SESU: An interdisciplinary project on sexualized substance use.

Author: Claudia Bernardini, Lina Hijazi, Falk Von Staufenberg

Theme: Models of Care Year: 2023

The stigma correlated with sexual orientation, sexual habits and substance consumption delays and complicates the access to healthcare, with problems that are often not addressed or even neglected.
The lack of clear guidelines on sexualized substance use is the reason behind the SeSu (Sexualized Substance Use) pro

Description of model of care/intervention:
The project started in January 2022 with different interventions:
1) developing a multidisciplinary model of care including psychiatric/psychologic, internal medicine/infectious disease, sexual health, and social work support, 2) handling internal and external inquiries about patients, 3) networking and collaboration with external experts nationally and internationally
The project is guided by current scientific knowledge and consultations with experts in the field.

To date 29 patients have been enrolled, all men who have sex with men (MSM), aged between 24 and 64 years old. 17 of them are born in Switzerland.
Twenty have psychiatric diagnosis, mostly attention-deficit/hyperactivity disorder (10/20) or depression (9/20), sometimes combined.
At recruitment 52% (15/29) were HIV positive, already on therapy, with a controlled viral load, 2 were on PreExposure Prophylaxis (PrEP). All were actively consuming substances in a sexualized contest: 93% crystal Meth, 31% GHB/GBL (Gamma hydroxybutyrate/Gamma hydroxybutyrolactone), 27% cocaine, 10% benzodiazepine.
In the first year of the project 11 patients have started PrEP und 10 (34%) are abstinent.

Conclusion and next steps:
These results support that, an interdisciplinary under-one-roof model of care can support people with sexualized substance consumption and reach the goal of harm reduction.
For the years 2023/2024, we aim to increase integration of sexuality as a treatment topic for our patients. The cooperation with external institutions aims to develop further competences and establish guidelines in the context of an open innovative culture.

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