A pilot RCT of an online mindfulness-based cognitive intervention for chemsex

Abstract

Objectives: Chemsex is a term used to describe sex acts using psychoactive substances to enhance the sexual experience/arousal and predominates among men who have sex with men (MSM). Chemsex drugs predominantly include γ-hydroxybutyric acid (GHB) and analogues, methamphetamine, mephedrone and erectile dysfunction agents (e.g., Sildenafil). Mindfulness-based cognitive therapy (MBCT) combines cognitive therapy and mindfulness and has been shown to help support both sexual functioning and methamphetamine use. However, limited clinical trials have evaluated the use of cognitive mindfulness for chemsex in MSM. The present study assessed the effectiveness of an online mindfulness-based cognitive intervention (MBCI) among 29 MSM aged 18–30 years engaged in chemsex. Design and Setting: A mixed methods approach consisted of a randomised waitlist-controlled trial and a content analysis reviewing participants' feedback on MBCI. The design of the intervention was based on a behavioural taxonomy mapped to selected behaviour change techniques (BCTs) to support the reliability of MBCI in its delivery. Main Outcome Measures: Participants completed assessments measuring levels of chemsex, mindfulness, sexual self-efficacy and well-being, taken at Weeks 0, 8 and 12 (follow-up). Results: Participants reported lower levels of chemsex and higher levels of cognitive mindfulness, sexual self-efficacy and well-being postintervention and at the 12-week follow-up. The content analysis feedback responses yielded favourable outcomes, suggesting that participants developed a sense of self-compassion, confidence and positive identity. Conclusions: The MBCI effectively reduced chemsex; however, this study warrants replication with a larger, more diverse group of participants.