Foundations of health psychology

Indigenous Theories of Contagious Disease. Edward C. Green. Walnut Creek, CA: Sage, 1999.31 lpp.

Indigenous Theories of Contagious Disease

Objective

Substance-related expectancies are associated with substance use and post-substance use thoughts, feelings and behaviours. The expectancies held by specific cultural or sub-cultural groups have rarely been investigated. This research maps expectancies specific to gay and other men who have sex with men (MSM) and their relationship with substance patterns and behaviours following use, including sexual practices (e.g., unprotected anal intercourse). This study describes the development of a measure of such beliefs for cannabis, the Cannabis Expectancy Questionnaire for Men who have Sex with Men (CEQ-MSM).
Method

Items selected through a focus group and interviews were piloted on 180 self-identified gay or other MSM via an online questionnaire.
Results

Factor analysis revealed six distinct substance reinforcement domains (“Enhanced sexual experience”, “Sexual negotiation”, “Cognitive impairment”, “Social and emotional facilitation”, “Enhanced sexual desire”, and “Sexual inhibition”). The scale was associated with consumption patterns of cannabis, and in a crucial test of discriminant validity not with the consumption of alcohol or stimulants.
Conclusions

The CEQ-MSM represents a reliable and valid measure of outcome expectancies, related to cannabis among MSM. Future applications of the CEQ-MSM in health promotion, clinical settings and research may contribute to reducing harm associated with substance use among MSM, including HIV transmission.

The Amyl nitrite expectancy questionnaire for men who have sex with men (AEQ-MSM): A measure of substance-related beliefs

Background The national guideline extends the recommendation for initiating antiretroviral therapy in HIV infected persons, regardless of baseline CD4 since 2013 but the choice of treatment regimens in our guide is determined by the CD4 levels. Objectives: analyzing ART regimens prescribed in newly HIV-infected patients, identifying the factors that influenced regimens choice and analyzing viro-immunological evolution under therapy.

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Initiating the antiretroviral therapy in treatment-naïve patients

Substance use within the LGBTIQ community has been long established. However chemsex, the use of recreational substances within the context of sexual activity (for the purpose of enhancement), is a new and emerging area of research, particularly in Australia. Chemsex is most commonly associated with men who have sex with men (MSM) and often involves stimulants, such as crystal methamphetamine. The current study was developed in partnership with the Queensland AIDS Council to inform future health promotion. Participants were 663 MSM, the majority of whom resided in South East Queensland. Questionnaires were completed online or on paper. The questionnaire asked about demographic details, substances used in the last 12 months, sexual health details and engagement in a variety of sexual behaviours, including chemsex. Those who reported engagement in chemsex were asked further questions about these behaviours. Descriptive results provided rates of substance use within particular sub-groups. In addition, it was found that crystal methamphetamine was associated with increased rates of condomless anal intercourse (CAI); increased sexual session length was found to increase the likelihood of engagement in CAI; chemsex, use of PrEP and having an undetectable viral load (UVL) were also shown to be significant predictors of CAI. Finally, chemsex and PrEP were shown to be significantly associated with increased reporting of sexually transmitted infections. These results provide useful insight for future HIV prevention, health promotion and clinical intervention planning. Implications for chemsex participants and the wider MSM community are discussed and recommendations for future research are made.

Madeleine Ray

Papers

An exploration of ‘chemsex’ in an Australia sample: when drug use and high risk sex intersect