Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

Links SU-Sex: development of a screening tool for health-risk sexual behaviours related to substance use among men who have sex with men

Mathieu Goyette A B C F , Jorge Flores-Aranda A B C , Karine Bertrand A B C , Frédérick Pronovost D , Valérie Aubut A , Roberto Ortiz E and Marianne Saint-Jacques A
+ Author Affiliations
- Author Affiliations

A Department of Community Health Sciences, Addiction Research Study Program, University of Sherbrooke, 150 Place Charles-Le-Moyne, bureau 200, Longueuil, QC, J4K 0A8, Canada.

B Centre de recherche – Hôpital Charles-Le Moyne, 150 Place Charles-Le Moyne, bureau 200, Longueuil, QC, J4K 0A8, Canada.

C Institut Universitaire sur les Dépendances, 950 rue Louvain Est, Montréal, QC, H2M 2E8, Canada.

D RÉZO – Santé et mieux-être des hommes gais et bisexuels, cisgenres et transgenres, 2075 rue Plessis, C.P. 246, Succursale C., Montréal, QC, H2L 4K1, Canada.

E MAX – Ottawa’s Health Connection for Guys into Guys, 251 rue Bank St., 5th floor, Ottawa, ON, K2P 1X3, Canada.

F Corresponding author. Email: mathieu.goyette@usherbrooke.ca

Sexual Health 15(2) 160-166 https://doi.org/10.1071/SH17134
Submitted: 1 August 2017  Accepted: 12 January 2018   Published: 16 March 2018

Abstract

Background: Men who have sex with men (MSM) have distinctive substance use (SU), which is more often linked to a sexual context than it is for their heterosexual peers. Screening of MSM’s SU, its sexual contexts and the associated risks, is of clinical and public health concern. This paper aims to describe the preliminary development of a screening tool for health-risk sexual behaviours related to SU and to make recommendations for its potential use. Methods: Community-based participatory research and transdisciplinary approaches guided the development process. The Links SU-Sex screening tool is the result of the integration of findings from a scoping review and from four meetings among SU and sexual health experts (n = 19), consisting of researchers, community stakeholders, as well as substance-using MSM. Results: The Links SU-Sex questionnaire consists of 64 items divided into 13 components that focus on the links between SU and sexual health. It addresses the contexts in which SU occurs, its frequency, its perceived influence, as well as MSM’s concerns about these various links. In accordance with current knowledge, the interpretation of the instrument offers feedback that is based on the respondents’ answers to the various components assessed. Conclusions: The Links SU-Sex represents a potential screening tool that rests on a robust development process supporting its content validity that aims to identify MSM at risk or with concerns surrounding the influence of their SU on their sexual health. The psychometric qualities and the interpretation validity both remain to be established.

Additional keywords: alcohol and drug use, chemsex, harm reduction, screening tool, sexual health, sex under the influence.


References

[1]  Green KE, Feinstein BA. Substance use in lesbian, gay, and bisexual populations: an update on empirical research and implications for treatment. Psychol Addict Behav 2012; 26 265–78.
Substance use in lesbian, gay, and bisexual populations: an update on empirical research and implications for treatment.CrossRef |

[2]  Buffin J, Roy A, Williams H, Winter A. Part of the picture: lesbian, gay and bisexual people’s alcohol and drug use in England (2009–2011). Lancashire: The National LGB Drug and Alcohol Database; 2012.

[3]  McKay TA, McDavitt B, George S, Mutchler MG. “Their type of drugs”: perceptions of substance use, sex and social boundaries among young African American and Latino gay and bisexual men. Cult Health Sex 2012; 14 1183–96.
“Their type of drugs”: perceptions of substance use, sex and social boundaries among young African American and Latino gay and bisexual men.CrossRef |

[4]  Hickson F, Bonell C, Weatherburn P, Reid D. Illicit drug use among men who have sex with men in England and Wales. Addict Res Theory 2010; 18 14–22.
Illicit drug use among men who have sex with men in England and Wales.CrossRef |

[5]  Patterson TL, Semple SJ, Zians JK, Strathdee SA. Methamphetamine-using HIV-positive men who have sex with men: correlates of polydrug use. J Urban Health 2005; 82 i120–6.
Methamphetamine-using HIV-positive men who have sex with men: correlates of polydrug use.CrossRef |

[6]  Folch C, Esteve A, Zaragoza K, Munoz R, Casabona J. Correlates of intensive alcohol and drug use in men who have sex with men in Catalonia, Spain. Eur J Public Health 2010; 20 139–45.
Correlates of intensive alcohol and drug use in men who have sex with men in Catalonia, Spain.CrossRef |

[7]  Myers T, Aguinaldo JP, Dakers D, Fischer B, Bullock S, Millson P, Calzavara L. How drug using men who have sex with men account for substance use during sexual behaviours: questioning assumptions of HIV prevention and research. Addict Res Theory 2004; 12 213–29.
How drug using men who have sex with men account for substance use during sexual behaviours: questioning assumptions of HIV prevention and research.CrossRef |

[8]  O’Byrne P, Holmes D. Desire, drug use and unsafe sex: a qualitative examination of gay men who attend gay circuit parties. Cult Health Sex 2011; 13 1–13.
Desire, drug use and unsafe sex: a qualitative examination of gay men who attend gay circuit parties.CrossRef |

[9]  Bourne A, Reid D, Hickson F, Torres-Rueda S, Steinberg P, Weatherburn P. “Chemsex” and harm reduction need among gay men in South London. Int J Drug Policy 2015; 26 1171–6.
“Chemsex” and harm reduction need among gay men in South London.CrossRef |

[10]  Race K, Lea T, Murphy D, Pienaar K. The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men. Sex Health 2017; 14 42–50.
The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men.CrossRef |

[11]  Hardesty M, Cao D, Shin H-C, Andrews CM, Marsh J. Social and health service use and treatment outcomes for sexual minorities in a National sample of substance abuse treatment programs. J Gay Lesbian Soc Serv 2012; 24 97–118.
Social and health service use and treatment outcomes for sexual minorities in a National sample of substance abuse treatment programs.CrossRef |

[12]  Allen JL, Mowbray O. Sexual orientation, treatment utilization, and barriers for alcohol related problems: findings from a nationally representative sample. Drug Alcohol Depend 2016; 161 323–30.
Sexual orientation, treatment utilization, and barriers for alcohol related problems: findings from a nationally representative sample.CrossRef |

[13]  McCabe SE, West BT, Hughes TL, Boyd CJ. Sexual orientation and substance abuse treatment utilization in the United States: results from a national survey. J Subst Abuse Treat 2013; 44 4–12.
Sexual orientation and substance abuse treatment utilization in the United States: results from a national survey.CrossRef |

[14]  Cochran BN, Peavy KM, Robolm JS. Do specialized services exist for LGBT individuals seeking treatment for substance misuse? A study of available treatment programs. Subst Use Misuse 2007; 42 161–76.
Do specialized services exist for LGBT individuals seeking treatment for substance misuse? A study of available treatment programs.CrossRef |

[15]  Keogh P, Reid D, Bourne A, Weatherburn P, Hickson F, Jessup K, Hammond G. Wasted opportunities. Problematic alcohol and drug use among gay and bisexual men. London: Sigma Research; 2009.

[16]  Barbara AM. Substance abuse treatment with lesbians, gay, and bisexual people: a qualitative study of services providers. J Gay Lesbian Soc Serv 2002; 14 1–17.
Substance abuse treatment with lesbians, gay, and bisexual people: a qualitative study of services providers.CrossRef |

[17]  Eliason MJ. Substance abuse counselor’s attitudes regarding lesbian, gay, bisexual, and transgendered clients. J Subst Abuse 2000; 12 311–28.
Substance abuse counselor’s attitudes regarding lesbian, gay, bisexual, and transgendered clients.CrossRef | 1:STN:280:DC%2BD3MvgtF2ksw%3D%3D&md5=dc3e35914903676c40a242e9146b8f89CAS |

[18]  Schmidt AJ, Bourne A, Weatherburn P, Reid D, Marcus U, Hickson F. Illicit drug use among gay and bisexual men in 44 cities: findings from the European MSM Internet Survey (EMIS). Int J Drug Policy 2016; 38 4–12.
Illicit drug use among gay and bisexual men in 44 cities: findings from the European MSM Internet Survey (EMIS).CrossRef |

[19]  Bonell C, Watherburn P, Rhodes T, Hickson F, Keogh P, Elford J. Addressing gay men’s use of methamphetamine and other substances. Addict Res Theory 2008; 16 417–20.
Addressing gay men’s use of methamphetamine and other substances.CrossRef |

[20]  Lovett C, Yamamoto T, Hunter L, White J, Dargan PI, Wood DM. Problematic recreational drug use: is there a role for outpatient sexual health clinics in identifying those not already engaged with treatment services? Sex Health 2015; 12 501–5.
Problematic recreational drug use: is there a role for outpatient sexual health clinics in identifying those not already engaged with treatment services?CrossRef |

[21]  Flores JM, Santos G-M, Makofane K, Arreola S, Ayala G. Availability and use of substance abuse treatment programs among substance-using men who have sex with men worldwide. Subst Use Misuse 2017; 52 666–73.
Availability and use of substance abuse treatment programs among substance-using men who have sex with men worldwide.CrossRef |

[22]  Moradi B, Mohr JJ, Worthington RL, Fassinger RE. Counseling psychology research on sexual (orientation) minority issues: conceptual and methodological challenges and opportunities. J Couns Psychol 2009; 56 5–22.
Counseling psychology research on sexual (orientation) minority issues: conceptual and methodological challenges and opportunities.CrossRef |

[23]  Canadian Institutes of Health Research. CIHR HIV/AIDS Community-based research. Health research in action. Ottawa: Government of Canada; 2016. Available online at: http://www.cihr-irsc.gc.ca/e/25835.html [verified November 2017].

[24]  Abell N, Springer DW, Kamata A. Developing and validating rapid assessment instruments. Oxford: Oxford University Press; 2009.

[25]  Haynes RB, Richard D, Kubany ES. Content validity in psychological assessment: a functional approach to concepts and methods. Psychol Assess 1995; 7 238–47.
Content validity in psychological assessment: a functional approach to concepts and methods.CrossRef |

[26]  DeVellis RF. Scale development: Theory and applications. Thousand Oaks: SAGE; 2012.

[27]  Israel BA, Schulz AJ, Parker EA, Becker AB, Community-Campus Partnerships for Health Community-based participatory research: Policy recommendations for promoting a partnership approach in health research. Educ Health (Abingdon) 2001; 14 182–97.
Community-based participatory research: Policy recommendations for promoting a partnership approach in health research.CrossRef | 1:STN:280:DC%2BD2c%2Fkt1yrsw%3D%3D&md5=9c5003f79f8858858e6cd7bebb71cb3dCAS |

[28]  Greaves L, Poole N, Boyle E, editors. Transforming addiction: gender, trauma, transdisciplinarity. New York: Routledge; 2015.

[29]  Hall KL, Feng AX, Moser RP, Stokols D, Taylor BK. Moving the science of team science forward: collaboration and creativity. Am J Prev Med 2008; 35 S243–9.
Moving the science of team science forward: collaboration and creativity.CrossRef |

[30]  Kessel F, Rosenfield PL. Toward transdisciplinary research: historical and contemporary perspectives. Am J Prev Med 2008; 35 S225–34.
Toward transdisciplinary research: historical and contemporary perspectives.CrossRef |

[31]  Higgins DL, Metzler M. Implementing community-based participatory research centers in divers urban settings. J Urban Health 2001; 78 488–94.
Implementing community-based participatory research centers in divers urban settings.CrossRef | 1:STN:280:DC%2BD3MrhvVSjsg%3D%3D&md5=fab3ea7ccd206cd992a30a3270bdbc81CAS |

[32]  Israel BA, Krieger J, Vlahiv D, Ciske S, Foley M, Fortin P, Guzman RJ, Lichtenstein R, McGranaghan R, Palermo AG, Tang G. Challenges and facilitating factors in sustaining community-based participatory research partnerships: lessons learned from the Detroit, New York City and Seattle Urban Research Centers. J Urban Health 2006; 83 1022–40.
Challenges and facilitating factors in sustaining community-based participatory research partnerships: lessons learned from the Detroit, New York City and Seattle Urban Research Centers.CrossRef |

[33]  Flicker S, Wilson M, Travers R, Bereket T, McKay C, van der Meulen A, Guta A, Cleverly S, Rourke SB. Community-based research in AIDS-service organizations: what helps and what doesn’t? AIDS Care 2009; 21 94–102.
Community-based research in AIDS-service organizations: what helps and what doesn’t?CrossRef |

[34]  Otis J. De l’émergence d’un besoin à la pérennisation de l’action: Un modèle de recherche participative avec les communautés. In Otis J, Bernier M, Lévy JJ, editors. La recherche communautaire VIH/sida. Montréal: Presse de l’Université du Québec; 2015. pp. 185–220.

[35]  Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares Baldini C. Guidance for conducting systematic scoping reviews. Int J Evid-Based Healthc 2015; 13 141–6.
Guidance for conducting systematic scoping reviews.CrossRef |

[36]  Petticrew M, Roberts H. Systematic reviews in the social sciences: a practical guide. Malden: Blackwell Publishing; 2008.

[37]  Otis J, Bernier M, Lévy JJ. La recherche communautaire VIH/SIDA. Montréal: Les Presses de l’Université du Québec; 2015.

[38]  Miles MB, Huberman AM, Saldana J. Qualitative data analysis: a methods sourcebook, 3th edn. Thousand Oaks: Sage Publications; 2014.

[39]  Crosby GM, Stall RD, Paul JP, Barrett DC, Midanik LT. Condom use among gay/bisexual male substance abusers using the timeline follow-back method. Addict Behav 1996; 21 249–57.
Condom use among gay/bisexual male substance abusers using the timeline follow-back method.CrossRef | 1:STN:280:DyaK283ptFOlsQ%3D%3D&md5=aad5d0018c69beae532d692b55f98571CAS |

[40]  Kahler CW, Wray TB, Pantalone DW, Mastroleo NR, Kruis RD, Mayer KH, Monti PM. Assessing sexual motives for drinking alcohol among HIV-positive men who have sex with men. Psychol Addict Behav 2015; 29 247–53.
Assessing sexual motives for drinking alcohol among HIV-positive men who have sex with men.CrossRef |

[41]  Rawson RA, Washton A, Domier CP, Reiber C. Drugs and sexual effects: role of drug type and gender. J Subst Abuse Treat 2002; 22 103–8.
Drugs and sexual effects: role of drug type and gender.CrossRef |

[42]  Drabkin AS, Sikkema KJ, Wilson PA, Meade CS, Hansen NB, DeLorenzo A, Kochman A, MacFarlane JC, Watt MH, Aunon FM, Ranby KW, Mayer G. Risk patterns preceding diagnosis among newly HIV-diagnosed men who have sex with men in New York City. AIDS Patient Care STDS 2013; 27 333–41.
Risk patterns preceding diagnosis among newly HIV-diagnosed men who have sex with men in New York City.CrossRef |

[43]  Irwin TW, Morgenstern J. Drug-use patterns among men who have sex with men presenting for alcohol treatment: differences in ethnic and sexual identity. J Urban Health 2005; 82 i127–33.
Drug-use patterns among men who have sex with men presenting for alcohol treatment: differences in ethnic and sexual identity.CrossRef |

[44]  Irwin TW, Morgenstern J, Parsons JT, Wainberg M, Labouvie E. Alcohol and sexual HIV risk behavior among problem drinking men who have sex with men: an event level analysis of timeline followback data. AIDS Behav 2006; 10 299–307.
Alcohol and sexual HIV risk behavior among problem drinking men who have sex with men: an event level analysis of timeline followback data.CrossRef |

[45]  Vosburgh HW, Mansergh G, Sullivan PS, Purcell DW. A review of the literature on event-level substance use and sexual risk behavior among men who have sex with men. AIDS Behav 2012; 16 1394–410.
A review of the literature on event-level substance use and sexual risk behavior among men who have sex with men.CrossRef |

[46]  Wells BE, Golub SA, Parsons JT. An integrated theoretical approach to substance use and risky sexual behavior among men who have sex with men. AIDS Behav 2011; 15 509–20.
An integrated theoretical approach to substance use and risky sexual behavior among men who have sex with men.CrossRef |

[47]  Calsyn DA, Cousins SJ, Hatch-Maillette MA, Forcehimes A, Mandler R, Doyle SR, Song YS, Coyer S, Pelta S. Sex under the influence of drugs or alcohol: common for men in substance abuse treatment and associated with high-risk sexual behavior. Am J Addict 2010; 19 119–27.
Sex under the influence of drugs or alcohol: common for men in substance abuse treatment and associated with high-risk sexual behavior.CrossRef |

[48]  Bourne A, Reid D, Hickson F, Torres Rueda S, Weatherbum P. The Chemsex Study: drug use in sexual settings among gay and bisexual men in Lambeth, Southwark and Lewisham. London: Sigma Research, London School of Hygiene and Tropical Medicine; 2014. Available online at: www.sigmaresearch.org.uk/chemsex [verified November 2017]

[49]  Barbara AM, Doctor F. Asking the right questions 2: talking with clients about sexual orientation and gender identity in mental health, counselling and addiction settings. Toronto: Centre for Addiction and Mental Health; 2007.

[50]  Anderson SC. Substance use disorders in lesbian, gay, bisexual, and transgender clients: assessment and treatment. New York: Columbia University Press; 2009.

[51]  Center for Substance Abuse and Mental Health Services Administration (SAMHSA). A provider’s introduction to substance abuse treatment for lesbian, gay, bisexual, and transgender individuals. Rockville: U.S. Department of Health and Human Services; 2012.

[52]  Bracchi M, Stuart D, Castles R, Khoo S, Back D, Boffito M. Increasing use of “party drugs” in people living with HIV on antiretrovirals: a concern for patient safety. AIDS 2015; 29 1585–92.
Increasing use of “party drugs” in people living with HIV on antiretrovirals: a concern for patient safety.CrossRef | 1:CAS:528:DC%2BC2MXhsVOnsLzK&md5=9f5575e93a1c3b018c6a015d6a6756cfCAS |

[53]  James RL. Sexuality and addiction: making connections, enhancing recovery. Santa Barbara: Praeger; 2012.

[54]  Braun-Harvey D. Sexual health in recovery: a professional counselor’s manual. New York: Springer; 2011.

[55]  Schroder KEE, Carey MP, Vanable PA. Methodological challenges in research on sexual risk behavior: I. Item content, scaling, and data analytical options. Ann Behav Med 2003; 26 76–103.
Methodological challenges in research on sexual risk behavior: I. Item content, scaling, and data analytical options.CrossRef |

[56]  Schroder KEE, Carey MP, Vanable PA. Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports. Ann Behav Med 2003; 26 104–23.
Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports.CrossRef |

[57]  Napper LE, Fisher DG, Reynolds GL, Johnson ME. HIV risk behavior self-report reliability at different recall periods. AIDS Behav 2010; 14 152–61.
HIV risk behavior self-report reliability at different recall periods.CrossRef |

[58]  Leigh BC, Stall R. Substance use and risky behavior for exposure to HIV. Am Psychol 1993; 48 1035–45.
Substance use and risky behavior for exposure to HIV.CrossRef | 1:STN:280:DyaK2c%2FnvFSluw%3D%3D&md5=8c4bd1ee1d8ff52d7303c7f9ab93b3c6CAS |

[59]  Miller WR, Rollnick S. Motivational interviewing: helping people change, 3rd edn. New York: Guilford Press; 2013.

[60]  Prochaska JO, DiClemente CC. Stages and process of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 1983; 51 390–5.
Stages and process of self-change of smoking: toward an integrative model of change.CrossRef | 1:STN:280:DyaL3s3jvFaksw%3D%3D&md5=bb56bfc2d7daaac765be785e1e4c0c29CAS |

[61]  Prochaska JO, Norcross JC, DiClemente CC. Changing for good. New York: Avon Books; 1994.

[62]  Connors GJ, DiClemente CC, Velasquez MM, Donovan DM. Substance abuse treatment and the stages of changes: selecting and planning interventions, 2nd edn. New York: The Guilford Press; 2013.

[63]  Goyette M, Flores-Aranda J, Bertrand K, Pronovost F, Aubut V, Saint-Jacques M. Links between your substance use and your sexual health (v. 1.1). Québec: Recherche et intervention sur les substances psychoactives – Québec 2017. Available online at: http://www.webcitation.org/6wLfTG8xa [verified November 2017]

[64]  American Psychiatric Association. The American Psychiatric Association practice guidelines for the psychiatric evaluation of adults, 3th edn. Arlington, American Psychiatric Pub; 2016.

[65]  Bullinger M, Anderson R, Cella D, Aaronson N. Developing and evaluating cross-cultural instruments from minimum requirements to optimal models. Qual Life Res 1993; 2 451–9.
Developing and evaluating cross-cultural instruments from minimum requirements to optimal models.CrossRef | 1:STN:280:DyaK2c3hsVeqsA%3D%3D&md5=dcdde4515e345201c3cff65f04d4376aCAS |

[66]  World Health Organization (WHO). Process of translation and adaptation of instruments. Québec: Recherche et intervention sur les substances psychoactives – Québec; 2017. Available online at: http://www.who.int/substance_abuse/research_tools/translation/en/ [verified November 2017]

[67]  Bourne A, Weatherburn P. Substance use among men who have sex with men: patterns, motivations, impacts and intervention development need. Sex Transm Infect 2017; 93 342–6.
Substance use among men who have sex with men: patterns, motivations, impacts and intervention development need.CrossRef |

[68]  Halkitis PN, Levy MD, Solomon TM. Temporal relations between methamphetamine use and HIV seroconversion in gay, bisexual, and other men who have sex with men. J Health Psychol 2016; 21 93–9.
Temporal relations between methamphetamine use and HIV seroconversion in gay, bisexual, and other men who have sex with men.CrossRef |

[69]  Stuart D. ChemSex Care Plan. 2017. Available online at: http://www.davidstuart.org/care-plan [verified November 2017].

[70]  Parsons JT, Lelutiu-Weinberger C, Botsko M, Golub SA. A randomized controlled trial utilizing motivational interviewing to reduce HIV risk and drug use in young gay and bisexual men. J Consult Clin Psychol 2014; 82 9–18.
A randomized controlled trial utilizing motivational interviewing to reduce HIV risk and drug use in young gay and bisexual men.CrossRef |

[71]  Wray TB, Braciszewski JM, Zywiak WH, Stout RL. Examining the reliability of alcohol/drug use and HIV-risk behaviors using timeline follow-back in a pilot sample. J Subst Use 2016; 21 294–7.
| 1:STN:280:DC%2BC2srptVSktQ%3D%3D&md5=bf9c96bf3869d6b45ae98b48e6c3bcacCAS |

[72]  Wray TB, Kahler CW, Monti PM. Using ecological momentary assessment (EMA) to study sex events among very high-risk men who have sex with men (MSM). AIDS Behav 2016; 20 2231–42.
Using ecological momentary assessment (EMA) to study sex events among very high-risk men who have sex with men (MSM).CrossRef |



Rent Article (via Deepdyve) Export Citation Cited By (1)

View Altmetrics