TY - JOUR
T1 - Enhancing help-seeking behaviour among men who have sex with men at risk for sexually transmitted infections
T2 - The syn.bas.in randomised controlled trial
AU - Achterbergh, Roeland Christiaan Alfons
AU - Van Rooijen, Martijn S.
AU - Van Den Brink, Wim
AU - Boyd, Anders
AU - De Vries, Henry John Christiaan
N1 - Funding Information: The study design and protocol of this syndemic-based intervention (syn.bas.in) have been published previously.18 We recruited MSM from the MS2 cohort, which included MSM with high-risk behaviour who are screened trimonthly for STIs.16 Eligible participants for the syn.bas.in study were self-identified MSM, aged 18 years or above and showing high-risk sexual behaviour within the last 24 months (for HIV-negative MSM: having had two or more STI diagnoses or postexposure prophylaxis treatment; for HIV-positive MSM: having had one or more STI diagnosis). Recruitment occurred between 1 September 2016 and 1 September 2017. Data collection ended at 1 September 2018. The study was funded by the PHS of Amsterdam (project 2372394). Following the recommendations of Michie et al,19 a theoretical framework for our help-seeking intervention is presented in online supplementary appendix 1. Funding Information: Funding The study received funding from The Public Health Service of Amsterdam, Department of Infectious Diseases project 2372394. Publisher Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2/1
Y1 - 2021/2/1
N2 - Objectives Men who have sex with men (MSM) are at increased risk for STIs and mental disorders. Syndemic theory holds that psychosocial issues co-occur and interact, and thus increase sexual risk behaviour. Psychosocial issue identification, referral and management might reduce risk behaviour. Methods In the syndemic-based intervention study, an open-label randomised controlled trial, MSM were enrolled at the STI outpatient clinic of the Public Health Service of Amsterdam. We screened participants using validated questionnaires on the following problem domains: alcohol and substance use, sexual compulsivity, anxiety, depression, attention deficit hyperactivity disorder, alexithymia, intimate partner violence and childhood sexual abuse. Individuals were randomly assigned (1:1) to receive either tailored, face-to-face feedback and help-seeking advice on mental health screening, or no feedback and no help-seeking advice. Participants were followed trimonthly for a year. The primary outcomes were self-reported and confirmed help-seeking behaviour. Results We included 155 MSM: 76 in the intervention group and 79 in the control group. At inclusion, 128 participants (83.1%) scored positive in at least one problem domain. We found no significant differences in self-reported or confirmed help-seeking behaviour between the intervention and the control group: 41% vs 29% (p=0.14) and 28% vs 22% (p=0.44), respectively. There were also no differences in STI incidence and condomless anal sex acts between the two groups. Conclusion Screening showed high prevalence of problems related to mental health and substance use, while tailored feedback, advice and referral did not significantly increase help-seeking behaviour. Other interventions are needed to tackle the high burden of mental disorders among MSM. Trial registration number NCT02859935.
AB - Objectives Men who have sex with men (MSM) are at increased risk for STIs and mental disorders. Syndemic theory holds that psychosocial issues co-occur and interact, and thus increase sexual risk behaviour. Psychosocial issue identification, referral and management might reduce risk behaviour. Methods In the syndemic-based intervention study, an open-label randomised controlled trial, MSM were enrolled at the STI outpatient clinic of the Public Health Service of Amsterdam. We screened participants using validated questionnaires on the following problem domains: alcohol and substance use, sexual compulsivity, anxiety, depression, attention deficit hyperactivity disorder, alexithymia, intimate partner violence and childhood sexual abuse. Individuals were randomly assigned (1:1) to receive either tailored, face-to-face feedback and help-seeking advice on mental health screening, or no feedback and no help-seeking advice. Participants were followed trimonthly for a year. The primary outcomes were self-reported and confirmed help-seeking behaviour. Results We included 155 MSM: 76 in the intervention group and 79 in the control group. At inclusion, 128 participants (83.1%) scored positive in at least one problem domain. We found no significant differences in self-reported or confirmed help-seeking behaviour between the intervention and the control group: 41% vs 29% (p=0.14) and 28% vs 22% (p=0.44), respectively. There were also no differences in STI incidence and condomless anal sex acts between the two groups. Conclusion Screening showed high prevalence of problems related to mental health and substance use, while tailored feedback, advice and referral did not significantly increase help-seeking behaviour. Other interventions are needed to tackle the high burden of mental disorders among MSM. Trial registration number NCT02859935.
KW - homosexuality
KW - sexual health
KW - substance misuse
UR - http://www.scopus.com/inward/record.url?scp=85089516123&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/sextrans-2020-054438
DO - https://doi.org/10.1136/sextrans-2020-054438
M3 - Article
C2 - 32737210
SN - 1368-4973
VL - 97
SP - 11
EP - 17
JO - Sexually transmitted infections
JF - Sexually transmitted infections
IS - 1
ER -