Background. Interventions addressing sexualized substance use (SSU) among gay, bisexual, and other men who have sex with men (gbMSM) often focus on biological risks like HIV and STIs, emphasizing substance use reduction or abstinence. This approach may not be universally suitable, especially when considering sexual and substance use pleasure. A harm reduction strategy rooted in a global health perspective offers an opportunity to reconsider interventions, embracing pleasure in recovery rather than focusing on biological consequences.
Objective. This presentation aims to outline the contribution of integrating sexuality into the original harm reduction definition in SSU interventions.
Methods. In-depth interviews were conducted with 20 gbMSM adults engaged in SSU practices within the past year. Thematic analysis of their experiences and perspectives on SSU practices and their intervention needs was conducted.
Results. Participants highlighted the need for healthcare providers (HCPs) to possess specific knowledge, skills, and attitudes when addressing gbMSM with SSU practices. They emphasized the importance of HCPs having knowledge about both sexuality and addiction and understanding how these components influence each other. The study identified a crucial competency—attitude (e.g., non-judgment, acceptance)—within the context of SSU. HCPs should empower individuals engaged in SSU practices, recognizing their self-determination by allowing open discussions about positive elements, including pleasure.
Implications. Assessment and intervention must address inequalities, fostering an inclusive, anti-oppressive approach. Revisiting harm reduction's initial conceptualization is vital, acknowledging diverse identities and characteristics in SSU practices, often overlooked in certain health services with persistent inequality factors.