Search Results (227)

Background: Chemsex, the intentional use of psychoactive substances to enhance sexual experiences, is an emerging public health issue in Brazil, associated with increased risks of sexually transmitted infections and complex psychosocial vulnerabilities. Despite the universal coverage provided by the Unified Health System (SUS), individuals who practice chemsex often encounter barriers to healthcare, including stigma, discrimination, and a lack of specialized services. To date, no comprehensive reviews appear to synthesize evidence on how this population accesses healthcare in the Brazilian context; existing knowledge remains fragmented across individual studies. Objectives: The aim is to map and synthesize the available evidence regarding access to health services among people who engage in chemsex in Brazil, identifying health needs, professional demands, barriers, and facilitators. Methods: The protocol follows the Joanna Briggs Institute methodology for scoping reviews and PRISMA-ScR guidelines. A systematic search will be conducted in MEDLINE (PubMed), Embase, Scopus, SciELO, and LILACS for studies published between 2014 and 2024 in Portuguese, English, or Spanish. Data will be summarized using descriptive and narrative synthesis, presented in tables and thematic categories. Studies will be included if they address chemsex or sexualized drug use in Brazil and report on healthcare access, regardless of gender identity, sexual orientation, or drug type. Studies that do not address chemsex, focus on drug use outside a sexual context, or are unrelated to Brazil will be excluded. Expected results: The review is expected to identify key barriers and facilitators to healthcare access, highlight knowledge gaps for underrepresented groups, and support recommendations for research, policy, and practice to improve care for people engaging in chemsex in Brazil. By focusing on an underexplored intersection of drug use, sexuality, and healthcare access in Latin America, this study aims to provide an innovative contribution to public health literature. Full article

Background: Research exploring the context in which ASD and offending are associated is limited, despite stereotyped perceptions that individuals with ASD are more violent than their typically developing peers. To address this gap, this research explored the influence of ASD, mental health and behavioural presentation, adverse childhood experiences, and demographic characteristics on offending presentations in a forensic youth sample. Methods: This was a cross-sectional study of a retrospective cohort, utilising secondary data of 327 young people from a forensic London-based service (83% male, M_age = 14.9 years old, SD = 1.90). Results: One hundred forty-two of these young people presented with either confirmed or suspected ASD diagnoses (83.8% male, M_age = 14.8 years old, SD = 1.84). Five offending categories (violence, sexually harmful behaviour, drug possession/supply, gang involvement, theft) and 32 offending behaviours were analysed in total. Poisson and negative binomial regression analyses indicated that ASD traits only increased the rate ratio of violent offences (p = 0.036) and gang involvement (p = 0.002). The use of substances significantly increased the rate ratio of theft (p = 0.012), gang involvement (p = 0.004), and drug possession/supply (p = 0.012). Conclusions: Our findings suggest that ASD, in the context of substance use, may increase a young person’s risk for more variable violent offences or gang involvement. Findings are discussed in the context of current research and recommendations for clinical practice and future research are made. Full article

Adverse childhood experiences (ACEs) are critical determinants of long-term psychological and physiological health outcomes. Transgender and gender nonconforming (TGNC) individuals are at increased risk for ACEs, including family rejection, peer victimization, and systemic discrimination. Despite the growing body of research on this topic, an updated synthesis of recent literature is needed to understand the evolving landscape of ACE-related risks and protective factors in TGNC populations. This systematic review, conducted according to PRISMA guidelines, examined studies published between 2020 and 2024 that were related to the association between ACEs and mental health outcomes in TGNC individuals. A comprehensive database search yielded 6124 articles, 42 of which met the inclusion criteria. Data extraction focused on the type of ACEs reported, associated mental health outcomes, resilience factors, and clinical implications. The results showed that TGNC individuals are significantly more likely to experience childhood maltreatment, including emotional, physical, and sexual abuse, as well as transphobia-specific ACEs such as forced gender conformity and identity denial. These experiences are associated with an increased risk of depression, PTSD, suicidality, and substance use disorders. Family rejection was found to be a critical risk factor, while social support, gender-specific care, and self-efficacy showed protective effects. The reviewed studies emphasize the urgent need for trauma-informed and gender-affirming mental health interventions to mitigate the effects of ACEs on TGNC individuals. Limitations and future research directions are discussed. Full article

Background: Research shows that experiences of sexual violence and the use of substances hurt mental health, predisposing individuals to the development of psychological symptoms of somatization, depression, and anxiety. Objective: The main objective of this study is to assess substance use, sexual violence, and psychological symptoms (BSI-18) in a community sample of Portuguese college students. Participants: 459 college students aged 18 to 50 years participated in this study (mean = 21.55; SD = 3.15). Methods: A survey was created online and disseminated via mailing lists and social networks, and the measurement instruments used were an informed consent form, a sociodemographic questionnaire, the Brief Symptom Inventory-18 (BSI-18), a Sexual Violence Questionnaire, and a Substance Use Questionnaire. Results: We found that men consume more substances, but women report more sexual victimization and psychological symptoms. Non-heterosexuals report significantly more sexual violence experiences and higher substance consumption and psychological symptoms than heterosexuals. Sexual victimization showed strong correlations with both substance use and psychological symptoms, while only some substances correlated with psychological symptoms. Age, gender, sexual orientation, sexual violence, and the substance “Hashish/Marijuana” were shown to be significant and strong predictors of psychological symptoms. Conclusions: As shown in previous studies, sexual and gender minorities are more at risk of experiencing sexual victimization and are more prone to consuming substances and developing psychological symptoms, except for men, who tend to consume more substances. Sexual violence and psychological symptoms are highly correlated, while the relation between substance use and psychological symptoms is not entirely clear. Our findings highlight the need for stronger educational and clinical interventions and increased mental health resources, with training on topics involving sexual violence, substance use, and addressing the specific challenges faced by minority groups, to create safer, inclusive, and more supportive Portuguese universities. Full article

Chemsex is a phenomenon involving the intentional use of psychoactive substances before or during sexual activity, especially among men who have sex with men (MSM). It is associated with various health risks, including substance dependence, risky sexual behaviors, and both mental and somatic disorders. Despite its growing prevalence and public health relevance, chemsex lacks a clear definition and is not recognized as a distinct diagnostic entity. This narrative review synthesizes clinical, epidemiological, and technological evidence on chemsex; argues for its classification as a form of mixed addiction; and preliminarily proposes diagnostic criteria for a potential entity in the International Classification of Diseases, 12th Revision (ICD-12). This paper highlights key psychotropic substances used in chemsex, patterns of use, and their neurobiological, psychological, and behavioral consequences. It explores the relationship between chemsex and compulsive sexual behavior disorder (CSBD), current diagnostic frameworks (ICD-10 and ICD-11), and challenges in clinical practice. Therapeutic strategies discussed include cognitive behavioral therapy (CBT), digital interventions, and emerging applications of artificial intelligence (AI) in prevention and treatment. Attention is also given to epidemiological trends, sociocultural influences, and barriers to seeking help. This review concludes by identifying research gaps and advocating for a more integrated, multidimensional approach to classifying and treating chemsex-related syndromes. Full article

Since the popularization of dating apps, the scientific literature developed in the last decade still has various limitations that concern both the populations studied and the variables evaluated. Therefore, this study aimed to analyze the use of dating apps among adults (25–50 years) and the relationship between the use of these apps and mental, physical and sexual health and substance use. A total of 1004 adults of both sexes (M = 36.61, SD = 7.16; 50.7% women, 49.3% men) participated in the study, filling out a battery of online questionnaires. A 40% prevalence of dating apps use was found. Men, non-heterosexuals, and single people showed higher use of these apps. No relationship was found between the use of dating apps and mental health (self-esteem, anxiety, depression). On the other hand, a direct association was found between being a dating app user and the consumption of substances (tobacco, alcohol, marijuana, cocaine, mental health medication), concern about physical appearance, and the practice of physical exercise. In addition, app users showed better sexual functioning than non-users. The main finding of the study is that there are no differences in mental health (self-esteem, anxiety, depression) between adult users and non-users of dating apps. The results obtained have significant implications both a psychological and social viewpoint. Therefore, they must be considered when implementing prevention and promotion programs for sexual health. Full article

Introduction: Sexual minority men (SMM) are at increased risk for psychosocial stressor exposure, substance use, and poor mental health relative to heterosexual men. While the burden of mental health is growing in the United States, among SMM these trends are increasing at a greater rate, driving health disparities. Methods: Framed within a minority stress framework, these analyses examine how stressors explain substance use and poorer mental health over time. Participants were asked questions on stressor exposure (stigma, discrimination, internalized homophobia, perceived stress), mental health (anxiety, depression, PTSD), and substance use (alcohol to intoxication, club drugs, poly club drugs) over 36 months among 528 SMM in NYC. Results: Perceived stress increased frequency of all substance use, whereas discrimination decreased days of club and poly club drug use. Depression severity predicted increased days of club drug and poly club drug use. PTSD severity predicted increased days of club drug and poly club drug use. Conclusion: We are able to expand on the literature with granular substance use data to highlight associations with stressors and mental health. These findings support an increased need for systematic policy solutions and public health interventions to address drivers of substance use disparities among young SMM. Full article

Though previous studies have demonstrated the protective benefits of sports participation against illicit drug use for a general population, how these findings apply to LGBTQ youth remains unknown. This study specifically looks at the relationship between sports participation and prescription drug misuse among sexual and gender minority youth. Using secondary data from the 2019 YRBS, we analyze associations among sports participation, sexual orientation, gender identity, and prescription drug misuse among a representative sample of U.S. high school students in Florida. Our results show that sexual and gender minority youth are at increased risk for prescription drug misuse compared to their heterosexual and cisgender peers. Moreover, sports participation is associated with higher rates of prescription drug misuse among all students, and the nuances of these trends are discussed with particular attention paid to sexual and gender minority youth. These results challenge conventional wisdom about sports participation. Without the addition of new demographic survey questions and LGBTQ youth participation in the YRBS, common myths about sports might have persisted. Our findings point to the meaningful presence of LGBTQ youth in sports, call for research and programming on LGBTQ athletes’ unique needs regarding substance misuse risk, and encourage LGBTQ-inclusive policies and practices within schools and sports programs in particular. Full article

HIV disproportionately affects key populations (MSM, transgender people, sex workers and psychoactive substance users), who face greater social vulnerability and limited healthcare access. This study aimed at analyzing sexual orientation and gender identity and their association with sexual practices, sexually transmitted infections and psychoactive substance use among PrEP users. Method: A cross-sectional study was conducted between January 2018 and June 2021 with 736 Brazilian PrEP users from a health service in São Paulo. Sociodemographic data, sexual behaviors, STI history (past 3 months) and psychoactive substances use (past 3 months) were extracted from clinical records. The associations were analyzed using binomial logistic regression (p < 0.05). Results: Most of the participants were cisgender men (93.4%) and homosexual (84.8%), with a mean age of 34.9 years old. Condomless sex was reported by 98.5%, and 18.4% had some recent sexually transmitted infection, mainly syphilis. Psychoactive substance use was reported by 55.4%, especially marijuana, club drugs, erectile stimulants and poppers. Transgender and cisgender women were more likely to report sex work and crack use. Homosexual and bisexual participants had higher odds of using erectile stimulants. Conclusions: The study reveals key links between gender, sexual orientation and risk behaviors, highlighting the need for inclusive, targeted prevention. Full article

L-carnitine and Mildronate are substances that can significantly rearrange the energy metabolism of cells. This can potentially cause changes in the bacterial composition of the gut microbiome and affect testis functionality and male sexual health. Mice of the C57Bl/6 line were used. Sexual behavior was assessed using physiological tests, and gene expression patterns were assessed by qPCR. High-throughput sequencing of mouse fecal microbiota was performed. We showed that long-term administration of Mildronate has no significant effect on the intestinal microbiome, and there was a compensatory increase in the expression of genes involved in fatty acid and leptin metabolism. No impairment of sexual motivation in male mice was observed. Prolonged L-carnitine supplementation caused a decrease in alpha diversity of bacteria and a decrease in some groups of microorganisms that are components of a healthy gut microflora. A correlation was observed between the level of bacteria from Firmicutes phylum, indicators of sexual motivation of mice, and the dynamics of body weight gain. Our results may indicate that metabolic modulators can have a significant impact on the structure of the bacterial community of the gut microbiome, which may influence male sexual health through the gut–semen axis. Full article

Background/Objectives: Violence is a significant occupational health issue for paramedics, yet underreporting limits efforts to identify and mitigate risk. Leveraging a novel, point-of-event violence reporting system, we aimed to identify characteristics of 9-1-1 calls associated with an increased risk of violence in a single paramedic service in Ontario, Canada. Methods: We retrospectively analyzed all electronic violence and patient care reports filed by paramedics in Peel Region and used logistic regression to identify call-level predictors of any violence and, more specifically, physical or sexual assault. Results: In total, 374 paramedics filed 974 violence reports, 40% of which documented an assault, corresponding to a rate of 4.18 violent encounters per 1000 9-1-1 calls. In adjusted models, the risk of violence was elevated for calls originating from non-residential locations (e.g., streets, hotels, bars), occurring during afternoon or overnight shifts, and involving young or working-age males. Presenting problems related to intoxication, mental health, or altered mental status were strongly associated with increased risk, with particularly high adjusted odds ratios for assault. Conclusions: These findings support the utility of near-miss and violence surveillance systems and highlight the need for multidisciplinary crisis response to high-risk calls, especially those involving mental health or substance use. Full article

Background: Teen dating violence (TDV) is a serious public health concern, with sexual and gender minority youth (SGMY) at elevated risk due to minority stress and systemic inequalities. This systematic review examines individual, relational, and contextual risk factors for TDV among SGMY. Methods: A systematic search was conducted in Scopus, Web of Science, and APA PsycInfo on 10 December 2024. Studies published between 2014 and 2024 focusing on teen dating violence (TDV) as an outcome among sexual and gender minority youth (SGMY) aged 13–19 were included. Study selection was independently performed by multiple reviewers using Rayyan. Risk of bias was assessed using the JBI Critical Appraisal Tools. Due to heterogeneity in the study design and measurement tools, a narrative synthesis was conducted. Results: Six risk domains emerged: (1) Demographic/Identity (e.g., gender, orientation, or race); (2) Psychological/Behavioral (e.g., distress or substance use); (3) Violence/Bullying (e.g., cyberbullying or exclusion); (4) Family/Sexual Abuse (e.g., family rejection); (5) Relational/Social (e.g., partner outing); and (6) School/Community (e.g., non-inclusive environments). Bisexual, pansexual, transgender, and racialized youth showed heightened vulnerability. Most studies were conducted in the USA and relied on non-validated TDV measures and cross-sectional designs, limiting comparability and causal inference. Conclusions: SGMY face unique, often overlooked TDV risks. There is a need for intersectional, longitudinal research and inclusive, developmentally appropriate prevention efforts that address both relational and structural factors. This review received no external funding and was not registered. Full article

Background: Female Sexual Dysfunction (FSD) encompasses a range of conditions that can profoundly impact quality of life and intimate relationships. The primary classifications of FSD include female sexual interest and arousal disorder (FSIAD), genitopelvic pain and penetration disorder (GPPPD), female orgasmic disorder (FOD), and substance or medication-induced sexual dysfunction (SM-ISD). Despite its prevalence, FSD is often underdiagnosed and undertreated. Objectives: This scoping review follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to evaluate the existing literature on both U.S. Food and Drug Administration (FDA)-approved and off-label pharmacotherapies for FSD by study type, outcomes, and limitations. Eligibility Criteria: Eligible studies comprised randomized controlled trials (RCTs), systematic reviews, and cohort studies involving adult women (≥18 years) with any subtype of FSD. These studies assessed pharmacologic interventions against a comparator and reported at least one treatment efficacy outcome. Studies outside this scope were excluded. Sources of Evidence: A 25-year literature search was conducted using PubMed/MEDLINE, the Cochrane Library, reference lists of relevant articles, academic handbooks, and targeted journals. Charting Methods: Three independent reviewers screened and extracted data. Risk of bias was assessed using the Cochrane Risk of Bias Tool. Findings were organized into summary tables and categorized by pharmaceutical agent, pertinent study information, outcomes, and limitations. Results: A total of 44 human-based pharmacologic studies met inclusion criteria. FDA-approved agents were the most thoroughly studied pharmacotherapies. Hormonal, topical, and adjunctive agents demonstrated less robust evidence. Heterogeneity in outcome measures and inadequate long-term data were common limitations. Conclusions: Pharmacologic treatment for FSD shows promise but requires further research. Individualized, multifaceted care is essential for optimizing FSD outcomes. Full article

Background/Objectives: Over the past few decades, controlled substance abuse in drug-facilitated sexual assaults (DFSAs) has significantly increased worldwide, leading to an urgency to develop rapid and selective drug detection methods for field use (i.e., on-spot detection). Currently, techniques for detecting DFSA drug-associated samples are laborious and require skilled personnel to analyze/interpret the results. Moreover, most DFSA-associated drugs have a short half-life, making them more challenging to detect promptly. For instance, the timely detection of gamma-hydroxybutyrate (GHB) has been of ultimate concern for decades due to its fast elimination from the body. This study describes the development of a fluorescent ionic liquid nanosensor that can be used to rapidly detect GHB in the field. Methods: Trihexyltetradecylphosphonium fluorescein (THP₂FL) ionic liquid was synthesized and evaluated for its potential application in detecting GHB. THP₂FL nanoparticles in deionized water were synthesized with a size of 199 nm by a reprecipitation method. Results: The addition of GHB to THP₂FL nanoparticles resulted in up to a 60% increase in fluorescence intensity and a 79% increase in absorbance. These results suggest potential applications for using the fluorescent THP₂FL nanoparticles to detect GHB. The sensor’s selectivity was tested on compounds structurally similar to GHB, and the results showed that 1,4-butanediol (a precursor of GHB) is a potentially interfering species. Conclusion: This fluorescent technique allows for field deployable sensors, which would benefit screening GHB onsite. Full article

Background: Black sexual minority men (BSMM) are disproportionately affected by HIV incidence and have lower rates of HIV care engagement (e.g., retention in care, viral suppression), particularly in the US South. The COVID-19 pandemic exacerbated co-occurring psychosocial syndemic factors (e.g., depression, violence, substance use) that disproportionately impact BSMM living with HIV (BSMM+), but the impact of the pandemic on HIV care engagement among BSMM+ in the US South has not been explored in depth. Methods: BSMM+ (n = 27) were recruited from a longitudinal cohort in Dallas and Houston, Texas. Participants with less-than-optimal HIV care engagement, previous experiences of intimate partner violence (IPV), and prevalence of self-reported substance use were purposively selected for in-depth interviews from June 2022 to August 2023. Interviews lasted 54 min on average and were audio-recorded, transcribed, and de-identified before applying a thematic analysis approach. Results: Over half of participants experienced a relationship with IPV, used illicit substances in the past 60 days, and were depressed. Interviews highlighted that, during the COVID-19 pandemic, heightened levels of depression, substance use, and IPV individually and synergistically inhibited ART adherence and HIV care engagement. Participants described how IPV served to worsen their mental health and substance use, which, in turn, were the core drivers of poor HIV care engagement. Conclusions: The findings suggest that the COVID-19 pandemic exacerbated the syndemics of IPV, mental health, and substance use, and these acted as barriers to HIV care engagement. Future adherence interventions should synergistically address syndemic factors to maximize effectiveness. Full article