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Opening slide

Opening slide. The University of Illinois at Chicago Howard Brown Health Center Treatment Advocacy Program Alcohol & drug use and sexual safety. TAP: Alcohol - drug use & sex, goals. Goals:. Describe how alcohol / drugs may increase your sexual risk.

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Opening slide

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  1. Opening slide The University of Illinois at Chicago Howard Brown Health Center Treatment Advocacy Program • Alcohol & drug use • and sexual safety TAP: Sexual safety & alcohol-drug use 12/9/031

  2. TAP: Alcohol - drug use & sex, goals Goals: • Describe how alcohol / drugs may increase your sexual risk. • Develop plans to lessen drugs + sex risk. Explore when you combine alcohol or drugs with sex. TAP: Sexual safety & alcohol-drug use 12/9/032

  3. Alcohol-drugs & sex; overview, 1. • With certain partners? • Certain places or times? • Certain moods or feelings? When are you most likely to be high during sex? TAP: Sexual safety & alcohol-drug use 12/9/033

  4. Alcohol-drugs & sex; overview, 2 Are there particular drugs you combine with sex? • Drugs that: • “Sex drugs” that make sex better? • make you relaxed or confident? • your partner likes? • make safety difficult? TAP: Sexual safety & alcohol-drug use 12/9/034

  5. Alcohol-drugs & sex; positives. How does being high make sex better? • More sexually intense? • Less sad, depressed, angry • “Forget about” HIV and risks? • Get your partner relaxed or “willing”? TAP: Sexual safety & alcohol-drug use 12/9/035

  6. Alcohol-drugs & sex; negatives. • Concern about risk? • Less close to partner? • Hangover / concern about use? • Other things How does being high make sex worse? TAP: Sexual safety & alcohol-drug use 12/9/036

  7. Alcohol-drugs & sex; questionnaire intro. This section asks how alcohol or drugs affect you personally. • We will use these questions to begin developing change plans. • For these questions “getting high” means alcohol or other drugs TAP: Sexual safety & alcohol-drug use 12/9/037

  8. Click one 01234 not at all a little some a fair very much amount Questionnaire; Social facilitation Confidence How much does being high help you feel self-confident or make it easier to talk to people? TAP: Sexual safety & alcohol-drug use 12/9/038

  9. Social facilitation; discussion How does being high help your self- confidence? • Easier to relax? • More “in the moment”? • Not thinking as much? Particular times / places / people? What concerns do you have? • Amount of alcohol or drugs? • Areas you might want to change? Note for worksheet TAP: Sexual safety & alcohol-drug use 12/9/039

  10. Click one 01234 not at all a little some a fair very much amount Questionnaire; sexual enhancement Better sex How much do you associate being high with particularly good or intense sex? TAP: Sexual safety & alcohol-drug use 12/9/0310

  11. Sexual enhancement; discussion How does being high help with sex? • Easier to have the sex you want? • Simple sensation? • More “in the moment”? • Easier to keep erection / mood ? • Partner(s) more willing or relaxed? What concerns do you have? Note for worksheet • Other ways to enhance sex? • Areas you might want to change? TAP: Sexual safety & alcohol-drug use 12/9/0311

  12. Click one 01234 not at all a little some a fair very much amount Questionnaire; Cognitive escape Escape How much does being high help you to not think about HIV? TAP: Sexual safety & alcohol-drug use 12/9/0312

  13. Escape; discussion When is it difficult to think about HIV or HIV status? • Certain moods or times? • Certain sex partners? How does thinking about HIV affect sex? • More anxious or self-conscious? • Worried about talking to partner? • Feel less desirable? How do alcohol or drugs help you not think about HIV? TAP: Sexual safety & alcohol-drug use 12/9/0313

  14. Escape; concerns What are your concerns about getting high to not think about HIV? • More risk? • Amount of drug use? • Less enjoyable sex? • Areas you might want to change? TAP: Sexual safety & alcohol-drug use 12/9/0314

  15. Questionnaire; Risk Risk How hard is it to follow your safer sex limits or use a condom when you are high? Click one 01234 not at all a little some a fair very much amount TAP: Sexual safety & alcohol-drug use 12/9/0315

  16. Sexual risk; discussion How does being high interfere with safety? • Hard to talk about safety while high? • Keeps you from thinking about HIV or your HIV status? • Makes your partner less concerned? • Makes it difficult to get a condom on yourself or your partner? Areas you might want to change? Note for worksheet TAP: Sexual safety & alcohol-drug use 12/9/0316

  17. Questionnaire; places Places How much do you tend to meet partners in bars or clubs? Click one 01234 not at all a little some a fair very much amount TAP: Sexual safety & alcohol-drug use 12/9/0317

  18. Risky Places; discussion Where do you tend to meet people(or have sex)? • Partners you meet there • Hard to talk about safety • Getting high and having unprotected sex is just expected • Specific bars, clubs, baths? • How much is getting high a basic part of those places? What makes these places risky? TAP: Sexual safety & alcohol-drug use 12/9/0318

  19. Places: Safety Strategies • Avoid them altogether • Get support from others How can you stay safe in risky places? Have a safety plan • for alcohol / drug use • for sex Note for worksheet TAP: Sexual safety & alcohol-drug use 12/9/0319

  20. Questionnaire; Partners Partners How much is getting high a regular part of a relationship? Click one 01234 not at all a little some a fair very much amount TAP: Sexual safety & alcohol-drug use 12/9/0320

  21. Partners; discussion Which partners do you get high with during sex? • How does this improve sex with them? • How can you get those benefits without getting to high to be safe? What concerns do you have? • Use interfering with sex / intimacy? • Other ways to enhance sex? • Areas you might want to change? Note for worksheet TAP: Sexual safety & alcohol-drug use 12/9/0321

  22. Questionnaire; Moods Moods How much do you get high during sex to change moods, such as stress or sadness? Click one 01234 not at all a little some a fair very much amount TAP: Sexual safety & alcohol-drug use 12/9/0322

  23. Moods; discussion What moods do alcohol or drugs help you change? • Positive moods? • More sexual • More “energized” • Less stress / worry / sadness • Feel better about yourself • Less concerned about HIV Negative moods? How does changing your moods make sex better for you? TAP: Sexual safety & alcohol-drug use 12/9/0323

  24. Moods; changes Concerns about getting high to change moods? • Use interfering with sex / intimacy? • More negative moods after sex? • Safety concerns? • Too uninhibited? • “Empty headed” during sex? Areas you might want to change? Note for worksheet • Other ways to enhance moods & sex? • Dealing with moods directly? TAP: Sexual safety & alcohol-drug use 12/9/0324

  25. Summary of alcohol-drug motives Let’s summarize what we have been saying so far. When you think about being high and sexual risk, which of these factors seems really important… TAP: Sexual safety & alcohol-drug use 12/9/0325

  26. … to enhance sex … certain moods and feelings … to be relaxed & self-confident … in particular places … to not think about HIV or stress … with certain partners Others?: ___________________ Personal profile Risk Review, risk estimations How Important: Lowmoderatehigh Getting high during sex… We will make safety plans for the important factors… TAP: Sexual safety & alcohol-drug use 12/9/0326

  27. Control strategies; introduction • Now let’s begin talking about control strategies for: • Alcohol & drug use • Alcohol – drugs and risky sex TAP: Sexual safety & alcohol-drug use 12/9/0327

  28. Alcohol-Drug Control; overview 1 When have you wanted to change how you use alcohol or drugs? • Can you describe times you used too much? and times your use caused problems? How would you see yourself changing? • Use less – generally or in some situations? • Use the same, less harm / keep control? • Only use when not having sex? • Other changes? TAP: Sexual safety & alcohol-drug use 12/9/0328

  29. Alcohol-Drug Control; overview 2 • Strategies that have worked? • Strategies that have been difficult? • Times & places when it is easier to control use during sex? • Areas where you could use some help? How have you tried to use less? TAP: Sexual safety & alcohol-drug use 12/9/0329

  30. Control strategies Alcohol-Drug Control Strategies, basics Some basic control strategies. • Alternate alcohol & non-alcohol drinks • What is a drink you can alternate? • How can you schedule it? • How might you talk to others about it? Avoid combining different drugs / alcohol • What is your key drink or drug? • How can you plan for not combining? Don’t use before going out. TAP: Sexual safety & alcohol-drug use 12/9/0330

  31. Control strategies… Control strategies; Setting your limit Have a plan or “limit” for using How much does it take (or what drugs) get you beyond where you want to be? How much does it take to get you where you want to be? • as high as you want • still able to stay safe or keep control • What is the “right” number of drinks? • ..the “right” drugs / amounts of drugs? TAP: Sexual safety & alcohol-drug use 12/9/0331

  32. Per hour? • For the evening? • how will you keep track? Control strategies… Alcohol-Drug Control Strategies, plan / limit How can you follow your plan? • Count drinks / drugs [lines, bumps, etc.] • Avoid (or count!) alcohol / drug “rounds” • What would be a limit or plan for you? • Which drug / alcohol? • How many? • How could you talk to your partner(s) about your plan? Other control steps that may work for you? TAP: Sexual safety & alcohol-drug use 12/9/0332

  33. Control strategies Alcohol – drug Control strategies, cont. How would you feel trying these strategies? • Is this something you will be able to do? What would make these plans difficult? • Your partners / places • Moods? • Feeling sheepish / embarrassed? What would help? • Social support from others? • Change of places, partners, friends? • Your moods or feelings • Skills for communication TAP: Sexual safety & alcohol-drug use 12/9/0333

  34. Alcohol-Drug Control Strategies; refusal skills Controlling social pressure toward use What can you say to refuse (more) alcohol / drugs? After you decide how much to use: • What has worked for you in the past? • What have you heard other people use? • When can you talk to your partner about use? • Let’s role play a “refusal” situation How can you communicate your desires about drug use with sex? TAP: Sexual safety & alcohol-drug use 12/9/0334

  35. Sexual control, intro. • Now let’s talk about controlling sexual risk while you are high. TAP: Sexual safety & alcohol-drug use 12/9/0335

  36. Alcohol-Drugs & Sex; sexual safety overview How have you controlled sexual risk while high? • What risks have you tried to control? • Times or places you stayed safe even though you were high? • Times & places where being high makes it most difficult to be safe? What would you see yourself changing? • How confident are you that you can get high and still be safe? • Difficulties or barriers? TAP: Sexual safety & alcohol-drug use 12/9/0336

  37. Risk; change areas When have you been able to use condoms even though you were high? • Particular places or times? • Particular partner(s)? • Particular drugs? • Your own attitudes or plans? • Talking with partner? • Condoms before getting high? Which of these factors make it difficult to use condoms while high? TAP: Sexual safety & alcohol-drug use 12/9/0337

  38. Alcohol-Drugs & Sex; sexual safety skills Make a safety agreement. Some concrete strategies to reduce sexual risk while high Who can you form a “high but safe” plan with? How will you talk to him about it? What would that plan look like? • Non-penetrative sex? • Condom on before getting high? • Very important for poppers or crack cocaine.. • Other drugs? (“K”?) • Other plans / goals? TAP: Sexual safety & alcohol-drug use 12/9/0338

  39. Alcohol-Drugs & Sex; “strategic abstinence” overview • Sober in high risk situations, moods, etc. • High only in non-sexual situation. “Strategic abstinence” safety plan How can you enjoy getting high and be safe? • How can you separate drugs from sex? • Certain partners for sex OR drugs? • Times / days you can separate them? • Not use “trigger drugs” with risky partners? • Other steps that may work for you? TAP: Sexual safety & alcohol-drug use 12/9/0339

  40. Alcohol-Drugs & Sex; “strategic abstinence” plan What would a strategic abstinence plan look like for you? • What would be the barriers or difficulties? • Which drugs should YOU avoid while with … • Your steady • New partners • In really risky places (bathhouse) • Which drugs can you take and still be safe? • Talking to partners or friends? • A written plan? • What else? • What would help? TAP: Sexual safety & alcohol-drug use 12/9/0340

  41. Alcohol - Drugs & Sex; Reducing Risk • Would it help to talk to an alcohol / drug counselor or join a program? • Have you ever sought help before? • What would be your reservations or concerns about getting more focused help? • What might be a concrete plan for getting more help? What other resources might you use to deal with alcohol & drugs? TAP: Sexual safety & alcohol-drug use 12/9/0341

  42. Safety plan intro. Let’s write a safety plan Here is an example… TAP: Sexual safety & alcohol-drug use 12/9/0342

  43. An example of a personal goal worksheet Concerns Personal goals Action steps Whatdo you want to change….? Heavy weekend alcohol & drug use Personalgoal(s) for each area? -control alcohol - less cocaine.. Specific stepsto reach each goal? -plan # drinks -no “rounds” -NA program Sex risk while using ‘X’… -100% condom use -fewer partners on “X” nights -talk to partner & carry condoms -plan for “X sex” Heavy use & sex risk when depressed When depressed: - Use less - Avoid risk - get depression treatment - abstinent when depressed TAP: Sexual safety & alcohol-drug use 12/9/0343

  44. Alcohol - Drugs & Sex; Own safety plan Click for Safety worksheet Your own safety plan: 1. Concerns: What is your main concern or issue? Specific things you want to see different? 2. Goals: 3. Action Steps: Concrete actions to achieve your goal? • Control strategies • Dealing with moods, partners TAP: Sexual safety & alcohol-drug use 12/9/0344

  45. Alcohol - Drugs & Sex; Action steps To help us with action steps • What has worked in the past? • What is concrete and feasible -- what can you actually do? • What are the first steps? • How will you know if you are successful? • What else should we include? TAP: Sexual safety & alcohol-drug use 12/9/0345

  46. Checking in • About today’s visit • How did it feel to talk with me about these topics? • Did we get a chance to discuss the topics that are important to you? • How could we have addressed your concerns better? TAP: Sexual safety & alcohol-drug use 12/9/0346

  47. Advocate’s notes & checklist • Advocate: Visit Checklist • Coping interview form • Coping planning worksheet • Referral sheet (if used) • Next appointment hand card distributed Complete Counseling Notes Form and Visit Log for file. TAP: Sexual safety & alcohol-drug use 12/9/0347

  48. Safety & Treatment Planning Worksheet UIC / HBHC Treatment Advocacy Program Participant ID: _______ Advocate___________ Date ___________ Visit code _____ Concerns Goals Action Steps • Fill in one or several general areas of concern / change targets • Note personal goals for each; what specifically should be different. • Fill in actions that are specific, concrete, “do-able”. TAP: Sexual safety & alcohol-drug use 12/9/0348 TAP Planning worksheet,

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