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.
Maxime Blanchette is a professor of social work at the Université du Québec en Abitibi-Témiscamingue, working on the clinical aspects of sexualized substance use. He is also a social worker
providing services to gay, bisexual and men who have sex with other men who have difficulties with sexualized substance use.
Mathieu Goyette is a professor in the Department of Sexology at UQAM and an associate professor in the Department of Community Health Sciences at the Université de Sherbrooke. He is also a regular researcher at the Institut universitaires sur les dépendances, the Centre de recherche Charles-Le Moyne, and a member of the RISQ team. His research activities focus on sexuality in relation to substance use.
Karine Bertrand, Ph.D., psychologist, is a Full professor at Université de Sherbrooke, community health science department. She is the scientific director of the Institut universitaire sur les dépendances. She holds a CIHR Research Chair in Gender and Intervention in Addiction (“La GID”) that brings together people with various types of expertise (academic, professional, lived experience) to develop strategies and recommendations for improving addiction-related services.
Jorge Flores-Aranda is a professor in the School of Social Work at the Université du Québec à Montréal, a regular researcher at the University Institute on Addictions, the Research and Intervention on Psychoactive Substances – Quebec (RISQ) group and the Charles Le Moyne Research Centre. He is interested in the links between substance use and sexuality, and the social problems experienced by various populations, including sexually and gender-diverse individuals and people experiencing homelessness. He also studies the use of new technologies in social interventions. In the context of his projects, he works in close collaboration with the practice setting, particularly with community organizations.