ABSTRACT
ISSUE ADDRESSED: Stimulant use has been identified as a key risk factor for sexual behaviours leading to HIV transmission. Substance-related expectancies are associated with substance use and postsubstance use thoughts, feelings and behaviours. Expectancies held by specific cultural subgroups have rarely been investigated, particularly regarding a range of commonly used stimulants. METHOD: The Stimulant Expectancy Questionnaire for Men who have Sex with Men (SEQ-MSM) was initially generated through consumer panel and interviews regarding the most commonly used stimulants among MSM in Australia (methamphetamine, amphetamines and ecstasy), with initial administration among 98 MSM to facilitate item reduction. A community sample of 427 MSM was used to validate the SEQ-MSM, with exploratory factor analysis (EFA; n = 202) and confirmatory factor analysis (CFA; n = 225). RESULTS: EFA revealed three distinct substance reinforcement domains ('Enhanced sexual experience', 'Sexual communication and negotiation' and 'Cognitive impairment'). The scale was associated with stimulant consumption patterns (including greater expectancies regarding sexual enhancement among methamphetamine users), and the factor structure, comprising a final form of the MSM-SEQ, was confirmed through CFA. CONCLUSIONS: The SEQ-MSM represents a reliable measure of outcome expectancies related to the range of commonly used stimulants among Australian MSM. Development of applied validation studies with the SEQ-MSM is a key next step in advancing health promotion, clinical interventions and research efforts to reduce harm (eg, HIV transmission) associated with stimulant use (particularly methamphetamine) among MSM. SO WHAT?: Objectives: This research maps expectancies specific among gay and men who have sex with men (MSM), and relationships between expectancies and stimulant use patterns and behaviours postuse - including sexual activity (eg, condomless anal sex).
Subject(s)
Amphetamine-Related Disorders/psychology , Central Nervous System Stimulants/administration & dosage , Homosexuality, Male/psychology , Adult , Amphetamine-Related Disorders/epidemiology , Australia , Condoms/statistics & numerical data , Humans , Male , Middle Aged , Sexual Behavior/psychologyABSTRACT
We present a case involving an 85-year-old man with acute confusion and new onset seizure following a 1-week history of respiratory prodrome. This case report describes a case of influenza B-related meningoencephalitis supported by evidence of an influenza B infection and temporal relation of the neurological event and respiratory illness in the absence of other identifiable cause. Diagnosis is guided by cerebrospinal fluid profile and nasopharyngeal PCR. Treatment is largely supportive and the effect of vaccination on prevention of this neurological complication remains unclear.
Subject(s)
Antiviral Agents/therapeutic use , Betainfluenzavirus/isolation & purification , Influenza, Human/diagnosis , Influenza, Human/drug therapy , Meningoencephalitis/virology , Aged, 80 and over , Confusion/etiology , Humans , Influenza, Human/cerebrospinal fluid , Betainfluenzavirus/genetics , Levetiracetam , Male , Meningoencephalitis/cerebrospinal fluid , Meningoencephalitis/drug therapy , Nasopharynx/virology , Piracetam/analogs & derivatives , Piracetam/therapeutic use , Seizures/drug therapy , Seizures/etiology , Treatment Outcome , Valproic Acid/therapeutic useABSTRACT
A measure of perceived reinforcement associated with amyl nitrite was developed and evaluated among gay and bisexual men. This is the first known expectancy measure to date for this drug class. The Amyl Nitrite Expectancy Questionnaire for Men who have Sex with Men (AEQ-MSM) was completed online by 102 gay and bisexual men, between 2006 and 2008 in Queensland, Australia. The AEQ-MSM demonstrated good psychometric properties and was associated with consumption patterns. Factor analysis revealed three distinct reinforcement domains: "Enhanced sexual desire and pleasure," "Disorientation," and "Sexual negotiation." Limitations include sampling via self-selection, recruitment through health centers and self-report data. Implications for sexual activity and risk-taking, including reducing associated harm (e.g., HIV transmission), and future directions are discussed.
Subject(s)
Amyl Nitrite/administration & dosage , Attitude , Bisexuality/psychology , Homosexuality, Male/psychology , Reinforcement, Psychology , Adult , Aged , Humans , Male , Middle Aged , Reproducibility of Results , Self Medication/psychology , Substance-Related Disorders/epidemiology , Substance-Related Disorders/psychology , Surveys and QuestionnairesABSTRACT
INTRODUCTION AND AIMS: Alcohol expectancies are associated with drinking behaviour and post-drinking use thoughts, feelings and behaviours. The expectancies held by specific cultural or sub-cultural groups have rarely been investigated. This research maps expectancies specific to gay and other men who have sex with men (MSM) and their relationship with substance use. This study describes the specific development of a measure of such beliefs for alcohol, the Drinking Expectancy Questionnaire for Men who have Sex with Men (DEQ-MSM). DESIGN AND METHODS: Items selected through a focus group and interviews were piloted on 220 self-identified gay or other MSM via an online questionnaire. RESULTS: Factor analysis revealed three distinct substance reinforcement domains ('Cognitive impairment', 'Sexual activity' and 'Social and emotional facilitation'). These factors were associated with consumption patterns of alcohol, and in a crucial test of discriminant validity were not associated with the consumption of cannabis or stimulants. Similarities and differences with existing measures will also be discussed. DISCUSSION AND CONCLUSIONS: The DEQ-MSM represents a reliable and valid measure of outcome expectancies, related to alcohol use among MSM, and represents an important advance as no known existing alcohol expectancy measure, to date, has been developed and/or normed for use among this group. Future applications of the DEQ-MSM in health promotion, clinical settings and research may contribute to reducing harm associated with alcohol use among MSM, including the development of alcohol use among young gay men.