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.
This is a sequential exploratory mixed-methods implementation study conducted at IHRI clinics in Bangkok. The study includes a pre-implementation phase (qualitative interviews) and an implementation phase where the adapted "Pleasuremeter" is integrated into harm reduction services. Approximately 300 participants will be enrolled and followed at baseline, month 3, and month 6. Outcomes include sexual pleasure, behavioral risk, substance use, HIV/STI testing, mental health, and socio-legal factors. The study also evaluates acceptability, satisfaction, and feasibility of integrating a pleasure-based approach into existing services.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
300
Semi-structured in-depth interviews guided by the Pleasuremeter framework, covering 7 domains of sexual pleasure: * Physical and psychological satisfaction * Self-determination * Consent * Safety * Privacy * Confidence * Communication/negotiation
Participants will undergo: * Sexual pleasure assessment using Pleasuremeter (0-10 scale, 3-month recall) * Behavioral risk and substance use assessment * HIV/STI testing * Mental health screening using Electronic Mental Wellness Tool (e-mwTool) * Social and stigma assessment * Harm reduction services (drug literacy, counseling, referral, harm reduction kits) The intervention aims to facilitate structured discussions on sexual pleasure within harm reduction services.
Tangerine Clinic, Institute of HIV Research and Innovation
Pathum Wan, Bangkok, Thailand
RECRUITINGWillingness to engage in sexual pleasure discussions assessed using the Pleasuremeter tool
The primary outcome is the proportion of participants who agree to engage in structured discussions on sexual pleasure using the Pleasuremeter, a structured assessment tool covering 7 domains: * Physical and psychological satisfaction * Self-determination * Consent * Safety * Privacy * Confidence * Communication/negotiation Willingness will be assessed at each study visit (baseline, month 3, month 6) based on participant acceptance or refusal to complete the Pleasuremeter assessment.
Time frame: Baseline, Month 3, and Month 6 (over 6 months follow-up)
Sexual pleasure score assessed by the Pleasuremeter (0-10 scale)
Sexual pleasure will be measured using the Pleasuremeter, a composite self-reported scale assessing 7 domains of sexual experience. * Scale range: 0 to 10 * Minimum value: 0 (lowest level of sexual pleasure) * Maximum value: 10 (highest level of sexual pleasure) * Interpretation: Higher scores indicate better sexual pleasure and satisfaction Scores may be analyzed as: * Overall composite score * Domain-specific scores
Time frame: Baseline, Month 3, and Month 6
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