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Randomized Controlled Trial
. 2021 Feb;97(1):11-17.
doi: 10.1136/sextrans-2020-054438. Epub 2020 Jul 31.

Enhancing help-seeking behaviour among men who have sex with men at risk for sexually transmitted infections: the syn.bas.in randomised controlled trial

Roeland Christiaan Alfons Achterbergh  1 , Martijn S van Rooijen  1 , Wim van den Brink  2 , Anders Boyd  3   4 , Henry John Christiaan de Vries  5   6
Affiliations
Randomized Controlled Trial

Enhancing help-seeking behaviour among men who have sex with men at risk for sexually transmitted infections: the syn.bas.in randomised controlled trial

Roeland Christiaan Alfons Achterbergh et al. Sex Transm Infect. 2021 Feb.

Abstract

Objectives: Men who have sex with men (MSM) are at increased risk for STIs and mental disorders. Syndemic theory holds that psychosocial issues co-occur and interact, and thus increase sexual risk behaviour. Psychosocial issue identification, referral and management might reduce risk behaviour.

Methods: In the syndemic-based intervention study, an open-label randomised controlled trial, MSM were enrolled at the STI outpatient clinic of the Public Health Service of Amsterdam. We screened participants using validated questionnaires on the following problem domains: alcohol and substance use, sexual compulsivity, anxiety, depression, attention deficit hyperactivity disorder, alexithymia, intimate partner violence and childhood sexual abuse. Individuals were randomly assigned (1:1) to receive either tailored, face-to-face feedback and help-seeking advice on mental health screening, or no feedback and no help-seeking advice. Participants were followed trimonthly for a year. The primary outcomes were self-reported and confirmed help-seeking behaviour.

Results: We included 155 MSM: 76 in the intervention group and 79 in the control group. At inclusion, 128 participants (83.1%) scored positive in at least one problem domain. We found no significant differences in self-reported or confirmed help-seeking behaviour between the intervention and the control group: 41% vs 29% (p=0.14) and 28% vs 22% (p=0.44), respectively. There were also no differences in STI incidence and condomless anal sex acts between the two groups.

Conclusion: Screening showed high prevalence of problems related to mental health and substance use, while tailored feedback, advice and referral did not significantly increase help-seeking behaviour. Other interventions are needed to tackle the high burden of mental disorders among MSM.

Trial registration number: NCT02859935.

Keywords: homosexuality; sexual health; substance misuse.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Enrolment and follow-up of study participants of the syndemic-based intervention (syn.bas.in) study at the STI outpatient clinic in Amsterdam, 2016–2018.
Figure 2
Figure 2
Sexual behaviour over time by intervention and control group among men who have sex with men in the syndemic-based intervention (syn.bas.in) study at the STI outpatient clinic in Amsterdam, 2016–2018. (A) Number of partners over time (no difference between intervention (red) and control (black) (p=0.546). (B) Number of condomless anal sex acts with casual partners (no difference between intervention (red) and control (black) (p =0.494)). STI prevalence (no difference between intervention(red) and control (black) (p =0.914)).
See this image and copyright information in PMC

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