{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:59:19Z","timestamp":1784307559716,"version":"3.55.0"},"reference-count":29,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Public Health Service of Amsterdam","award":["project 2372394"],"award-info":[{"award-number":["project 2372394"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2020,7,6]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Men who have sex with men (MSM) are at increased risk for STIs and mental disorders. Syndemic theory holds that psychosocial issues co-occur and interact, and thus increase sexual risk behaviour. Psychosocial issue identification, referral and management might reduce risk behaviour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In the syndemic-based intervention study, an open-label randomised controlled trial, MSM were enrolled at the STI outpatient clinic of the Public Health Service of Amsterdam. We screened participants using validated questionnaires on the following problem domains: alcohol and substance use, sexual compulsivity, anxiety, depression, attention deficit hyperactivity disorder, alexithymia, intimate partner violence and childhood sexual abuse. Individuals were randomly assigned (1:1) to receive either tailored, face-to-face feedback and help-seeking advice on mental health screening, or no feedback and no help-seeking advice. Participants were followed trimonthly for a year. The primary outcomes were self-reported and confirmed help-seeking behaviour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 155 MSM: 76 in the intervention group and 79 in the control group. At inclusion, 128 participants (83.1%) scored positive in at least one problem domain. We found no significant differences in self-reported or confirmed help-seeking behaviour between the intervention and the control group: 41% vs 29% (p=0.14) and 28% vs 22% (p=0.44), respectively. There were also no differences in STI incidence and condomless anal sex acts between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Screening showed high prevalence of problems related to mental health and substance use, while tailored feedback, advice and referral did not significantly increase help-seeking behaviour. Other interventions are needed to tackle the high burden of mental disorders among MSM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02859935\">NCT02859935<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2020-054438","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T21:15:39Z","timestamp":1596230139000},"page":"11-17","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Enhancing help-seeking behaviour among men who have sex with men at risk for sexually transmitted infections: the syn.bas.in randomised controlled trial"],"prefix":"10.1136","volume":"97","clinical-trial-number":[{"clinical-trial-number":"nct02859935","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4352-5467","authenticated-orcid":false,"given":"Roeland Christiaan Alfons","family":"Achterbergh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn S","family":"van Rooijen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim","family":"van den Brink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Boyd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9784-547X","authenticated-orcid":false,"given":"Henry John Christiaan","family":"de Vries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,7,31]]},"reference":[{"key":"2024092304150917000_97.1.11.1","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2014.0031"},{"key":"2024092304150917000_97.1.11.2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-3149-z"},{"key":"2024092304150917000_97.1.11.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30003-X"},{"key":"2024092304150917000_97.1.11.4","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.93.6.939"},{"key":"2024092304150917000_97.1.11.5","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-014-0826-8"},{"key":"2024092304150917000_97.1.11.6","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000475"},{"key":"2024092304150917000_97.1.11.7","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000713"},{"key":"2024092304150917000_97.1.11.8","doi-asserted-by":"crossref","first-page":"e22","DOI":"10.1016\/S2352-3018(14)70001-3","article-title":"Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study","volume":"1","author":"Daskalopoulou","year":"2014","journal-title":"Lancet HIV"},{"key":"2024092304150917000_97.1.11.9","doi-asserted-by":"crossref","first-page":"e529","DOI":"10.1016\/S2352-3018(16)30053-4","article-title":"Cognitive behavioural therapy for adherence and depression in patients with HIV: a three-arm randomised controlled trial","volume":"3","author":"Safren","year":"2016","journal-title":"Lancet HIV"},{"key":"2024092304150917000_97.1.11.10","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25103"},{"key":"2024092304150917000_97.1.11.11","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-018-2180-8"},{"key":"2024092304150917000_97.1.11.12","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002009"},{"key":"2024092304150917000_97.1.11.13","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1607-3"},{"key":"2024092304150917000_97.1.11.14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7300.1451"},{"key":"2024092304150917000_97.1.11.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16588-4"},{"key":"2024092304150917000_97.1.11.16","unstructured":"Achterbergh RCA , J vdH , Peters I . A case-holding initiative for early detection of HIV and sexual transmitted infections among high risk MSM. World STI & HIV congress ISSTDR, Poster Presentation, Rio de Janairo, Brasil, 2016."},{"key":"2024092304150917000_97.1.11.17","doi-asserted-by":"publisher","DOI":"10.1080\/00224499.2020.1728514"},{"key":"2024092304150917000_97.1.11.18","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-017-2474-x"},{"key":"2024092304150917000_97.1.11.19","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-42"},{"key":"2024092304150917000_97.1.11.20","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000794"},{"key":"2024092304150917000_97.1.11.21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0057740"},{"key":"2024092304150917000_97.1.11.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2009.05.027"},{"key":"2024092304150917000_97.1.11.23","unstructured":"Schaik D . 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