Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

you know, high breath. How are you? I'm very well, thank you. Yes, Not too bad. Thank you. I've got a lease email, and she said that it would be yourself coming last minute traffic. No problem. So you happy for me to transfer the hosts yet that we have on your nerves? Great. Thank you. Uh, should be done. So you should get notification. Now that says that you're the host, right? Brilliant. Thank you. Do you need me to stay on the line for anything else? No. No, I think they hopefully can. Right. Do you need any guidance? It all on how to? I'm sure. I know everybody in the modern days used to do now, but I think just a hard right transfer hosted somewhere else. So all you need to do so if you were to offer over the image of myself. Yeah, and you should get in the right hand corner. Three dots. Yep. And then I believe in there. That should be an option that says make individual the host or may Yeah. And you can also make somebody The co host is last. It might be a useful idea when l e joins or anybody else who's overseeing the event. If you make them Costa's well, and all it does is just guarantee that it's safe. Someone's got technical issue or their Internet drops out. Somebody else, then is the host with you as well. Okay. And then, obviously, Teo, add any body in a swell. So you just click on the participant list and you'll get a list of all of the people who are in the waiting room, etcetera. And you can just click, admit whenever suits you. Yep. No problem. Breath a hobby. Uh, evening goes Well, it's nice to meet you. You did. You see eye flu? Hi. Yeah. Okay. Yeah. I won't get thinking you on a post. Their recording. Is that possible? Uh, is it recording now? Hi, everyone Things but bearing with us in the waiting room. Um, I'll just take a moment, say, to introduce things while a couple more people arrive. And then then I can hand over to, ah, Stephen and Christopher. So just quickly, kind of first he might. My name's Ellie on down part of this dash steering committee. So for those of you that came to our last event, welcome back and those of you that new to us. Don't worry, we're pretty new anyway. And you haven't missed out on much yet. Say, Stash formed earlier this year. Um, and essentially, we kind of want to just foster a collective of pre specialty doctors and medical students and just get them engaged with sexual health and HIV medicine. Help them to kind of discover it and to enjoy it as well. Uh, before we get started, just two things to mention still pushing them from last time. But, uh, firstly, we are keen. Start a podcast on. Do we want to get your ideas on how best to do that? So my colleague Jason and Hannah running a Google format moment, I'll pop the link in a chest in in just a second. And the other thing, um, if you're, uh if there's not a local ambassador at your local you know your in your local Diener E and you're, say, a medical student or a pre specialty doctor, then we'd be really came to hear from you if you're interested in getting involved, Um, we've been really fortunate to have our our investors kind of spreading the word, and it's probably why a lot of you here this evening, anyway. Again, I'll put the link in the chat about that as well, and then you can discover a little bit more. So we're here this evening to hear from Steven and Christopher. See, Stephen is a lecturer in mental health with a special interest in minority populations. Health in a quality, particularly mental health and sexual health. Um, he's competing. His PhD focused on men have sex with men. Substance use since prepped up. Take a swell as medication adherence on Do then we have crystal wards. So Christopher is, ah, project lead for a service aimed at improving health and wellbeing of all men who have sex with men and living in Scotland on his backgrounds, in health promotion, community development, on engagement with quick communities. So we'll hear from them both in there talking. You're welcome to put questions in the trap as we go along on by the I'll try and feel them to them, Uh, when it comes to it, if if the moment seems right or otherwise, we'll save them for the end. Super. So if I stop sharing my screen and then I can handle a bit. EBay share socks. So this is all? Yeah. Yep. No, it's perfect things. Hi. Everyone has the list here to molecular. And it broke and actually just completely refused to you. Thank you. Goodness, uh, except for, um so Slate for just, you know, kind of introductory came six on sitting like Sure, um, looking at mental health, but more interest from them. Play a pond and May of six with me. I'm, like, class introducing still? Yeah. Evening, everyone. So I'm Chris Wards and I'm the SX lead for the service for we'll take care for a game by sexual minute All men who have sex with men living across Scotland. So the basic former for the next, uh, orders walk with flu, maybe 10 drops late. It's just some basic information When boys came six. Um, what type of us? Because it involves. We're tape of these less production interventions. We we can consider Run him. We're working with that high in a script. That gauge came sex name on both couple cases. It ends on it. It gives me back on and the Crestor leader in the name That's the resources you cannot say saying for for reading and watching is really listen. But here is on some vaginal creations of the end on so many or sex with me and has a generalized epileptic Ultram includes gave a sexual and other media sex with men you me know identifying this could give or bisexual um, and terms of a the same as a general as a general group, the artist proportion effected by weight or health. The quality is not just sexual. I'm generally how could your health comes and compared to the jail life population on behind countries and other. And in conclusion, um, there are high risk smoking among name is in computers in life, population hired it's chronic diseases and that was being physical, chronic diseases on middle that comes on the considerably improved on the generalized population. Taking the mail to moderate for me to hold this protective actually is anxiety on melting. More clear, she it has the groups that was effective HIV or mother tingly advances in the last since it is a protective layer in the last 20 years old and each of the fridge generally, and it's a small cluster and hip technologically that are strong be effected. I had a high streets of reaching instance currently the UK and he starts one from 2020. 105,000 people are current living with the HIV off which approximately every saying mark equation between 45 47 1% ish or what number? Excuse me. What you mean by MSN? Maybe your sex with me? What mean here? Six with me. Men have sex with men. Yeah, well, okay. It's a generalized. It became a logical time. So came six isn't probably haired of King Six. There's not a lot of the new terror to most people. I never heard of 10 sex before. Okay? Some people may have came across the others, you know, it's available, typically the new term. And it's chemo drug misuse among mail your sex with men on. But that's been about maybe a few just in recent last few years. And so came Six does have a formalized definition from public health England, which is being around a few years now. So came six. Essentially, is the plan and use of cycle off drugs potentially psychoactive drugs. Umbilicus, um, was keep drugs before or during sex, which is two purposely and intentionally over to enhance it. A facilitated some prolong it in some way. Um, that's essentially taken. None been amended from the public. Your thing when definition Um, although there s a revealing definitions of work that might look at this other terminology that's use, which makes the final came six quite complicated. Um, in terms of payments for him sick someone, maybe your sex with men, Your weight being prevalence estimates, Um, depending on the sexual content. Rear that, um, really study sound has been taken from generally and the more generalized larger many or sex with males studies, samples, swings Pruthi 13% more short between 50 and 10%. So it's important to say, as a minority off maybe her sex with male, You actually on gauge what we define. This came six um, waiter, drug and alcohol misuse. Um oh, maybe your sex from a does have higher rates and compared to general population in a way. But there the tail came six on the behaviors. Associate it with our has a protect your tech alert kind of a cart full context. It's claim port is whale applies within the mortar a little bit. Why, maybe your sex with me and engaging came six. Crestfallen. Going to talk about is we'll market some of those behaviors was really weird d too, But that may be on again. There are definite are limitations and Esther Meeting prevalence is use the differences in terminology. Studies on radiation is naturally, and we'll take the drugs. That might be, for example, in hospitalization. It who has a general, corny, say the public health to England definition as a fuel real except standard definition. Some, um, I could eat a limitations with in it. Thanks, Stephen. So, yeah, I'm going to talk a bit about the motor that is, You're engaging in chemistry. So when we're talking about the inhibitions in relation to come sex, we generally talking about different experiences of game bisexual men and men who have sex with men, these can extend from internalized feelings of shame. Societal pressures and potentially group pressure's a swell about performing in an idea idealized way. This is sometimes actually perpetuated through pornography and other representation of sex between men. It's also been shown as well that, particularly with income sex communities, was a higher rate of people living with HIV or older men as well, who have known to be carrying more of the burdens in relation to when to health issues but also substance abuse issues as well. Now the drugs are used in camp. Sick scenarios enable men to escape from these internal and external pressures. And then Stephen is gonna go on to talk about that more of some of the specific drugs a bit later. But ultimately, many of these drugs can increase The sense of confidence, can make men feel more relaxed or more aroused and lead to more impulsive behaviors. And in some cases, the drugs can actually lose to a loss of feeling, which can leave people vulnerable to injurious. Well, Onda Some of the people that we've worked with directly have described as the best sex liver, perhaps Onda, as the drugs enable them to feel more in touch with their partners and last longer free from distractions. So there's many different reasons why individuals might engage from potential previous trauma is to just bit wider. Expectations on them is well, and these are kind of listed inside of kind of internal sexual pleasure into personal dynamics and escapism a swell if you want to go to the next slide Steven. So these are kind of listing some of the different drugs and desired enhancements that men may have. So the desire and handsome it's from the drugs they're interested in taming are not mentioned a few, but not limited to just the following. But these examples of social emotional alterations resonate with many of the experiences of our service users, with many of them noting that without drugs they feel unable to converse with guys, let alone feel any intimacy of connection with, um. In addition, many individuals note that they have taken part insects that they wouldn't have without the aid of these drugs as well. For example, fisting There's something that people engaged with your income's expertise that prior to that they wouldn't have engaged with. And this this is because of the suggestion that feel less pain. But also they feel more trust in their partner. So is more about realizing these things in isolation, in terms of how much they make people feel in the moment. This idea of sense, of increased confidence on just the increased sense of intimacy they have with the others, particularly for individuals who had really negative experiences growing up. A lot of shame around their sexuality and the desires Ken Sex provides is perfect storm of making them feel safe, making them feel loved and making them feel part of a community that they've always wanted to be part of. And in addition, these kind of ideas about having the best sex, how to perform better, how to just actually relax and get really into the moment are big drivers and big reasons why people struggle to come away from camp sex and go back to one. Airports would just be sober sex, and ultimately, this is the kind of thing that you'll see and kind of have to pick up on because the next slide Steven so much you don't have a look. It became six cortex and Tim's watch Little Carson thing. Remaining colon came six station and chills The wind Guys will complain drugs with six commonly association and within not when you press with that. Accordance. Commonly last few adversity, said lowers, maybe three hours over to 70 hours, and that's more common, although in some circumstances you get some sessions of last won't get up to to your Feet. He's on that as more than reality. Um, a lot of it has a potential for, um to happen. Stations usually occur mostly in people's probably holes, and seven years been moved towards more recently, some evidence? Sure not. Um, you know, with yourself things like social networking applications mid meeting people on lane offices that's facilitated and easier meet with people's private homes. Um seven. Historically, um, I'm certainly abusively on Still claim succession still Duke or car from six on plain machine use so that that little that will be places like soreness commercial based type payments is a lowered that trying probably a one C is that between 50 and 60 65% of the car with implying it warms lawyers potential the duke still occurring or not? Give it, and certainly assuring that um, usually start us is linked. On Day two came sex and Evolving became six, usually post of AMISOM on. More lately, 10 mg came sex and non HIV positive a medicine, and there's clearly evidence to indicate that defend that scenario is well. But as injecting of drugs within a claim succession like kind occur, Um, that's often a fair to Asar Cool Quit Kogelo Terror, which is called slumming. Um, a law again. The thing that came safe population. It's more the minority that will, um, inject came sex and she, um, and again, clearance estimates do really weight lift about like a waiter studies that look a prevalence estimates of large am It's generalized large a me see examples, um, for him, maybe six of me to combine drugs for 6% for purposes. Essentially, I'm sorry. 129% perspiration Those estimates on the drug most associate it Teo injecting with the came sex context, what we call Krystal myth and getting into a crystal made for short because it's words. It's usually called that are are the drugs that are injectable Israel wife owners a custom. If jail is the more calming drug within, that's not really a major sex minimal. And Jake for sexual reasons. Yeah, within the cortex of came succession often involves a few partners on which can over be cardinal Any changes that might get on a ms or the maybe known anonymous. So I phoned is the guy's engaging came, said when I came succession will often and do the regular northern ornaments partners so conscious during sex partners on sometimes ah, Guayaquil engaging came, say, through his long term need partners. Well, generally, um, came six just from my phone and my b section came six. Generally, um, has a few partners older? The Lasix vying for sex sometimes come in a 1 to 1 basis, several in some circumstances. And within bigger came six events that might last for longer periods. That has been evidence. Were came successions kind of both numbers, like 15 to 2025 partners. I gained more calmly sold on. But I'm not five partner number. And see my friends more. Coleman. Yeah, um certainly created association between everything. Really complaining off. Elicit drugs for six and elicit drugs Do effect their function called depart ways. Reason judgment on it affects influencing undeserving medically. So often than not. Point takes. Obviously, that will affect sexual judgment. Making decision making I'm just taking is well on. Remove those and depressions to with and not circumstance as create association. The evidence that I I risks appointment your sex within a came six station sitting off. That's important terms of HIV risk because we're playing you took some, um, a lot of sex with men for HIV as corn and muscle. No intercourse on that corn takes is really severe into the kid. That is it ticked were called VESIcare exceptional ox a certain been associated with. I came six context, for example, and vested, an office of that involves somehow your risks is well, from that context. That's, um, generalized. Less behavior in the balls for cell from a came six cortex is actually appreciate it. Um, as Christmas and earlier. I don't the drugs the drug see next. Okay, there's the drug shoes with, you know, that complains on with sex to in Heinz facility for long. The expedience the's are some of the mean dogs that are used in the UK or low. It's important to you besides that, um, across nations within unit the your expanded, uh on steel. Yeah, for example, In high income countries, drugs of choice do really defend regions on beside nations as well, Even within the UK andare relations and what may be used, um, seventies or some of the war eroded strokes are being went to came sex. Um, actually, more more calmly off and miss one C to to not take this naturally crystal meth off for two eyes tear GHB slash tbl or from the fertility makes the joint or And what about his limits? Me on now, cocaine Charlie on Katie Mean fair to scan that stuff. It just generalized Just involved with, You know, most are all types of the lessons trucks going back to some of them think I mentioned earlier about, um you know what effect important to function on a decision making ability. Uh, con and effect judgment on that's an association with most types of the less of drugs were were inevitably, when suddenly becomes disinhibited the wall take more risks. Generally, on the scene is treatable more substances, for example, calculable mostly on extreme stating that came six point takes for the tiredness behaviors thing takes if I miss the label of risk on your same time obviously increases the risk of, you know, things are usually about possession. For example, on the Effexor people, me years, percent of drugs for on different tests involved with yours and definitely is off menacingly strokes um Kissel myth, um again as I mentioned earlier, it's probably the most inject drugs within that came six context a lot con and be started swolled a swell the little bleeding If it's this is just a somebody will providing what information on these protect drugs is really can be cut. Teach. Be TBTO his office world in a liquid form. Clear liquid form by can be injected. Israel A PSA potential One breast part, particularly, is the highly addictive nature, or GHB. Risk of dependence when But Catalonia's up to succeed in the GI tree. Is the risk over overdose on Because as a replacement, and it comes generally in a clear liquid form on, there's a high risk. More doors protect it when it's combined with other drugs, like our whole or other places. Methedrine. Maybe more radiation or next quite commonly used. A preferred came six context and made it tapes and populations. Um, getting cold. Always swollen kind of started, um, so I just stayed obviously about anxiety. Increased heart palpitations on. Go along with that king again, more calmly waiting. You know one, um, and were generalized context of breath on the meaning of me. Six population again protect low risks with our again just hardly, um, can be some potential issues that, in part, annoying on chest on ketamine. Um, it's fully less well, normally used truck, and one probable Mason used Chantix looks but still can be used. Um, from that context, essentially effects of it are the numbness, feeling loss of feeling generally and being vulnerable to assault in engineering on coming again. Various mixed nations that come use like snorted, swollen on potentials can be injected. Um, certainly, Um, from my experience is looking with the search customer myth, there's heart, higher risk factors. Israel on potential weakening that and an addictive nature. Um, and obviously not association goes with injecting increases that those risk factors on Crestor made has been protected like to seven risk behaviors as well. Um, I meant to health, and part of our as well can be obviously difficult as well. The fisheries part noise. Listen, Asians, in a short period, after using these types of drugs on potential longer turns real, we'll provide more links in each separately of these drugs. Um, you can have a little comment on the website. Some prevention were you doing, and to get from all your resting. Quite a lot of different doctors future. Those tapes drugs to consider. But generally, ah, name drugs in the context may excuse. Probably Klestil may have a huge be made for drawing of often often seen Ecstasy is, well, um outside of London. On again come differences between 10 Wonderland on Don't Say the least you came directions for Potential impact on biological The psychologic on social health and claim sex on the card is it's one just factors when you combine your structure of six and risk behaviors involved in that was obviously a clear risk. Higher increased risk of reach any heart possession. The key sexual s factor, too. That's condom a skin or six a lot. Obviously, people are injecting and sharing injecting equipment off any tape. Obviously a Lescol actually being passed through sharing already taken from JT equipment, Hepatitis C. There being a few payments. Studies have done a bone hepatitis either. I mean, her six mean to engage in sexual eyes, drug use on the weight and veering play once a estimates, and because the nature of the studies it's difficult to draw on you from conclusions from North, say only obviously in terms of hepatitis C, even a breath came sex context. And one of the plain idiots options mission for hepatitis C is injecting drugs years on. That's more raised in generally the phone and injecting drugs. Using population, you can sort of came sex cortex up. Seems now your appliances sharing of injecting. From that came succession carries. Just keep a potato. See all you can't escape a sexual rescue. Attentional e off a hepatitis C past for in sexual Israel, it has they swelled on injecting, but it's still a potential risk sexual appetite. And see, um, when I mean just fucking times again over your blood borne viruses Hepatitis B because hepatitis B as more contagious essentially survives. That said the body longer a Z Z e t o. And passed on by feeling different methods again, sit for risk factors. Car you thought injection drug use carrots without arms. Also, sharing off snorting equipment is protective for a spot from not as well until she likes Norton ships. Excellent is using a cookie, for example. The's real things just read off gentle block born by. This is obviously Cuba spot for saying that, um I was looking at noon and open viruses arm or other, but usually to ST I Some things like chlamydia, gonorrhea, syphilis, syphilis or research. It's in recent years. In the last 10 years of taking a manual sex with me, the clear evidence there's that showing an association came sex engagement on Bacterial ST I diagnosis and treatment on Get another list up to actually within the context for when we are engage in sexual consultation with me in six men and you might engage came Sex is well and no biological to stop physical with our our be crazy important. And that kind of have a waiter and parked in the life is well until what we consider the sex a psychologic from social impact. Um, there's some evidence which is limited has been more the evidence done on the biological components like and other ST I see on the HIV risks of the house in the psychosocial components. But there's evidence to suggest that went for mean your sexual men who engage in caves X can have. I can have a negative impact on that side. Kalashnikov, A social well being, um, defend some of that context then parked from the wager Life know by large for the stupid, from individual to individual on our individual of experiences of those guys on how that manifests, you know, we know from the evidence is that is that compared to claim the mental functioning, more generalists or things like melt more? Give me to fill messed things like anxiety education? Um, social functioning as well, depending on the nature over social networks is finished. That can be potentially isolation from non came sex networks, like an isolation from family on my I don't know, came six friends, occupational declaim, um Israel and then called activity artwork and potential sickness from mark on potential losses of employment. Um, there's a star smoking declining in terms off a graduate to decline in terms off the impact on disability have been part of my half. Um, on came six in cages Life, um, say only evidence indicates that the higher the frequency intense deal became six. The higher degree off the problem Arctic and part of me humble in their psychosocial and part. I'm a lot of that may be given by wise reasons, again by some to make you to claims 67 sets. Um, for my PhD you could intimate that guys who region came six, maybe for escape. It's purpose is from wait are places and the life Worth Me have hard, femoral bit mental illness that's been exacerbated to me. Engaging came six for escapism on, then start to engage in it warfare and commendable control. Compulsion on that and irritably, wasn't test cycle declining. Calling to function under declaiming cycle, off cycle or psychological in social function and weight and part in our lives on certainly, like can be true of non came sakes. Problem like a drug use is really low and frequency and severity of drug use humbling tension on 70 of the unique factor of our obviously escapist mechanism. Why something engaging came six not needing to on increase desire to engage in just behaviors of the patients from wager, life or exacerbation all made film. This is the combination of that getting into a compulsion on 22 escape into the skiers, for example, and potential and parked in increasing intensity on the severity of imparting me half on whether it's mental health social, they'll be, um, occupation function, for example, and tells a generalized risk reduction. There are being kind. Of course, production lately is is really a car and discuss which applied to drug use and sexual behavior more. Jane Oy. Um, so and some of those key aspects we advised using came to someone that you trust. Obviously, as I mentioned earlier, Pair of judgment has impacted upon so often advised by using, came on duty and came six. It's whether people be know, establish some sort off, even if it's just a cardinal relationship and former be sick Lane of judgment. Um, we're not engaging in a came succession together. Some people, they're established on me. You just know where General it can slightly adjust. Our risk goes without saying limited with different types of drugs and the quantity of drugs. So often I came succession can involve, um, had polish sausages on the candy. Multiple substances used within one came sex session on the candy or them know, came six trucks substances within that context, like alcohol, for example. So um yes, attentional to advise the limit tapes of drugs to use a just limit, you know, it talks that the feel maybe harvest a detriment impact on their cottons cognizance on, then making and she shooting quantity are measuring of quantity off those drugs. Israel, which is important, um, avoid using cames for too long a pd. It again lately does longer the use men, not short period of time. The more little experience things like hallucinations and paranoia, which is always important under there called Function on this Fucking Always a risk factors that may be exposed to, you know and peed it on. And it came succession period after the claims extension. Avoid healing all snorting or injecting equipment. Smart relates to a kind of a drug. Use the cream at all and so snorken chips or if they are injecting, not doesn't just will be two needles that also leads to things like syringes and, like water mixing cops and a part of familiar involved in injecting. We advise looks they're not nearly can imagine. It'll did you start desk ah boy, relating it in one else. Inject a marking card. It's on risk. For example, have you seen our person use sterile injecting equipment? Half how is seen either Paris and draw up the drug that the point of injecting Beth harnessing on the Paris and measure like that drug and actually know what they're going to be injected with a roll. Key factors with a knife. Let somebody else inject them. That's quite important factors and not oxidase. Inject equipment provision that arm Judge Ginger's paraded between all nature tailings onset is across the U. K. Which people can access is well, I can get those from actual print services on medical or and can get the fuel injected. Quit prevention. Um, I think what guys are maybe or change it accessible service is not necessarily medicine and stuff has drug users. And there's always that stigmatization obsessing these tapes serious is that are some body is just trying to train a juice in terms of my guys perspective. What you mean you are on, you know, and being a service that me know before heading, for example. But it's important to oxidase stable. Injecting equipment on dust only use once a day and within that context, uh, kind of standard vaccinations protocol for manual sex, minutes for hepatitis B and Hepatitis C, much con or as Jonah given through our PT DPC directive, there are different combinations of that. I'm complaining vaccinations like trend looks. There are more nerve oxidation in Israel with schedules that will be taken to the local, and it chased trust for a board skates. And what was particles are That's a standard vaccinations for me and your sex. Meaning you kid, um, in terms of the structures associated thing came sex really? Really advise on standardize ST I HIV and hep C screening 1 63 months. Um, I'm being a bagel or thing. I'm just encouraging people to 10 once a good few months for a few months screen on. Obviously no real help the exposure prophylaxis or itching you pick, um, introduce. Engaging in came 67 and it was just factor to associate that quarter machine or six less associated of having to use that diagnosis for next year on intention 10 gauge in the corner machine or six. Um, you know, and we qualifying criteria for paper. You know it, um, I'm Keith. Thing about it is obviously the juices the vasculature in your possession by up to 90% which is clear within the evidence, which is always the higher effective, which is an important total of these other dress conduction years of reducing the risk of each other. Young quizzes she Thanks, Stephen. If you could click through those and yeah, I just wanted to highlight as well like, particularly when it comes to these different risk reduction strategies. It's always good to kind of be aware of simple questions around a Stephen highlighted lack of access of services or difficulty accessing services, but also additional concerns such a scorer gyn or intimate partner violence in a relationship that prevent someone from accessing. And when we're talking around setting boundaries in relation to restriction, the key thing is to focus on the list. It's a port as it to a system for reducing the risk, particularly when discussing topics around pleasure and consent on there Really vital to understand someone's motivation or so enable them to decide what is healthy and realistic for them. So he could click for the first one. Stephen just go through them. So the key thing is knowing what they're mixing, so particularly when it comes to camp sex drugs, some of them can really counteract each other on lead to really drastic consequences. Additionally, for someone who's living with Hatred IV, some of the drugs can affect. How I hate you're being medication works in their body as well. So it's key to keep that in mind and also be consider about who's organizing the party on where these drugs are coming from. A swell because it may come premixed. Be clear about the limits. So this is a big part of what we do through our camp. Six page on our website is understand what they're willing to do before they meet their partners as well and so clear expectations. Usually when it comes to come successions that prearranged they're pre agreed on. Do you need to be clear about what you're arriving two. And understand what your limits are when you're going to be at this session. Find out about the type of section session. As Steven alluded to some sessions congee very different to one another. Some could have new individuals arriving. People could have very set in kind of clear boundaries about but also around whether condoms are available, whether people are using prepping the party, but also in comes off the type of sex that they're having in terms of is fasting involved. What precautions are being managed there And what do they need to think about if they're going to attend the session? And here 31 is thinking about what they actually do, what they find pleasurable. And are they confident, uncomfortable? What's going on there? And this is a recap eating that we work on, talking about understanding, pleasure, understanding, consent and making sure that the sex that they're having is pleasurable and consensual with the least harm. And he think about concern it. If they want to change their mind even though they may have attended the party, they do have the right to leave and that they always have the right to say no, it's their body. So ultimately, these drugs can inhibit well, disinhibited your ability to kind of give consent. So the key thing is to keep in mind if you can stay level on, managed to maintain your ability to consent any situations. So I'm gonna talk a bit about one of the case studies of an individual that we worked with now the service use. It was referred by a sexual health clinic do to re occurring S t i Z over a few months, and I think for a case to the one. This is a key case to detail highlight because it notices a new of the motivations regarding internalized feelings of shame in relation to religion but also precious to perform a certain kind of sexualized stereotype with engage culture. So the key thing for him was actually shame around his sexuality. The fact that Ken Sex was the only time he fell able to enjoy sexuality and act upon it, but due to quite a lot of these drugs that he was using was leaving him. Teo being unable to consent also understand pain levels. There was some physical trauma that had happened in sex parties as well, and I think just a highlight. One of the key areas when we're thinking about motivators, towards came sex, he said. I want intimacy. I want to feel close to someone and came. So what made him feel naked and free from prejudice? So it's really understanding what these motivations and drivers for this person on just the the interest of time. I think what we'll do is go through these and then come up with questions around the case to do at the end. If you could click through Steven. So in terms of the incident intervention that we did, we kind of did basic sexual health interventions and the importance of guarding against infections, particularly HIV, with backup taking immunizations. But there were really concerned conversations around his identity. Is a gay man his interaction with that on his face than his community as well. On thinking about these wrist reductions in terms of safer practices in relation to come sex? Whether the party was attending, Listen, think he was comfortable attending whether he knew people involved, whether other people were mixing his drugs about people actually doing the injecting and how he felt shape with that and the needle exchanges as well, and a clear one was actually around consent and pleasure. The one thing we always talk about in our work is actually talking about how you have conversations around gaining consent and when you feel uncomfortable when it's not feeling comfortable on how you can be aware. Of course in so that this individual, the confidence was a big outcome foreign. He felt more confident going to situations he had actually reduced his attendants to come. Sex part is a swell and felt like he was able to understand triggers on build, healthy strategies to counter them when they arrived. They also managed to lower the amount of HIV risk on ST I. Risk had also get tested more regularly and pick them up and just see some questions. So this is a very different scenario in terms off the case study we've seen before. So this individual had very clear boundaries regarding partners usage, injection, sexual health and hatred be prevention. As he was already accessing three monthly testing, it was using event based preps and organizing the parties himself. He was linked into the local needle exchanges. He had very measured control in terms of it had impacted, and financially it wasn't affecting his work. But he wa seven difficulty about having sober sex. So again, it came to this link around intimacy and concerns that he couldn't engage with men with outcomes of the stage on. This was very clear that this was an area he wanted to work on, that he didn't see his camps. Excuse is something that he wanted to change. So, of course, the basics was around re dressing the six monthly testing vaccinations, reviewing his prep it here it's and making sure that it was effective for the kind of parties he was having. It was also around concerns about mixing Kemp's making sure he knew that safe practices information about consent and healthy relationships, particularly as well as he was an organizer of these parties that he was looking out for the other individuals attending these camps accessions and again, conversations about pleasure. There was actually a reduction and progress towards having sex with tens, but ultimately it was a situation where he didn't want to stop having camp sex. And it was the focus on the key strategy about having the most pleasurable in consensual sex with the least harms, regardless of drugs being used in this situation and management around ST I was going further and ongoing reduction in terms of hatred be. The key thing was he was learning to engage with partners emotionally with outcomes, but he was still worried about super sex. So this was known going conversation about understanding, pleasure, engagement, confidence and actually gaining intimacy with individuals. So we've kind of at the end just listed some useful information. So as I'm always going to talk s X Scotland. I think because I manager is a very useful resource community developed from our own information. SDF, which is the Scotch drugs for him on also lived experience with men around the different drugs, mixing cams, how living with HIV incomes and also some basic tips they've got jmf a Terrance Higgins Trust, Dean Street and also the video content that we have listed is really useful. And there's also a film called, Um Sex, which Steven told me to plug a virus. Differences from reading there if you are so old, planes on day to do some like a daily living you know, could take about motivation to do so. Um, there's quite a bit of a show in case Aches has been publishing out in evidence based on so carefully going up a little friendly. Don't you interested to do on the publisher? Came six review in 2019, um, which was quite common places, which is three months number three on Be quite interesting. We does. The first reference is their study by item border, and he's not living in a stroller was one of the first came six that's done in the U K which climb interesting article Israel on Does all the front of the things we'll keep in About you can became 67 cups mentioned. It does as kind of, um, as kind of educational. It kind of does sure came six. As so, It's not for the heart doctor, for an artist is Quinta watcher. You know it doesn't that advisory label will finish my ass feel explicit on the expense on dollars of the differences, the Christmas with the news on the for bleeding, particularly in a 60 mg. If you were saying it's particularly useful against, we also has good information, but it has. Links to our virtual are like a note when care plan could we could go through to Israel's like, I think your plan, that guy's conduce really quite a lot of resources out there to be able to do it in seven. Kenard and Mixed Up, protected from was protecting the dog. Start getting more information is veil. When the key came six strokes from the front sight and increases a cold anything. Thank you so much base of you. I think you had a PSA. We'll we'll hex and those case studies at the end, but really helpful to kind of bring it all together. There's a couple of questions in the chat, and just while anymore, coming through it wants to ask you is well with them when you were just talking through the kind of interventions that you can do that. And, um, I just want to kind of who or how many different kind of professional. Sorry. Hold it in that what might leave now? Well, thanks for Sunday. Thanks. Um, yes. So intend. The interventions kind of. There was some kind of different psychological and medical ones who who's kind of involved in that team. Yeah, That's the creation, Ellie. I mean, obviously stuff except for sale to deliver technology. Things have been certainly my comic clinician, buddy background, um, has enough having much safer hills and meet my health. Um, I think it's a combination of partner working on the federal on that will depend on how the services of the liver profend the local afford a TIA, which will obviously very some, For example, in a gym bra. Um, mean sexual health services there, dear look, the biomedical pregnancy, which is always the key focus or into ST I. Each IV tasting on delivery or play process mint on a plate. Views on toxicity. Things like post its water portal access. Um um, but within those services, Well, we do have a specialist any J service that set off in the mean by medical provisional and pervades specialist psych A social support for one to ones like talking about confidence about Except shall it either sexual health. Having was basically it's reduction to Benji's, there was a lot, of course, like between, um, our child for sexual health services that they were We would if there are people to class of service who deal off the psychosocial delivery and stuff he was talking about. I'm talking about sexuality confidence. I appreciating, Um, you know, behavior change type stuff is well by the same on a six. Historically, you know, or the change is recorded would have done, and rid of some clinics is way over there. Six, for example, that the charity under the chest with the clinics together, you know, and with really return tastings well, you know, three use of block, it takes, um so that's set up on the number of people involved we'll definitely daily. Certainly the traditional rules off the medic on the nurseries tasting problem still is the main focus. More looks good for those nurses and doctors to give the health those kind of conversations that I don't know, obviously rest reduction on the new multi. They discuss more to be as far engaging in came six others patient going them on the way Tomato health stuff. Competent stuff would be able to feel the morning two more specialists and really being services well, which is always important about having a real mess of the services available in your local area and that you can advise people to access, including Orlando's. Or she says, Well, obviously it became 60 applying, for example. Great, thank you. And, um, Rebecca had a question is well, and they asked in terms of how you approach the subject of specific types of activity, you discussed about kind of higher risk activities like fisting. How would you approach conversation asking about those behaviors? That's yeah. I mean, some people are because it is a step. It ties behind that injury. People do kind of shy. Three for my son's would indicate creations and certainly you know, working a section of the injury. You know, it's about asking those questions, and, you know, the confidence is just from the terrorists. More than anything else, you know, in the reason I would ask about our, you know, and depending of some discomfort, and I'm sure cause make you dizzy, Um, it's it's opening up with generalized questions. You know, everything's been since your last detained it for your last, you know, waste your HIV test. You know they're going to questions about, um, Central last, and I haven't used any drugs and more alcohol on D C area That conversation Gore's you know, separately asking, you know, everything. Yes, and that's going to tackle about the use off and came on did asking protected and sexual beginners. Historically, you you know, I read ask of some documents three months ago, little pullback in front, just under the taste. I would ask about what number earlier was a partner is that hard and not time types of partners On main, I would ask about label of us believe, or if there's any corned a machine or six on the nasty in your the types off and type of sexual behaviors are higher. Sort ask, um central last time. You know, many partners have confidence in those X rays, you know, just presenting with those factors. Hum, I think. And basically, with that, I think about don't move off. Simply asked, um, has that involved and resting? Protective. But it may be more of a general question, but it's really recording was, you know, six husband being in your other. You know, you know, six in the other in your six tapes at all and not more J lines open chord in Texas You, like I say, is, um thinking Tim's off the behavior like vesting. It's more to the read of our take a lot of circumstances. So the number goes, indigestion came six. It may be useful. Just ask and not using esoteric sexual acts that something really pain off and academic tear. So we'll use that. I would just ask the Corn 100 have you engaged 1000.6 and ask about Has there been any other? You know, they're, you know, types of sex at all in a more general lives. Real sure, plus make. Probably agree with her. Um, just keeping a quite walking about on, you know, pre, for example, and do that here in juice more generally and avoiding on keeping quite open, and they seem like they responses from that. You're much more polite. Then I I think I would say, What's the effects that you had recently? And, uh, is there anything new types of sex and have you tried annual play? Does that include Fistic doesn't include sex stories, because there's more questions to be asked. There, yeah, El Terminal depends on how the arms about creation about you know it's really asthma was corn pain. Treat a vehicle Sixes in a boat has a billion years, you know, play a toll and seeing what types of things that mainly dangle or going to on if you know they're engaged and came, say exactly, they come into play about, you know, Pacific last part of the scripts, the best thing of the past with those percent questions, for example, and seeing without risk and conversation goes, there's a couple more coming through. I'm trying to say Think how best to get three days. I don't want to keep your eyes too long. I will have to apologize that we'll have to do. Go. Sorry. So I mean, that's safe to be fine. I'm That's just a question for you about your outreach work anyway. Then I think, um, in terms of the average, do you do? Do you do things outside of clinics like in the community? I'm happy to talk about that one, because that's my main. The main renal of their sex is to kind of get people to engage in services, get involved in the clinical settings on. We do outreach through a variety of ways, from in person outreach in public sex environments, which is cruising grounds. We also do online outreach through certain sexual social APS, which will act as a meeting point for some guys. And we act as a Pulmicort is, um, so people can act as direct questions regarding prep, sexual health and also came sex During the pandemic. We previously would have gone into bars and clubs to do in face outreach, but due to the shut down of most night venues, we actually developed on online life chapter all and kept open during the evenings, and we found that a lot of concepts users would talk to us on a Monday when they'd accidentally missed work and kind of how to come down experience and talking through that on. That proved really, really useful in terms of getting people the right information and that was used across Scotland. And we also had enquiries around the whole UK because there wasn't, like, way service in the area. But outreaches really key because I think the connects are really important for getting people into their treatment, getting them on the treatment, getting tested and maintained. But there's also an element where people, particularly around this subject, don't want to talk to the end. It just a statue services about it for fear of kind of repercussions that may come about or perceived repercussions Girl, Thank you. If I can ask you just one more question, it's just about I try and summarize what uh, Thomas would be said. That's, um, about how we can kind of re conceptualize things like fisting and talk about them, that so it's not just a risk behavior and whether there's better kind of wordings that we can use s so that we're not pathologist. I was thinking kind of limits of comes excellent types of a day playing things. Interview. Very realistic. Um, virtually. Machines are Let's walk. I don't know if you'd be happy, so I meet yourself to ask. Sorry. Um, I suppose he's like money. Sorry. I suppose where my question is coming from is that I find discussions. It comes That's quite interesting, because, I mean, I think from a sexual health perspective, we take on this sort of an emphasis on the wrist, which I don't think necessarily aligns with people who engage in those practices. For example, take. It's taken allergy like I don't smoke, but lots of my friends do, and then was a little bit horrified that my friends smoke weed and clearly because we're operating with different conception of the lists involved. But I think that's okay, because I'm not a doctor. But when it comes to sort of, you know, sexual axe, um I suppose like, minority essential, I think Discussions about what do you convenient to be quite sticking time pathologize thing If the solar plexus is about, I don't know, actually being checked. And I think what I actually was just said, um yeah, sorry, I didn't actually Oh, I can't wait, you need, I mean, yeah, but yeah, because conversation is researchers like a damn, it's in them. Um, you speak to other people. Israel are maybe normal from the claims expired, like damaged here, obviously from going to sleep, for example, as one of the high ukx care center National Israel, and speak with a big marketing so that that is an excessive breast getting came six. Mr. Doctor, on a lot of the research is or rescan just risk, which is a kind of certain health point of view. There are other ways of factors that we need to think about it talk about like, the social cultural aspects of came six. You know, why do guys engage in King six in the first place? On that basis, mistakes just talked about, you know, a very sexual identity and cultural identity. Um, about feeling stigmatized, ashamed of me. Um, I'm talking about these things. They have, like a you know, with I came six sessions or with came six networks you even amongst the gate unity that does exist. So yeah, for the gait wouldn't see it, but it was way too far from national important against against weiners of the crocus address because because against the male profession do you have this sort of isolation? But no, um, you know, a specter state tell against health prevention more generally, take a listen and, you know, help patients like medicine gnashing whatever it may be in her revenge of religious that risk, Um, and against the corn takes one working. It's also important. Know Teo chastise guys for engaging came six. Um, no, I think it was called recision. Ideally, a rear. And some guys in Eugene came sex on the mileage and contain clips extra thin. The range that doesn't cover get really a way to determine to impact on the life because we have under control. And they continued it on, um, for the with guys notice conduction on your advisor, Bit less production. You know, a lot of milk lately, fear with that is just being forcing. It was approaches like using things like play on access testing, you know. But those weight of conversations have been some stuff. Just look about where there's more underlying patient a wire kind. My motivated condition came sixth and shame on steak. Mad and loneliness, intimacy. A Sephora of escapism, um, and other psychosocial weight factors in the life in that meeting, too. Compulsive issues potentially are important to address. It was like, you know, kind of site social cultural issues are reported. It's important for his conversations. I think in place. The only unfortunate in sexual see ever see is often there's limitations in time and resources to be able to do that. Israel on blocks that big state and buying medical intervention. So I think you're really it out without, and I can understand that we're coming, forming, you know, and guys getting Came six for several reasons. But it's important to find those readings That that makes sense to quit was years. And cultural social identity, which is more important, is Well, I don't know what helps it all, I think, were fledging in what you're saying. That helps sort of, um, tease out what I think. The original question was crying to get out. So, for example, and I think, obviously, um, I'm going to struggle to be taking it again. I I think so. When you say sort of, they managed to contain chemists Axe. I think that's a very soon powerful medicine for that will be a lot about foods drug use in general. And so far it is not, You know, even if someone is using insect in the form of escapism or the way to navigate it showing on this actuality or have you, I find it interesting that it's sort of gets category, um, that used to come in disgrace me there, for example. I might want to, you know, um, exercise a lot of the form of escapism or right or literature or what I didn't even know that said earlier smoke cigarettes or whatever I just find. I think there's a lot of tension there in sort of constructing this category of practice and and sort of scrutinizing, studying yet seeing, you know, Well, why do people behave that way? Why do people, you know, engage in this practice unsettled, not wanting to shame these people or, um, make out that practice to be silly. I get sort of over treat the meaning that active that makes yeah, whatever you're seeing. And if someday, when Steve did, you came safe. Ultimately, people will do for individual lesions are not in or those lines. Reasons will be left experiences for me and you're engaging claim six. It's now both from a perspective. It's not go chastising until people often and getting and came sex andan fortunate Think sometimes that maybe, is the approach not just became six, but your drug Use more weight, unfortunately, is about, You know, Tim, people offer, but it's wrong. She do not on. Actually, that's not constructive. And anyway, it also That's not how I approach from a consultation with patients. I know sometimes that has been the approach a little up from research teams and sexual health services that cumbia split between home. Well informed conditions are on there. The approach to take on baby, how the engaging guys with can sex even just more weight, little bit meal, same sexes. Well, more lately, on day came six. Unfortunate does have its own stigma and hide your challenge on. And I think the first thing we do is know by judging guys for waving you to keep six. Um, on. Um, you know when I think what's important, as well as remission constructed with your pin questions, you know, and not telling them all from getting came. Six guys truly deconstruct up to is very puting interaction with patients. And anyway, I think about straw important event of some of your what stage He came six. That's entirely done to feed him a choice like any other drug use. Is that just from our point of yourself professions to help, um, on half that I tools to reduce that rescue went to engage in came six. And I think some of those other drivers about it does hard paying on the reasons of them Problematic drug use and laid was issues may develop into came six becoming See, for example, compulsive. The other reasons behind that on that will very for people that why not? Maybe so. I mean, that's really report. Men gauging came 16 individual cases where patients getting the main. The waiter context of some of those case. That is, for example, inhalers too difficult drastically. Studies on it was love. Experience is very, very different for both falls, you know, kiss them to include study to help me. Extent. Yeah. Thank you. Really? Thank you so much for staying on just a touch longer there. Steven. Um, I think we'll wrap up now, so but I don't want to keep you any longer, but yet massively great pull food for you both. Joining us in, please Also know thanks to Christopher a swell. Um, and we're getting feedback. Three from people. Um two. So I'm I'm happy to share that with you. If that That that's a value to yourselves. A swell. Um, thank you. So, so much. Thank you. Any creations? Just please feel free to let me know. Oh, yeah? Well, if we can show the the links from your slides and but yeah, I'll follow you up with an email, and we can We can make sure we get those. That's people. Cheers. Thank you. Thank you.