| Approaching the forth decade of the AIDS epidemic, HIV incidence rates in the US remain high among men who have sex with men (MSM). The new millennium witnesses MSM living at the intersections of HIV and stimulant use (i.e., crack, cocaine, and methamphetamine), contributing to the rise in HIV risk related sexual behaviors. For some MSM, stimulant use is intimately tied to having a sexual life with men. Hence, there is a need for an intervention that can address those issues hindering development of a healthy sexual life with men; and, also contributing high risk for HIV and other sexually transmitted infections (STIs).;The purpose of this dissertation is to disseminate an innovation in the form of an original intervention that holds the promise of functioning as a model of sexual health relapse-prevention, specifically designed for stimulant using MSM. Further, the purpose of this dissertation is to report the results of this writer's experience across 6-years (2001--2007) working with substance using MSM---developing, implementing, and refining what emerged as an 8 month sexual health group counseling intervention (SHGCI) for stimulant using MSM.;The process of arriving at the elements of the SHGCI approach transpired across 3 group settings between 2001 and 2007, and included journal notes. Each setting provided a slightly different MSM population---including variations in primary substance used and severity of substance abuse. The results codified in this dissertation include describing the components of the emergent SHGCI, as well as illustrations of the resultant group process. Finally, the SHGCI was analyzed as being informed by various approaches to behavior change (e.g., stages of change, motivational interviewing, relapse prevention, sexual health model, system for analyzing verbal interaction, systems-oriented approach [based on the theory of living human systems/systems-centered therapy], and mindfulness approach (i.e., breathing exercise). The SHGCI presents a novel approach to working with MSM who use stimulants in need of research and evaluation to test efficacy, and to determine viability as a new model for meeting the HIV prevention and sexual health promotion needs of stimulant using MSM. |
