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Understanding the Service Needs and Preferences of Men Who Have Sex with Men Who Use Crystal Methamphetamine in British Columbia, Canada: a Qualitative Study


Gay, bisexual, and other men who have sex with men (gbMSM) use crystal methamphetamine at higher rates than the general population, often in a sexual context. Some require support for problematic methamphetamine use. Health services are available for this population, but little information is available on how gbMSM who use methamphetamine view these supports. We explored the perspectives of gbMSM who used methamphetamine regarding available and desired treatment, support services, and resources to inform improvements to these services in British Columbia, Canada. We conducted semi-structured interviews with 33 participants and used thematic analysis to identify participants’ needs and preferences regarding treatment and services. Participants desired services that incorporated peers and providers with similar lived experience, tailored to their specific needs, including addressing overall mental health. The findings indicate that making culturally competent adjustments related to sexuality to provide gbMSM-specific treatment and integrating peer support would better serve gbMSM who use methamphetamine. Mental health and substance use should be addressed simultaneously.

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This study is supported by the CIHR Canadian HIV Trials Network (CTNPT 030). David Moore and Nathan Lachowsky are supported by Scholar Awards from the Michael Smith Foundation for Health Research (#5209, #16863). Karyn Fulcher is supported by a Mitacs Elevate Postdoctoral Fellowship.

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Correspondence to K. Fulcher.

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The authors declare no competing interests.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). The study was approved by the Human Research Ethics Committees of the University of Victoria, University of British Columbia, and Simon Fraser University (No. BC17-485). Informed consent was obtained from all participants for being included in the study.

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Fulcher, K., Berlin, G., Taylor, K. et al. Understanding the Service Needs and Preferences of Men Who Have Sex with Men Who Use Crystal Methamphetamine in British Columbia, Canada: a Qualitative Study. Int J Ment Health Addiction (2022).

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  • Men who have sex with men
  • Crystal methamphetamine
  • Chemsex
  • Substance use treatment
  • Mental health treatment