Background: Chemsex refers to the intentional use of drugs before or during sex among men who have sex with men (MSM). Engaging in chemsex has been linked to significant negative impacts on physical, psychological, and social well-being. However, no evidence-based support tools have addressed either these harms or the care needs of MSM who engage in chemsex.
Objective: The purpose of this paper was to describe the development of a mobile health intervention (named Budd) using the intervention mapping protocol (IMP). Budd aims to support and inform MSM who participate in chemsex, reduce the negative impacts associated with chemsex, and encourage more reasoned participation.
Methods: The IMP consists of 6 steps to develop, implement, and evaluate evidence-based health interventions. A needs assessment was carried out between September 2, 2019, and March 31, 2020, by conducting a literature study and in-depth interviews. Change objectives were selected based on these findings, after which theory-based intervention methods were selected. The first version of the intervention was developed in December 2020 and pilot-tested between February 1, 2021, and April 30, 2021. Adjustments were made based on the findings from this study. A separate article will be dedicated to the effectiveness study, conducted between October 15, 2021, and February 24, 2022, and implementation of the intervention. The Budd app went live in April 2022.
Results: Budd aims to address individual factors and support chemsex participants in applying harm reduction measures when taking drugs (drug information, drug combination tool, and notebook), preparing for participation in a chemsex session (articles on chemsex, preparation tool, and event-specific checklist), planning sufficient time after a chemsex session to recover (planning tool), seeking support for their chemsex participation (overview of existing local health care and peer support services, reflection, personal statistics, and user testimonials), taking HIV medication or pre-exposure prophylaxis in a timely manner during a chemsex session (preparation tool), and contacting emergency services in case of an emergency and giving first aid to others (emergency information and personal buddy).
Conclusions: The IMP proved to be a valuable tool in the planning and development of the Budd app. This study provides researchers and practitioners with valuable information that may help them to set up their own health interventions.
International Registered Report Identifier (irrid): RR1-10.2196/39678.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9813820 | PMC |
J Med Internet Res
January 2025
Department of Community Health Sciences, Boston University, Boston, MA, United States.
Background: Improving adherence to pre-exposure prophylaxis (PrEP) via digital health interventions (DHIs) for young sexual and gender minority men who have sex with men (YSGMMSM) is promising for reducing the HIV burden. Measuring and achieving effective engagement (sufficient to solicit PrEP adherence) in YSGMMSM is challenging.
Objective: This study is a secondary analysis of the primary efficacy randomized controlled trial (RCT) of Prepared, Protected, Empowered (P3), a digital PrEP adherence intervention that used causal mediation to quantify whether and to what extent intrapersonal behavioral, mental health, and sociodemographic measures were related to effective engagement for PrEP adherence in YSGMMSM.
JAMA Neurol
January 2025
Department of Radiology, Mayo Clinic, Rochester, Minnesota.
Importance: Although 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is a well-established cross-sectional biomarker of brain metabolism in dementia with Lewy bodies (DLB), the longitudinal change in FDG-PET has not been characterized.
Objective: To investigate longitudinal FDG-PET in prodromal DLB and DLB, including a subsample with autopsy data, and report estimated sample sizes for a hypothetical clinical trial in DLB.
Design, Setting, And Participants: Longitudinal case-control study with mean (SD) follow-up of 3.
Anesth Analg
February 2025
SC Terapia Intensiva Neurochirurgica, Ospedale San Carlo Borromeo, ASST Santi Paolo e Carlo, Milano, Italy.
Background: Computed tomography (CT)-derived low muscle mass is associated with adverse outcomes in critically ill patients. Muscle ultrasound is a promising strategy for quantitating muscle mass. We evaluated the association between baseline ultrasound rectus femoris cross-sectional area (RF-CSA) and intensive care unit (ICU) mortality.
View Article and Find Full Text PDFEur J Neurol
January 2025
Stroke Unit, Udine University Hospital, Udine, Italy.
Background: Although mechanical thrombectomy (MT) represents the standard of care for ischemic stroke due to large-vessel occlusion (LVO), the impact of sex on outcomes in tandem occlusions remains unclear. We investigated sex-based differences in outcomes after MT for tandem occlusions.
Methods: This multicenter observational study included consecutive patients with tandem occlusion treated with MT across three stroke centers (2021-2023).
Sex Reprod Health Matters
January 2025
Associate Professor, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Associate Professor, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
We investigated the association between values and attitudes toward sexual and reproductive health and rights (SRHR) and gender equality, with reproductive agency in Ethiopia, Kenya, and Zimbabwe. Using 2020-21 World Values Survey (WVS) data (n = 3,096), we utilized the SRHR Support Index including five subindices to gauge SRHR attitudes, the WVS Equality Index for gender equality values, and the perceived level of freedom of choice and control over whether, when, and how many children to have as a proxy for reproductive agency. Descriptive statistics, bivariate, and multivariable logistic regressions were used to analyse how values and attitudes differed between respondents of high vs low reproductive agency using the median as cutoff, stratified by country and sex.
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