Development of the chemsex assessment for referral and evaluation (CARE) with preliminary psychometric properties: A screening tool for referral needs in community settings.

BACKGROUND

Chemsex, the use of substances to enhance or prolong sexual experiences before or during sex, is an important public health issue among gay, bisexual, and other men who have sex with men (gbMSM). To address the lack of tailored screening tools, this study developed the Chemsex Assessment for Referral and Evaluation (CARE) to identify gbMSM who may benefit from specialised care.

METHODS

A cross-sectional online survey for gbMSM who engaged in chemsex in the past year was conducted in Taiwan. Exploratory factor analysis and Rasch analysis assessed the 18 dichotomous CARE items; Kuder-Richardson Formula 20 (KR-20) evaluated internal reliability; the Severity of Dependence Scale (SDS) and Drug Abuse Screening Test (DAST)-10 determined the optimal cut-off for comparing substance-related traits between low- and high-score groups.

RESULTS

Using data from 730 participants, the analyses suggested a three-factor structure of CARE-social function, psychological well-being, and physiological needs-comprising of 14 items with high reliability (KR-20 = 0.830). Rasch analysis indicated good item performance, and correlations with SDS (r = 0.52) and DAST-10 (r = 0.66) demonstrated strong concurrent validity. A cut-off score of ≥ 4 showed 82.9 % sensitivity and 68.0 % specificity (DAST-10 > 5) and 75.8 % sensitivity and 63.2 % specificity (SDS > 4). High-scoring participants exhibited more substance-related traits.

DISCUSSION: The findings indicate that the CARE demonstrates acceptable psychometric properties, encompassing social, psychological, and physiological dimensions. This simple screening tool could be used in community settings to identify gbMSM needing support or as a self-assessment tool in digital solutions. (245 words).