Re-Wired: treatment and peer support for men who have sex with men who use methamphetamine
Kent Burgess A D , Garth Parkhill A , Jeremy Wiggins A , Simon Ruth A and Mark Stoovè B CA Victorian AIDS Council, 615 St Kilda Rd, Melbourne, Vic. 3004, Australia.
B Alfred Hospital, 55 Commercial Rd, Melbourne, Vic. 3004, Australia.
C Burnet Institute, Centre for Population Health, 85 Commercial Rd, Melbourne, Vic. 3004, Australia.
D Corresponding author. Email: kent.burgess@vac.org.au
Sexual Health 15(2) 157-159 https://doi.org/10.1071/SH17148
Submitted: 16 August 2017 Accepted: 17 November 2017 Published: 16 March 2018
Journal compilation © CSIRO 2018 Open Access CC BY-NC-ND
Abstract
Background: This paper examines a methamphetamine treatment and peer support program for gay men and other men who have sex with men (MSM) who use methamphetamine. Australian MSM use illicit drugs including methamphetamine at significantly higher rates than the broader community.1,2 Methamphetamine rates are higher again amongst HIV positive MSM. Methamphetamine in the MSM community is associated with sexual activity and may be associated with psychosocial harms including risk of the transmission of HIV and sexually transmissible infections.3,4,7,8 Methods: This paper presents the formal evaluation of Re-Wired, Australia’s first structured methamphetamine treatment and support program for MSM, consisting of a free, six week therapeutic group and Re-Wired 2.0, a follow up peer support group. Data collection included baseline and post intervention administration of the Kessler Scale of Psychological Distress (K10) and the Drug Use Disorders Identification Test (DUDIT), the Personal Wellbeing Index (PWI) and the Readiness to Change Questionnaire (RCQ). This was complemented with qualitative session feedback and a small number of post intervention participant interviews. Results: Program evaluation demonstrated modest improvements in participant psychological distress, personal well-being and stage of change and reductions in methamphetamine use post intervention. Qualitative data revealed benefits of a specialised harm reduction intervention for this population through addressing fear of discrimination and stigma. Conclusions: The presented harm reduction program for MSM who use methamphetamine demonstrates the potential for a specialist peer-based approach to reduce harm in this vulnerable population. This approach may be suitable for adaptation with MSM populations in similar high-income settings.
Additional keywords: Community interventions, drug use, gay men, harm reduction, HIV prevention, HIV risk, illicit drug use, Injecting drug use, peer support, STI risk, therapeutic group.
References
[1] Australian Institute of Health and Welfare. National Drug Strategy Household Survey detailed report 2013. Drug statistics series no. 28. Cat. No. PHE 183. Canberra: AIHW; 2014.[2] Douglas Scott S, Pringle A, Lumsdaine C. Sexual exclusion – homophobia and health inequalities: a review. London: UK Men’s Health Network; 2004.
[3] Lee E, Mao L, McKenzie T, Batrouney C, West M, Prestage G, Zablotska I, de Wit J, Holt M. Gay Community Periodic Survey: Melbourne 2016. Sydney: Centre for Social Research in Health, UNSW Australia; 2016.
[4] Hull P, Mao L, Kolstee J, Duck T, Feeney L, Prestage G, Zablotska I, Lea T, de Wit J, Holt M. Gay Community Periodic Survey: Sydney 2016. Sydney: Centre for Social Research in Health, UNSW Australia; 2016.
[5] Shoptaw S, Reback CJ, Peck JA, Yang X, Rotheram-Fuller E, Larkins S, Veniegas RC, Freese TE, Hucks-Ortiz C. Behavioral treatment approaches for methamphetamine dependence and HIV-related sexual risk behaviors among urban gay and bisexual men. Drug & Alcohol Depend 2005; 78 125–34.
| Behavioral treatment approaches for methamphetamine dependence and HIV-related sexual risk behaviors among urban gay and bisexual men.Crossref | GoogleScholarGoogle Scholar |
[6] Hammoud M, Jin F, Degenhardt L, Lea T, Grierson J, Mackie B, Pastorelli M, Batrouney C, Bath N, Bradley J, Prestage G. Flux: Following Lives Undergoing Change, Gay community life, drug use, and taking care of ourselves and each other, Report 2014–15. Monograph. Sydney: The Kirby Institute, UNSW Australia; 2016.
[7] Hopwood M, Cama E, Treloar C. Methamphetamine use among men who have sex with men in Australia: a literature review. Sydney: Centre for Social Research in Health, UNSW Australia; 2016.
[8] Eu B, Roth N. Association between known recent HIV infections and methamphetamine use (ASK HIM study) in Melbourne between 2011 and 2013: a case-control study. Sex Health 2014; 11 583–4.
| Association between known recent HIV infections and methamphetamine use (ASK HIM study) in Melbourne between 2011 and 2013: a case-control study.Crossref | GoogleScholarGoogle Scholar |
[9] McCormack A, Vella A, Stoové M. Altered states: alcohol and other drug services at the Victorian AIDS Council: final report. Melbourne: Burnet Institute; 2016.
[10] Beck AK, Forbes E, Baker AL, Kelly PJ, Deane FP, Shakeshaft A, Hunt D, Kelly JF. Systematic Review of SMART Recovery: outcomes, process variables, and implications for research. Psychol Addict Behav 2017; 31 1–20.
| Systematic Review of SMART Recovery: outcomes, process variables, and implications for research.Crossref | GoogleScholarGoogle Scholar |
