Digital Chemsex Support and Care: The Potential of Just-In-Time Adaptive Interventions
Tailored toward all providers working with gay, bisexual, and other men who have sex with men (GBMSM), this article argues for the feasibility and relevance of digital support models for GBMSM who PnP. Following the recognition that GBMSM already commonly use digital platforms such as Grindr to facilitate connection, the researchers describe interactive communication tools as a potential platform for providing support for GBMSM who PnP. As well, providing digital support tends to be more accessible, as community members can receive support 24/7 from wherever they may be. As well, GBMSM who may not feel comfortable disclosing their orientation and/or substance use can remain anonymous but still receive the same support. Similarly beneficial to digital support, researchers describe just-in-time adaptive interventions (JITAI) as best practice for engaging with GBMSM who PnP. Under JITAI principles, GBMSM who PnP should not be confronted with sexual or drug-related support when this is not needed, or when the person is not receptive of such support.
In addition, following JITAI, service providers and clients can identify distal and proximal outcomes, focusing on both overarching and short-term goals, respectively. As well, service providers and clients can identify tangible points, where intervention strategies can most efficiently be employed. These specific points can be 1) pre-specified time-intervals (e.g., consistently monitoring a client’s location for high-risk locations); 2) specific, pre-defined time points during the day/week/month (e.g., Friday nights); 3) a dynamic response to user self-report data indicating a support need (e.g., when self-reported mental health declines); or 4) on-demand, in response to a user’s request for support.
Following these outlined best practice points, the researchers describe the Chemfield project, a pilot project from Antwerp, Belgium that sought to establish the efficacy of these such digital intervention approaches for folks engaging in PnP. The intervention followed JITAI-principles and consisted of both static information (e.g., harm reduction tips and referrals) and dynamic support (e.g., tailored advice before, during and after the party). Importantly, under the dynamics support function users could transform harm reduction facets into personal action plans, set reminders to improve achievement of action plans, gather tips to tackle the afterparty dip, and self-reflect after a party. Upon surveying users, receiving harm reduction tips before and after the party, easily accessible and reliable information about drugs and sexual health, monitoring the frequency of participation in PnP to prompt reflection, the possibility of receiving harm reduction messages during the party, and an overview of existing health service in the region emerged as the most relevant and useful aspects of the application. Despite the potential for an online app to transform service provision for GBMSM who PnP, some limitations remain. In particular, users noted some intrusion and privacy concerns, and that the app was sometimes not dynamic enough.
Ultimately, this article neatly outlines an online tool that service providers could introduce in their practices to support their clients inside and outside of their practice. By following a JITAI framework, service providers will be equipped to meet clients where they are at, rather than imposing an abstinence only approach. In addition, the app represents a one-stop-shop for static information (e.g., harm reduction, healthcare referrals), as well as dynamic support (e.g., check-ins, reminders), allowing the client to garner comprehensive support 24/7. In light of the COVID-19 pandemic and associated lockdown measures, an application of this sort represents a unique opportunity for service providers to support their clients ongoingly from a distance. Check out the link below for some more information on how to best introduce JITAI into your practice and/or programming.
Platteau, T., Herrijgers, C., & de Wit, J. (2020). Digital Chemsex Support and Care: The Potential of Just-In-Time Adaptive Interventions. International Journal of Drug Policy, 85. https://doi.org/10.1016/j.drugpo.2020.102927