Clinical Research Directory

Integrating Sexual Pleasure Into Harm Reduction Services for Men Who Have Sex With Men and Transgender Persons Who Engage in Chemsex or Substance Use in Thailand

The study evaluates the integration of a sexual pleasure-based approach into harm reduction services for MSM and transgender persons engaging in chemsex or substance use in Thailand, using the "Pleasuremeter" tool to improve sexual health and related outcomes.

The Implementation of a Trans-tailored Harm Reduction Service for Transgender Persons in Relation to chemsEX and Substance Use (iT-REX)

This study evaluates a comprehensive transgender-tailored harm reduction service for transgender women, transgender men, and non-binary individuals engaging in chemsex or substance use in Thailand, focusing on PrEP uptake, HIV/STI outcomes, mental health, and socio-legal impacts.

Faisability and Efficacity of the Reinforced Communautary Support Program (PARC) on the Complications of Chemsex

The complications associated with chemsex concern infectious disease specialists, addiction specialists, and public authorities. Chemsex is defined among men who have sex with men (MSM) and trans and non-binary individuals participating in gay hookup networks due to their specific psychological, sexual, and social characteristics. The drugs used in France are cathinones (3MMC), GBL, and methamphetamine, administered orally, nasally, rectally, and intravenously (\"\"slam\"\"). Building on change models and health education theories, the teams at 190 and Spot Beaumarchais (AIDES) have created, within their shared facilities, the Parcours d\'Accompagnement Renforcé Communautaire (PARC), a multidisciplinary and community-based program providing comprehensive care for chemsex complications. The program aims to achieve clinical benefits: * Reducing addiction symptoms * Decreasing somatic, psychiatric, and social risks related to chemsex * Exploring and addressing the determinants of consumption and complications, especially psychological and psychiatric * Improving social connections * Maintaining life and professional goals * Perceiving or creating new types of connections between men * Resuming physical activity * Improving self-esteem * Finding a satisfying and fulfilling sexuality * Enhancing overall quality of life The goal of this study is to ensure that the PARC program, as designed, reaches its target population, is feasible, sustainable, at an acceptable cost, and improves the conditions of the population accessing it throughout the course. Thus, in the medium term, this study will identify all success factors for deploying such a program and build a toolkit for its dissemination to other regions with similar issues but somewhat different contexts. The primary objective is to evaluate the feasibility of the PARC program in terms of implementation by measuring patient adherence to the program. The primary outcome measure is the rate of patients who completed the follow-up in the PARC program compared to the number of patients who started the PARC program (at least the inclusion visit) over 18 months. A patient is considered adherent if they have attended at least one of each type of workshop offered during the first month AND continued to attend at least 4 workshops and 2 consultations per month during months 2 and 3. The secondary objectives are: 1. To evaluate the feasibility of the PARC program in terms of implementation, using the RE-AIM methodology (Glasgow): * Reach: Does the included patient population accurately represent the target population? Does patient loss represent the most vulnerable patients? * Intermediate Effectiveness at 3 months: (self-administered questionnaires) * Overall quality of life * Addiction criteria * Somatic complications * Social life * Sexual quality of life * Adoption of the intervention by professionals: Do addiction networks, CeGIDD, CSAPA, and city doctors refer their patients to the PARC program? * Implementation of the intervention: Has the program evolved from the beginning to the end of the study? Have there been adaptations? * Maintenance or sustainability: Is the financial model of the program sustainable and does it ensure a return on investment by analyzing the cost of care? 2. To identify contextual factors that are facilitators or barriers to optimal implementation and effectiveness. (qualitative analysis) The expected sample size is 60 patients included over a period of 18 months. Each patient will be included for a duration of 6 months, and the study will last for 24 months. Once included, participants will complete the initial self-questionnaire collecting baseline socio-demographic, clinical characteristics, and all intermediate effectiveness outcome criteria \"\"before\"\". Concurrently with their participation in the program, they will complete various intermediate effectiveness evaluation questionnaires (\"\"after\"\") at 3 months (end of PARC) and 6 months (Post-PARC). Healthcare professionals running the PARC program will also complete questionnaires related to implementation indicators throughout the patients\' course (Adoption, Implementation, Maintenance). Qualitative interviews will be conducted with patients and relevant healthcare professionals to explore barriers and drivers to the optimal deployment of the PARC program and to examine each of the Reach, Adoption, Implementation, Maintenance indicators through an organizational approach

Effectiveness of tDCS on Reducing Craving in Patients Practicing Chemsex: a Single-center, Double-blind, Randomized Controlled Pilot Trial

The aim of this research is to evaluate the efficacy of a new treatment for chemsex or "chemical sex", the use of psychoactive substances to modify sexual experience and performance. This treatment, called Transcranial direct current stimulation (tDCS) aims to modulate the cortical activity of brain areas involved in the desire to use psychoactive substances, or drugs, and the desire for uncontrolled sexual intercourse. This treatment should therefore lead to a reduction in the craving for consumption of psychoactive substances and/or the practice of uncontrolled sexual activity. The stakes of this new treatment are high, because chemsex exposes people to health risks for themselves and others. These risks include the risk of infection (skin infections, HIV infection, hepatitis viruses), psychological harms (anxiety attacks, depression, suicide risk), risk of addiction (addiction to the psychoactive product used, sex addiction), and toxicological harm (overdose, dangerous combination of psychoactive substances) or trauma (blows, trauma to the genitals or anorectal trauma). To date, there is no proven therapeutic treatment for people wishing to reduce or stop chemsex. 40 participants will be randomized into 2 groups: * 20 patients will receive active stimulation * 20 patients will receive sham stimulation The total duration of the study for each patient will be 13 weeks: 1 week of stimulation and 12 weeks of follow-up.