- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05929040
The Use of Cognitive Mindfulness for Chemsex
Using the Behaviour Change Technique Taxonomy v1 to Conceptualize the Clinical Content of a Preliminary Randomised Controlled Study of an Online Mindfulness-based Cognitive Intervention for Chemsex
Title of research: A preliminary RCT of an online mindfulness-based cognitive intervention for Chemsex
Research aim: To determine how an online mindfulness-based cognitive intervention, might reduce Chemsex engagement, risky sexual behaviours, sexual self-efficacy and increase overall wellbeing among men who have sex with men.
Research intention: If the mindfulness based cognitive intervention reduces Chemsex engagement and risky sexual behaviours and supports sexual and general wellbeing, then we would repeat this study on a larger scale within the National Health Service among men who have sex with other men and who engage in Chemsex. Both academic output and dissemination accordingly.
A brief overview of intervention:
Chemsex, sometimes coined as Chemfun, is a term used to describe the use of psychoactive substances with the intention of enhancing and/or facilitating the sexual experience/arousal and predominates among gay and bisexual men. Chemsex drugs tend to include, γ-hydroxybutyric acid and congeners, methamphetamine, mephedrone, erectile dysfunction agents, and alkyl nitrites often in combination.
A growing body of research has suggested that mindfulness supports minimize drug using behaviors HIV stress and risky sexual behaviours. However, there appears no current mindfulness intervention that has been evidenced for Chemsex. Our intervention is hoped to become part of a multidisciplinary approach in supporting Chemsex which includes a cross-over effect between drugs, sexual well-being, and general wellbeing.
Quantitatively, the research is structured so that participants will be randomized to either the experimental or control group (n=20 experimental; n=20 control waitlist). The MBCI for each group is 1 month (4 wks experimental and 4 wks waitlist control). This is followed by a 3-month follow-up to determine the sustainability of this intervention. Qualitatively, participants will be asked approx 8 open-ended feedback questions forming part of 4 groups of 10, at the 3-month follow-up.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The principal researcher developed an online cognitive mindfulness intervention.
The main target in this study was to engage participants with mindfulness exercises whilst improving wellbeing and mindfulness whilst reducing Chemsex use. The main exercises included mindfulness, breathing exercises, relaxation techniques, being mindful of the senses and the body and understanding of the self. This online mindfulness based cognitive intervention contains cognitive, emotional, and behavioural factors and each of the 4 sessions included substance use and sexual behaviour, working with the inner critic and high-risk situations, sex without drugs and sexual identity and psychosexual wellbeing, substance use and self-compassion. Homework exercises were encouraged which consisted of education, training, modelling, and enablement. To expand, education included psychoeducational information on chemsex, sexual wellbeing, and mindfulness along with additional resources. Training provided the instructions on how to go about engaging in these online activities. Modelling provides examples in action such as MSM discussing their experiences of Chemsex including verbal persuasion and challenging negative self-talk, and how to go about doing the exercises, and enablement is aimed at increasing participants capability of engaging in these activities towards wellbeing. This would be further supported by charts, self-monitors, diaries, and journaling. Further, prompts, action plans, and cues were supportive intervention components. Feedback and support along with discussing the educational components, training, modelling and enablement had been addressed throughout the duration of this study.
The development of the mindfulness based cognitive intervention has been based on a behavioral change techniques taxonomy. This have been used because the behavioural change techiques taxonomy has been rigorously tested to evidence the effectiveness in support of interventions associated with change behaviour. The 93 behavior change techniques are the active ingredients of behavior change where each intervention is likely to consist of more than one behaviour change technique and serve as having more than one function. In total, the intervention in this study included 15 domains in which 35 out of the 93 behaviour change techniques listed in the behavioural change technique taxonomy were identified. The selection of these domains used a process of triangulation to ensure consistency in mapping the behaviour change techniques to the intervention.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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London, United Kingdom, N7 8DB
- Samantha Banbury
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Aged 18 years old and above
- Are engaged in chemsex
- Men who have sex with men
- Can read and write English
- Had access to a password-protected laptop/computer
- Registered with a General Practitioner
- Registered with a health care service supporting substance use/chemsex.
Exclusion Criteria:
- Aged below 18 years old
- Those who do not engage in Chemsex
- Are not registered with a General Practitioner
- Did not have access to a password-protected laptop/computer
- Are not registered with a health care service supporting substance use/chemsex
- Have difficulties reading and writing in English
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: Immediate group
Randomized controlled waitlist study Behavioral: Mindfulness based cognitive intervention based on the behavioural change techniques taxonomy An online mindful cognitive intervention is used as a proposed treatment intervention for chemsex among men ho have sex with men in the United Kingdom. |
Mindfulness based cognitive intervention based on the behavioural change techniques taxonomy
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Other: Delayed group
Randomized controlled waitlist study Behavioral: Mindfulness based cognitive intervention based on the behavioural change techniques taxonomy An online mindful cognitive intervention is used as a proposed treatment intervention for chemsex among men who have sex with men in the United Kingdom. |
Mindfulness based cognitive intervention based on the behavioural change techniques taxonomy
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Changes in Chemsex behaviour, measurements taken at weeks 0, 8 and 12
Time Frame: Measurements taken at weeks 0, 8 and 12
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There is currenlty no standardised questionnaire on chemsex.
This is a 19-item questionnaire with 4 response categories (1=never through to 4= always).
Scores ranged between 19 (low chemsex engagement) to 76 (very high chemsex engagement).
19 No Chemsex; 20-34 Low chemsex; 35-50 Moderate chemsex; 51- 66 High chemsex and 67 + very high chemsex.
Questions 1-4 includes drug use, 5-7 self-care, 8-10 lifestyle, 11-14 risk behaviour, 15-19 well-being/mental health.
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Measurements taken at weeks 0, 8 and 12
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Changes in cognitive mindfulness, measurements taken at weeks 0, 8 and 12.
Time Frame: Measurements taken at weeks 0,8 and 12
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The Cognitive and Affective Mindfulness Scale-Revised.
This is a 10-item measure with four response categories 1= rarely/not at all to 4 = almost always.
Higher scores indicate higher levels of mindfulness (range 4-40).
Cronbach's alphas ranged between 0.82 and 0.84.
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Measurements taken at weeks 0,8 and 12
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Changes in sexual self efficacy, measurements taken at weeks 0, 8 and 12.
Time Frame: Measurements taken at weeks 0, 8 and 12
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This is a six-item questionnaire which consists of 4 response categories (1=not at all through to 4= very much).
Cronbach's alpha ranges between 0.58- 0.74.
Questions centre on the self-efficacy for carrying out healthy sexual behaviours including condom use and sexual consent.
There is no reverse scoring.
Scores range from 6 (little to no self-efficacy) to 24 (high self-efficacy).
This will be adapted accordingly… Think about the time you have engaged in chemsex, how confident are you that you could..
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Measurements taken at weeks 0, 8 and 12
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Changes in wellbeing, measurements taken at weeks 0, 8 and 12.
Time Frame: Measurements taken at weeks 0, 8 and 12
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This is a positively worded 7 item questionnaires with 5 response categories looking at functioning and feeling aspects of well-being.
The response categories include 1=none of the time to 5=all of the time.
Cronbach alpha- 0.89-0.91.
There is no reverse scoring.
Scores range from 7 to 35 where the latter is the highest level of wellbeing.
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Measurements taken at weeks 0, 8 and 12
|
Collaborators and Investigators
Sponsor
Publications and helpful links
General Publications
- Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006 Mar;13(1):27-45. doi: 10.1177/1073191105283504.
- Bossio JA, Basson R, Driscoll M, Correia S, Brotto LA. Mindfulness-Based Group Therapy for Men With Situational Erectile Dysfunction: A Mixed-Methods Feasibility Analysis and Pilot Study. J Sex Med. 2018 Oct;15(10):1478-1490. doi: 10.1016/j.jsxm.2018.08.013.
- Alvy LM, McKirnan DJ, Mansergh G, Koblin B, Colfax GN, Flores SA, Hudson S; Project MIX Study Group. Depression is associated with sexual risk among men who have sex with men, but is mediated by cognitive escape and self-efficacy. AIDS Behav. 2011 Aug;15(6):1171-9. doi: 10.1007/s10461-010-9678-z.
- Flores Anato JL, Panagiotoglou D, Greenwald ZR, Trottier C, Vaziri M, Thomas R, Maheu-Giroux M. Chemsex practices and pre-exposure prophylaxis (PrEP) trajectories among individuals consulting for PrEP at a large sexual health clinic in Montreal, Canada (2013-2020). Drug Alcohol Depend. 2021 Sep 1;226:108875. doi: 10.1016/j.drugalcdep.2021.108875. Epub 2021 Jun 25.
- Banbury, S., Moneta, G & Chandler, C (2021) An exploratory study examining the relationship between sexual self efficacy and premature ejaculation mediated by depression, anxiety and sexual fantasy among a British cohort. Sexual and Relationship Therapy, (7), 1-17DOI: 10.1080/14681994.2021.1932796
- Banbury, S., Lusher, J., Snuggs, S & Chandler, C., (2021). Mindfulness-based therapies for men and women with sexual dysfunction: a systematic review and meta-analysis. Sexual and Relationship Therapy, DOI: 10.1080/14681994.2021.1883578.
- Bohn A, Sander D, Kohler T, Hees N, Oswald F, Scherbaum N, Deimel D, Schecke H. Chemsex and Mental Health of Men Who Have Sex With Men in Germany. Front Psychiatry. 2020 Nov 4;11:542301. doi: 10.3389/fpsyt.2020.542301. eCollection 2020.
- Bandura, A. (1992). Exercise of personal agency through the self-efficacy mechanism. In R. Schwarzer (Ed.), Self-efficacy (pp.3-38). Washington DC US: Hemisphere Publishing Corp.
- Bandura, A., (1997). Self-efficacy: The exercise of control. New York: W. H. Freeman. ISBN 978-0- 7167- 2850-4. ISBN 0-7167-2850-8, OCLC 36074515
- Blomquist PB, Mohammed H, Mikhail A, Weatherburn P, Reid D, Wayal S, Hughes G, Mercer CH. Characteristics and sexual health service use of MSM engaging in chemsex: results from a large online survey in England. Sex Transm Infect. 2020 Dec;96(8):590-595. doi: 10.1136/sextrans-2019-054345. Epub 2020 Mar 5.
- Bowen S, Enkema MC. Relationship between dispositional mindfulness and substance use: findings from a clinical sample. Addict Behav. 2014 Mar;39(3):532-7. doi: 10.1016/j.addbeh.2013.10.026. Epub 2013 Oct 29.
- Bracchi M, Stuart D, Castles R, Khoo S, Back D, Boffito M. Increasing use of 'party drugs' in people living with HIV on antiretrovirals: a concern for patient safety. AIDS. 2015 Aug 24;29(13):1585-92. doi: 10.1097/QAD.0000000000000786.
- Cadogan CA, Ryan C, Francis JJ, Gormley GJ, Passmore P, Kerse N, Hughes CM. Development of an intervention to improve appropriate polypharmacy in older people in primary care using a theory-based method. BMC Health Serv Res. 2016 Nov 16;16(1):661. doi: 10.1186/s12913-016-1907-3.
- Cane J, O'Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012 Apr 24;7:37. doi: 10.1186/1748-5908-7-37.
- Carrico AW, Neilands TB, Dilworth SE, Evans JL, Gomicronmez W, Jain JP, Gandhi M, Shoptaw S, Horvath KJ, Coffin L, Discepola MV, Andrews R, Woods WJ, Feaster DJ, Moskowitz JT. Randomized controlled trial of a positive affect intervention to reduce HIV viral load among sexual minority men who use methamphetamine. J Int AIDS Soc. 2019 Dec;22(12):e25436. doi: 10.1002/jia2.25436.
- Chan, K.K.S., Lee, C.W.L., & Mak, W.W.S., (2018). Mindfulness model of stigma resistance among individuals with psychiatric disorders. Mindfulness, 9(5), 1433-1442. http://dx.doi.org/10.1007/s12671- 018-0887-2
- Dakwar E, Nunes EV, Hart CL, Foltin RW, Mathew SJ, Carpenter KM, Choi CJJ, Basaraba CN, Pavlicova M, Levin FR. A Single Ketamine Infusion Combined With Mindfulness-Based Behavioral Modification to Treat Cocaine Dependence: A Randomized Clinical Trial. Am J Psychiatry. 2019 Nov 1;176(11):923-930. doi: 10.1176/appi.ajp.2019.18101123. Epub 2019 Jun 24.
- Giorgetti R, Tagliabracci A, Schifano F, Zaami S, Marinelli E, Busardo FP. When "Chems" Meet Sex: A Rising Phenomenon Called "ChemSex". Curr Neuropharmacol. 2017;15(5):762-770. doi: 10.2174/1570159X15666161117151148.
- Gu J, Strauss C, Bond R, Cavanagh K. How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clin Psychol Rev. 2015 Apr;37:1-12. doi: 10.1016/j.cpr.2015.01.006. Epub 2015 Jan 31. Erratum In: Clin Psychol Rev. 2016 Nov;49:119.
- Kurtz SP. Post-circuit blues: motivations and consequences of crystal meth use among gay men in Miami. AIDS Behav. 2005 Mar;9(1):63-72. doi: 10.1007/s10461-005-1682-3.
- Maxwell S, Shahmanesh M, Gafos M. Chemsex behaviours among men who have sex with men: A systematic review of the literature. Int J Drug Policy. 2019 Jan;63:74-89. doi: 10.1016/j.drugpo.2018.11.014. Epub 2018 Dec 1.
- McKirnan DJ, Ostrow DG, Hope B. Sex, drugs and escape: a psychological model of HIV-risk sexual behaviours. AIDS Care. 1996 Dec;8(6):655-69. doi: 10.1080/09540129650125371.
- Rostosky SS, Dekhtyar O, Cupp PK, Anderman EM. Sexual self-concept and sexual self-efficacy in adolescents: a possible clue to promoting sexual health? J Sex Res. 2008 Jul-Sep;45(3):277-86. doi: 10.1080/00224490802204480. Erratum In: J Sex Res. 2008 Oct-Dec;45(4):402.
- Tomkins A, George R, Kliner M. Sexualised drug taking among men who have sex with men: a systematic review. Perspect Public Health. 2019 Jan;139(1):23-33. doi: 10.1177/1757913918778872. Epub 2018 May 30.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- London Met University
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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