Understanding the Needs and Experiences With Health Services of Gay and Bisexual Men (GBM) Who Engaged in Chemsex During the First Year of the COVID-19 Pandemic in Quebec, Canada
Bibliographic record
Abstract
Gay and bisexual men (GBM) engaging in chemsex can face various health and well-being-related challenges, the extent of which remains unknown given the limited research in the context of the COVID-19 pandemic. This paper examines the pandemic impacts on the health needs of GBM who engaged in chemsex and their experiences with related services. We applied interpretive description to produce knowledge with direct implications for improving practices and policies. Data were collected between July 2020 and January 2021 using in-depth semi-structured interviews with eight key informants who held chemsex expertise and 13 GBM with chemsex lived experiences. Interviews were transcribed, anonymized, and analyzed thematically, yielding three interrelated themes. First, participants argued that the COVID-19 public health response was heteronormative and moralizing, reinforcing feelings of shame among GBM who engaged in chemsex and further isolating them. This added a layer of stigma and exposed them to increased drug-related risks by obstructing harm reduction practices. Second, participants contended how the pandemic worsened the scarcity and shortcomings of chemsex-specialized services. The mandatory shift to online services made it harder to form meaningful therapeutic relationships, especially given the unique sensitivity and stigma associated with chemsex, further heightened during the pandemic. Third, this online shift simultaneously facilitated access to personalized and culturally sensitive care, especially for those with less urgent needs. Our findings' implications emphasize the importance of adopting a comprehensive approach in chemsex care, integrating both in-person and online methods, to counteract health iniquities reinforced by the pandemic and the institutional responses to it.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".