Background In Singapore, where drug use is a highly stigmatized and criminalized issue, there is limited understanding of the challenges faced by individuals, particularly sexual minorities, in their journey towards recovery from... more
Background In Singapore, where drug use is a highly stigmatized and criminalized issue, there is limited understanding of the challenges faced by individuals, particularly sexual minorities, in their journey towards recovery from substance dependence or addiction. This qualitative study aimed to investigate the driving forces behind drug use, the factors contributing to drug cessation, and the elements influencing the recovery process. Methods Data were extracted from clinical records provided by < blinded for review > between January 2020 to May 2022. These records encompassed information from four distinct forms: the intake assessment, progress notes, case closing summary, and the care plan review. Thematic analysis was employed to identify and categorize recurring themes within the data. Results Data from beneficiaries (N = 125) were analyzed and yielded a series of themes related to facilitators of drug use, motivations to cease drug use, and managing one’s ongoing recover...
BACKGROUND Sexualised drug use (SDU) has been identified as a major risk factor for HIV, as well as other mental health comorbidities among gay, bisexual and other men who have sex with men (GBMSM). While multiple studies have been... more
BACKGROUND Sexualised drug use (SDU) has been identified as a major risk factor for HIV, as well as other mental health comorbidities among gay, bisexual and other men who have sex with men (GBMSM). While multiple studies have been conducted on the topic, few have explored the role of trauma in underpinning experiences of SDU among substance use treatment-experienced GBMSM. This qualitative study investigates life histories of trauma, and proposes a framework to better situate the factors driving SDU among treatment-experienced GBMSM. METHODS We conducted semi-structured in-depth interviews with 33 purposively-sampled GBMSM with a history of SDU, and seeking treatment for it in Singapore. Interview topics included participants' experiences and life histories of SDU, substance use, incarceration, trauma, as well as stories of resilience and ongoing recovery from SDU. Interviews were audio-recorded, transcribed, coded, and analysed using inductive thematic analysis, from which a trauma-informed framework was developed. RESULTS Participants firstly articulated the positive and desired aspects of SDU, such as its utility in allowing them to achieve positive emotional states, sexual enhancement, and feelings of connectedness and intimacy. Participants also described how SDU, in contrast, was used as a coping mechanism to deal with emotional and situational 'precipitants', including dealing with loneliness and a low self-esteem, sexual shame and social anxiety, as well as general stressful situations. Participants also articulated how such precipitants were underpinned by experiences of trauma, including those relating to HIV-related stigma, racism, sexual violence, death and loss, neglect, as well as internalised homophobia. Next, participants illustrated how such trauma were in turn reinforced by several 'preconditions', including the accessibility of substances, emphasis on sexual capital, and lack of access to mainstream support structures in the gay male community, alongside general sociolegal barriers to accessing care. CONCLUSIONS This study proposes the role of trauma and the preconditions underpinning them in motivating SDU among a sample of largely substance use treatment-experienced GBMSM in Singapore. Interventions that provide support for GBMSM seeking treatment for SDU should provide trauma-informed care to address the complex barriers to treatment effectiveness.
Research Interests: Psychology, Drugs And Addiction, Gay And Lesbian Studies, Trauma Studies, LGBT Issues, and 12 moreMedicine, Post traumatic stress disorder, Drug Policy, LGBT Studies, Methamphetamine, Loneliness, Drug Addiction, Men who have Sex with Men, ChemSex, Psychology and Cognitive Sciences, Sexualised Drug Use, and Medical and Health Sciences
Background: Sexualised drug use (SDU) has been identified as a major risk factor for HIV, as well as other mental health comorbidities among gay, bisexual and other men who have sex with men (GBMSM). While multiple studies have been... more
Background: Sexualised drug use (SDU) has been identified as a major risk factor for HIV, as well as other mental health comorbidities among gay, bisexual and other men who have sex with men (GBMSM). While multiple studies have been conducted on the topic, few have explored the role of trauma in underpinning experiences of SDU among substance use treatment-experienced GBMSM. This qualitative study investigates life histories of trauma, and proposes a framework to better situate the factors driving SDU among treatment-experienced GBMSM.
Methods: We conducted semi-structured in-depth interviews with 33 purposively-sampled GBMSM with a history of SDU, and seeking treatment for it in Singapore. Interview topics included participants’ experiences and life histories of SDU, substance use, incarceration, trauma, as well as stories of resilience and ongoing recovery from SDU. Interviews were audio-recorded, transcribed, coded, and analysed using inductive thematic analysis, from which a trauma-informed framework was developed.
Results: Participants firstly articulated the positive and desired aspects of SDU, such as its utility in allowing them to achieve positive emotional states, sexual enhancement, and feelings of connectedness and intimacy. Participants also described how SDU, in contrast, was used as a coping mechanism to deal with emotional and situational ‘precipitants’, including dealing with loneliness and a low self-esteem, sexual shame and social anxiety, as well as general stressful situations. Participants also articulated how such precipitants were underpinned by experiences of trauma, including those relating to HIV-related stigma, racism, sexual violence, death and loss, neglect, as well as internalised homophobia. Next, participants illustrated how such trauma were in turn reinforced by several ‘preconditions’, including the accessibility of substances, emphasis on sexual capital, and lack of access to mainstream support structures in the gay male community, alongside general sociolegal barriers to accessing care.
Conclusions: This study proposes the role of trauma and the preconditions underpinning them in motivating SDU among a sample of largely substance use treatment-experienced GBMSM in Singapore. Interventions that provide support for GBMSM seeking treatment for SDU should provide trauma-informed care to address the complex barriers to treatment effectiveness.
Methods: We conducted semi-structured in-depth interviews with 33 purposively-sampled GBMSM with a history of SDU, and seeking treatment for it in Singapore. Interview topics included participants’ experiences and life histories of SDU, substance use, incarceration, trauma, as well as stories of resilience and ongoing recovery from SDU. Interviews were audio-recorded, transcribed, coded, and analysed using inductive thematic analysis, from which a trauma-informed framework was developed.
Results: Participants firstly articulated the positive and desired aspects of SDU, such as its utility in allowing them to achieve positive emotional states, sexual enhancement, and feelings of connectedness and intimacy. Participants also described how SDU, in contrast, was used as a coping mechanism to deal with emotional and situational ‘precipitants’, including dealing with loneliness and a low self-esteem, sexual shame and social anxiety, as well as general stressful situations. Participants also articulated how such precipitants were underpinned by experiences of trauma, including those relating to HIV-related stigma, racism, sexual violence, death and loss, neglect, as well as internalised homophobia. Next, participants illustrated how such trauma were in turn reinforced by several ‘preconditions’, including the accessibility of substances, emphasis on sexual capital, and lack of access to mainstream support structures in the gay male community, alongside general sociolegal barriers to accessing care.
Conclusions: This study proposes the role of trauma and the preconditions underpinning them in motivating SDU among a sample of largely substance use treatment-experienced GBMSM in Singapore. Interventions that provide support for GBMSM seeking treatment for SDU should provide trauma-informed care to address the complex barriers to treatment effectiveness.
