在澳大利亞由於對批判的恐懼阻斷了同性戀和雙性戀男性與醫護人員討論藥愛行為
資料來源：Oğuzhan Nuh /2022 年 1 月 31 日/ Aidsmap /；財團法人台灣紅絲帶基金會編譯
圖：Vlad Orlov/Shutterstock.comtock.com
根據 Daniel Demant 博士及其同事最近發表在《成癮行為報告》上的一項研究，在澳大利亞從事藥愛性行為的男同性戀和雙性戀男性中，只有三分之一表示他們願意與家庭醫生/全科醫生討論藥愛性行為。大多數男性同意他們知道在哪裡可以獲得有關減害和藥愛性行為的相關信息，但許多參與者擔心被衛生專業人員評判。
藥愛（Chemsex） 是使用娛樂性藥物來促進性行為。 Chemsex 可以被當作一種應對機制去運作，以提高表現、信心和性體驗。用於 chemsex 的物質因國家和可獲得性而異，但包括甲氧麻黃酮（又名4-甲基甲基卡西酮、喵喵）、γ–羥基丁酸酯 (GHB)、γ–丁內酯 (GBL)、甲基安非他命、K他命和可卡因。
在這項橫斷性研究中，數據來自 184 名參與者，他們在 2020 年 11 月至 2021 年 1 月期間填寫了一項線上調查，重點關注 chemsex 參與、知識、感知和使用健康和支持服務。所有參與者都是與男性進行chemsex 的男性，所有的人出生時都被認定為男性，平均年齡為 38 歲。大多數參與者被認定為同性戀（81%），14% 被認定為雙性戀，5% 被認定為酷兒/泛性戀/或其他。 27% 的參與者出生在澳大利亞以外：亞洲（9.4%）、歐洲（6.1%）、新西蘭（5.6%）、中東（2.2%）、非洲（2.2%）和南美（1.7%）。幾乎 40% 的非出生在澳大利亞的參與者已在該國生活了五年以上。大多數參與者認定為白人，9.2% 認定為亞洲人，4.3% 為中東人，1.6% 為土著人，4.9% 為其他人。
大多數參與者表示他們在五年多前開始進行藥愛性行為（54%），而 25% 是在過去兩年內開始的，21% 是在過去三到五年內開始的。三分之二的參與者在調查前三個月從事過藥愛性行為。約有一半表示他們每週（21%）或每月（32%）進行一次藥愛性行為，而另一半表示他們在過去 12 個月內進行過一次或兩次藥愛性行為。
當被問及他們的信息管道時，參與者表示他們從朋友 (33%)、LGBTİ+ 組織 (30%)、臨時性伴侶 (32%)、約會應用程式上的陌生人 (26%)、線上社群 ( 25%)、固定或浪漫伴侶 (23%) 和非 LGBTI+ 社群組織 (9%)。此外，參與者曾經與他的性健康醫生 (28%)、全科醫生 (25%)、性健康護士 (22%)、一般輔導員 (17%)、社區衛生工作者 (15%) 和性健康輔導員 (13 %)討論過藥愛。
儘管有各種渠道可以獲取有關物質使用和藥愛的信息，但信息的適切性和可信度因參與者而異，具體取決於其來源。
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從 LGBTI+ 組織收到的信息被認為是最適切的，其他依次是其他社群組織、臨時性伴侶、常規或浪漫伴侶和朋友。從線上社群和約會軟體上的陌生人收到的信息被認為是最不適切的。從性健康醫生、LGBTI+ 和藥物使用組織和全科醫生等專業來源所獲得的信息被認為比性伴侶、朋友、線上社群和政府部門或組織等來源更值得信賴。
相較於願意與全科醫生 (34%) 和一般輔導員 ( 36%）交談，有更多的參與者表示願意與性健康醫生 (59%)、性健康輔導員 (53%)、性健康護士 (46%) 或社區衛生工作者 (44%) 交談。此外，很大一部分參與者認為他們會受到衛生專業人員的評判。這種擔憂是獲得醫療服務的障礙，因為那些害怕被批判的人對在哪裡獲得專業幫助或減害之信息知之甚少。此外，只有一小部分參與者曾與任一的醫療保健專業人員討論過 chemsex。
更多來自澳大利亞的新聞
研究者還向參與者展示了五個潛在的信息來源，並詢問他們使用它們的可能性有多大。最被喜歡的信息來源是匿名的個人化專家建議（54%），其次是正式的同伴支持網絡（51%）、非正式的同伴支持網絡（49%）、公共信息會議（34%）和同伴主導的研討會（31%）。
研究人員特別強調所收到信息的可信度和適切性對信息尋求行為的作用，並得出結論，這正是社區組織和性健康服務仍需改進的空間。
他們建議社區組織「與該社區建立更牢固的關係，以了解他們的信息需求和信息尋求行為。參與在協同設計的過程中較有可能為這一人群帶來適切性更高的資源和產品，特別是低門檻的介入措施和產品，這些介入措施和產品可能會接觸到相當大比例的從事 chemsex 的人」。
他們補充說，「性健康服務機構應考慮對醫療和護理人員進行有針對性的藥愛教育，並向社區宣傳此類專業知識的可用性」。
參考文獻
Demant D 等人：澳大利亞從事藥愛的性少數男性之信息尋求行為。成癮行為報告，2021 年 12 月 11 日（印刷前線上開放獲取）。
https://doi.org/10.1016/j.abrep.2021.100399。
Fear of judgement prevents gay and bisexual men from discussing chemsex with healthcare workers in Australia
Oğuzhan Nuh 31 January 2022
Vlad Orlov/Shutterstock.com
Only a third of gay and bisexual men who engage in chemsex in Australia said they would feel comfortable discussing chemsex with their family doctor/general practitioner, according to a study by Dr Daniel Demant and colleagues recently published in Addictive Behaviours Reports. Most men agreed they knew where to access relevant information on harm reduction and chemsex, but many participants were worried about being judged by health professionals.
Chemsex is the use of recreational drugs to facilitate sex. Chemsex can operate as a coping mechanism and enhance performance, confidence and sexual experiences. Substances used for chemsex vary depending on the country and accessibility, but include mephedrone, gamma-hydroxybutyrate (GHB), gamma-butyrolactone (GBL), crystal methamphetamine, ketamine and cocaine.
In this cross-sectional study, data come from 184 participants who filled in an online survey focusing on chemsex engagement, knowledge, perception and use of health and support services between November 2020 and January 2021. All participants were men who engage in chemsex with men, all were assigned male at birth, and the mean age was 38 years. Most participants identified as gay (81%) while 14% identified as bisexual and 5% as queer / pansexual / other. Twenty seven percent of the participants were born outside of Australia: in Asia (9.4%), Europe (6.1%) New Zealand (5.6%), the Middle East (2.2%), Africa (2.2%) and South America (1.7%). Almost 40% of participants who weren’t born in Australia had lived in the country for more than five years. The majority of the participants identified as White, while 9.2% identified as Asian, 4.3% as Middle Eastern, 1.6% as Indigenous and 4.9% as other.
Most of the participants said they started having chemsex more than five years ago (54%), while 25% started in the last two years and 21% within the last three to five years. Two-thirds of participants had engaged in chemsex in the three months before the survey. Half said they had chemsex on a weekly (21%) or monthly (32%) basis, while the other half said they engaged in chemsex once or twice in the last 12 months.
When asked about their information channels, participants said they had received information on chemsex from friends (33%), LGBTİ+ organisations (30%), casual sex partners (32%), strangers on dating apps (26%), online community (25%), regular or romantic partners (23%) and non-LGBTI+ community organisations (9%). Additionally, participants had discussed chemsex with sexual health doctors (28%), general practitioners (25%), sexual health nurses (22%), general counsellors (17%), community health workers (15%) and sexual health counsellors (13%).
Although there were various channels to access information regarding substance use and chemsex, the relevancy and trustworthiness of the information varied for participants depending on the source.
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Information received from the LGBTI+ organisations was perceived to be the most relevant, followed by other community organisations, casual sex partners, regular or romantic partners and friends. Information received from the online community and strangers on dating apps were perceived as the least relevant. The information received from professional sources such as sexual health doctors, LGBTI+ and substance use organisations and general practitioners were perceived more trustworthy than sexual partners, friends, online community, and government departments or organisations.
More participants would feel comfortable talking to a sexual health doctor (59%), sexual health counsellor (53%), sexual health nurse (46%) or community health wo