A Biopsychosocial Model for the Counseling of Hormonal Contraceptives: A Review of the Psychological, Relational, Sexual, and Cultural Elements Involved in the Choice of Contraceptive Method

Nimbi, Filippo Maria; Rossi, Roberta; Tripodi, Francesca; Wylie, Kevan; Simonelli, Chiara

doi:10.1016/j.sxmr.2019.06.005

Cited by 16 publications

(18 citation statements)

References 74 publications

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“…But at the same time, the extreme usefulness and need for specific support that helps them reducing the risks or to getting out of problematic situations is largely recognized. In this line, sex-positive biopsychosocial method, which gathers the expertise of services on addictions, mental health, STIs, and sexual health, could be a key approach 37,38 to better understand and act toward an improvement of quality of life in MSM practicing chemsex. From this synergy might arise a movement of reception and recognition of a reality that does not concern exclusively drugs or sexual behavior but has its own characteristics that need to be listened and understood.…”

Section: Resultsmentioning

confidence: 99%

Chemsex in Italy: Experiences of Men Who Have Sex with Men Consuming Illicit Drugs to Enhance and Prolong Their Sexual Activity

Nimbi

Rosati

Esposito

et al. 2020

The Journal of Sexual Medicine

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Background Chemsex is a novel phenomenon referring to the consumption of illicit drugs to facilitate, enhance, and prolong the sexual experience in men who have sex with men (MSM). Aim The present study aims to investigate contexts, patterns of substance use, first chemsex experience, and harm reduction in a group of MSM practicing chemsex in Italy. Methods Thirty MSM involved in chemsex activities were interviewed between February and July 2019. Outcomes The interviews were conducted using an ad hoc grid exploring general characteristics of Italian chemsex, patterns of substance use, first chemsex experience, and harm reduction opinions. Results Chemsex in Italy showed important peculiarities and patterns because of sociocultural background. Chemsex was mainly reported in private venues within couple and group sexual activities. Most participants attended chemsex sessions about 1-2 times per month often concurring with men-only club events. Freebase cocaine emerged among the most relevant substances consumed together with gamma-hydroxybutyrate/gamma-butyrolactone, crystal methamphetamine, and mephedrone. A rare use of injected substances compared with other European Union countries was shown. Given the high prevalence of erectile problems, a large use of phosphodiesterase type 5 inhibitors was reported, and noncoital sexual activities were usually preferred (eg, oral sex, fist fucking). The first chemsex experiences were usually accessed by geolocation-based dating apps and sexual partners and were generally described as positive experiences, with some negative consequences at the end of the session (dysphoric mental states, guilt, craving). Taking part in international gay events seems to favor the first experience of chemsex for some participants. Moreover, some MSM practiced chemsex only abroad or in other cities in Italy so as not to be recognized as chem users in their daily environment. Clinical Translation Implications for ad hoc harm reduction programs are discussed. Strengths & Limitations Despite the methodological limitations due to participants’ number and the absence of interviews audio recording, results highlighted some relevant characteristics of chemsex in Italy, such as freebase cocaine use, attitudes regarding slamming, geographical movements, and secrecy. Conclusion The results revealed a need for greater scientific and public attention on chemsex to act with the most specific and effective prevention and harm reduction tools.

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Section: Resultsmentioning

confidence: 99%

Chemsex in Italy: Experiences of Men Who Have Sex with Men Consuming Illicit Drugs to Enhance and Prolong Their Sexual Activity

Nimbi

Rosati

Esposito

et al. 2020

The Journal of Sexual Medicine

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“…Meanwhile, beliefs about the medication were associated with non-adherence when it was used for gynecological purposes. Identifying the psychological factors and beliefs linked to contraception could guide health professionals to provide counseling to women about the best contraceptive method for them, thus increasing their adherence to medication and maximizing their well-being [ 57 , 58 ].…”

Section: Discussionmentioning

confidence: 99%

Adherence to Oral Contraception in Young Women: Beliefs, Locus of Control, and Psychological Reactance

Fumero

Marrero

Castro

et al. 2021

IJERPH

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Background: There is a high dropout rate of oral contraceptive pills (OCP), mainly due to a lack of adherence to treatment. The aim of this study was to identify the psychological processes and attitudes toward medication involved in adherence to OCP, depending on the prescription, to avoid unintended pregnancies (AUP) or gynecological problems (GP). Methods: This cross-sectional study was conducted by asking 689 young women in the fertile period, mean age 23.41 (SD = 5.90), to complete questionnaires related to attitudes, beliefs, psychological reactance, locus of control, and adherence to contraceptive medication. Descriptive analyses and a binary logistic regression were performed. Results: The results confirmed that different beliefs and psychological processes were involved in adherence to oral contraception, based on women’s reasons for taking contraceptive medication. More psychological processes were involved in non-adherence in the AUP group than in the GP group. Psychological reactance contributed most to explaining non-adherence in women who used the OCP to prevent unintended pregnancies. Conversely, women with gynecological problems reported difficulties in adherence, mainly due to their beliefs about contraceptive pills. Conclusions: These findings indicate that attitudes toward medication and psychological processes can play an important role in adherence to OCP, including reasons for using the pill. Identifying the psychological factors and beliefs linked with contraception could guide health professionals to provide counseling to women, thus increasing their adherence to medication and maximizing their health and well-being.

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“…Moreover, both professionals tend to generally undervalue the influence of societies and cultures in sexuality (Kirana et al, 2013). Therefore, the "S" of the BPS approach seems to have a limited space in the minds of clinicians despite many authors' arguments that beliefs, schemas and scripts are important factors in the onset of sexual dysfunctions and can play a significant role in understanding sexual behaviours, promoting adherence to treatments and improving clinician-patient relationships (Coyne et al, 2019;Maxwell et al, 2017;Nimbi et al, 2018Nimbi et al, , 2019Tavares et al, 2020).…”

Section: Some Shadows Of the Bps Model: When Culture And Attitudes Are Neglectedmentioning

confidence: 99%

“…In this regard, the emphasis on the negative consequences of sex for health is not enough to promote safer sex. Nimbi et al (2019) highlighted that contraception is more effective when it involves clear and open communication on sex. Moreover, there is the opportunity for sex education that endorses pleasure to challenge gendered socio-cultural expectations of heteronormativity that favours the silence around female pleasure (Berdychevsky & Carr, 2020).…”

Section: Sex Educationmentioning

confidence: 99%

The Biopsychosocial Model and the Sex-Positive Approach: an Integrative Perspective for Sexology and General Health Care

Nimbi

Galizia

Rossi³

et al. 2021

Sex Res Soc Policy

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Introduction The Biopsychosocial model (BPS) represents a comprehensive paradigm of consolidated practices. Although it has been outlined as the gold standard in sexology, its implementation is often challenging. The sex-positive approach is a ground-breaking movement that is gaining popularity all over and is focused on the recognition of different sexual expressions as valid, consensual, healthy, and meaningful. However, a pragmatic implementation of this approach is still missing. Methods A critical review was conducted based on bibliographic research on Medline, PubMed, EBSCO, Cochrane Library, Scopus and Web of Science on relevant articles published from January 2011 to July 2021. Results A total of 116 papers were included in the following review, indicating an increasing body of research about BPS and sex-positive frameworks during the last 10 years. One of the main limitations in the BPS is the scarce attention paid to socio-cultural factors involved in sexual expressions, such as the role of negative attitudes towards sexuality that may affect health care professionals’ work. An application of the sex-positive approach to the BPS model may bring greater attention to the needs, values and desires of the individual, as well as allow a new knowledge and understanding of sexuality within a broader spectrum, including diversities and pleasures. Conclusions The sex-positive approach represents a viable path that entails the willingness of health care professionals to get involved actively; criticize their personal attitudes, beliefs, and knowledge about sex and work hard to improve their practice in sexology. Policy Implications A discussion of the possible fruitful integration between the BPS and the sex-positive approach is presented, highlighting practical applications in research, clinical practice, training and sex education and giving possible directions for future studies and policies.

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A Biopsychosocial Model for the Counseling of Hormonal Contraceptives: A Review of the Psychological, Relational, Sexual, and Cultural Elements Involved in the Choice of Contraceptive Method

Cited by 16 publications

References 74 publications

Chemsex in Italy: Experiences of Men Who Have Sex with Men Consuming Illicit Drugs to Enhance and Prolong Their Sexual Activity

Chemsex in Italy: Experiences of Men Who Have Sex with Men Consuming Illicit Drugs to Enhance and Prolong Their Sexual Activity

Adherence to Oral Contraception in Young Women: Beliefs, Locus of Control, and Psychological Reactance

The Biopsychosocial Model and the Sex-Positive Approach: an Integrative Perspective for Sexology and General Health Care

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