Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Faculty of Psychology, Open University, Heerlen, Netherlands.
Front Public Health. 2022 Jun 15;10:894415. doi: 10.3389/fpubh.2022.894415. eCollection 2022.
Few theory-informed interventions to support people who use drugs during sex have been conceptualized and developed. We conceptualize sexualized drug use, also referred to as chemsex or pharmacosex, as a self-control challenge, and draw on extant theory and research to propose intervention approaches that can be tailored to meet the differing needs of people who engage in sexualized drug use. We draw on a continuum perspective of sexualized drug use, in particular chemsex, and discuss the role of reasoned and automatic processes in behavioral decisions, as well as critical components of effective self-control of behavior. A self-control approach can empower people to tackle their sexualized drug use, and classify their experienced sex-related drug use as problematic. Self-control encompasses clarifying one's goals and identifying strategies to mitigate behaviors to achieve these goals, despite competing pharmacosex desires. Our approach to self-control sexualized drug use contains three critical components: goal setting, goal enactment, and goal progress appraisal and goal adjustment. Goals should be formulated specific, ambitious yet realistic, and tailored to the individual's needs and wishes. Goals may target aspects of drug use, protecting sexual health and mitigating negative impacts. Implementing goal enactment implies translating goals into concrete (short-term) actions to move toward the higher-order goal via goal intentions and action/coping plans. During the goal progress appraisal and adjustment stage, people compare their actual with their planned behavior. This reflection may result in goal adjustment through feedback loops to adjust their goals and action/coping plans. We propose that our self-control approach can guide the development of interventions to effectively support people to prevent or limit pharmacosex, and helps to effectively mitigate or reduce negative impacts via self-help, peer support or professional support, offered via personal counseling or digital tools.
目前，针对性行为活跃人群，仅有少数基于理论的干预措施被提出和发展。我们将性化药物使用（也称为“嗑药性行为”或“药物性行为”）视为自我控制的挑战，并借鉴现有理论和研究，提出可以根据性化药物使用者的不同需求进行定制的干预方法。我们借鉴了性化药物使用的连续体观点，特别是“嗑药性行为”，并讨论了理性和自动过程在行为决策中的作用，以及有效控制行为的关键组成部分。自我控制方法可以使人们有能力解决性化药物使用问题，并将其与相关的药物使用问题区分开来。自我控制包括明确目标和确定策略来减轻行为，以实现这些目标，尽管存在药物性行为的竞争欲望。我们的自我控制性化药物使用方法包含三个关键组成部分：目标设定、目标实施和目标进展评估和目标调整。目标应该具体、有野心但又现实，并针对个人的需求和愿望进行定制。目标可以针对药物使用的各个方面，保护性健康并减轻负面影响。目标实施意味着将目标转化为具体的（短期）行动，通过目标意图和行动/应对计划朝着更高阶的目标前进。在目标进展评估和调整阶段，人们将实际行为与计划行为进行比较。这种反思可能会通过反馈回路进行目标调整，以调整目标和行动/应对计划。我们提出，我们的自我控制方法可以指导干预措施的开发，有效地支持人们预防或限制“嗑药性行为”，并通过自助、同伴支持或专业支持，通过个人咨询或数字工具，帮助有效地减轻或减少负面影响。
