Online Intervention as Strategy to Reach Men Who Have Sex With Other Men and Who Use Substances in a Sexual Context. Development of the MONBUZZ.ca Project.

Men who have sex with men (MSM) use more psychoactive substances and a greater variety of them compared to their heterosexual peers. In this population, substance use is particularly characterized by polydrug use, binge, and sexualized substance use. MSM who use substances do not recognize themselves in public health messages targeting substance users. In addition, they recognize their problematic substance use later than heterosexuals and, as a result, they use addiction services later in their addiction trajectories. When accessing addiction services, the links between drug use and sexual life are rarely considered. Because of this profile, online interventions are a promising way to reach this hard-to-reach population. Currently available online interventions targeting MSM address the topics of substance use and sexual life separately. To deal with this situation, our team wanted to develop an online intervention platform for MSM who use substances in a sexual context. Given that online addiction interventions do not address sex and that MSM drug use is highly related to sexual activity, we first explored the literature related to online interventions targeting MSM and HIV risk behaviors, as well as online interventions targeting general population in order to: (1) identify relevant (or personalized) intervention methods; (2) describe the approaches used; and (3) describe their effects. Second, we turned to the literature to develop the MONBUZZ.ca project in collaboration with community organizations. The results of the narrative review provided a critical portrait of online interventions for MSM and guided the development process of MONBUZZ.ca. We discuss issues of co-development of a research and brief intervention tool based on promising practices as well as challenges of its implementation and evaluation.