: We thematically analysed data from 22 in-depth semi-structured interviews conducted in the fall 2021 with managers and counselors who work with sexual and gender minority people who engaged in SSU in the province of Québec (Canada).

Results: Participants expressed a lack of confidence when discussing sexual and gender minority and express fear in using terms that may be offensive. They also shared a need for training on various topics, such as gaining greater knowledge on the experiences of oppression and its effects on sexual and gender minority people and SSU practices among that population. Participants identified the need to appropriately accommodate people involved in SSU, such as having respite beds and providing outreach services. From a harm reduction perspective, participants stressed the importance of having SSU supplies and equipment in addiction services. This includes pipes for smoking methamphetamine, needle-less syringes for anal injection and providing drug checking services. Participants stressed the importance of involving peer support workers into their teams as an impactful strategy to provide optimal care to sexual and gender minority people.

Conclusion: Training on SSU and on sexual and gender diversity are not always easily accessible to those working amongst them (lack of trainers, paid training). Moreover, public health policies should consider the need for substance use organizations to involve peers as staff members as well as to support the set-up of drug checking services.