Clear Links between Starting Methamphetamine and Increasing Sexual Risk Behavior: A Cohort Study among Men Who Have Sex with Men

It remains unclear if methamphetamine is merely associated with high risk behavior or if methamphetamine use causes high risk behavior. Determining this would require a randomized controlled trial, which is clearly not ethical. A possible surrogate would be to investigate individuals before and after starting the use of methamphetamine.

We performed a cohort study to analyze recent self-reported methamphetamine use and sexual risk behavior among 8,905 MSM receiving the "Early Test", a community-based, HIV screening program in San Diego, California, between April 2008 and July 2014 (total 17,272 testing encounters). Sexual risk behavior was evaluated using a previously published risk behavior score (San Diego Early Test [SDET] score) that predicts risk of HIV acquisition.

Methamphetamine use during the last 12 months (hereafter, recent-meth) was reported by 754/8,905 unique MSM (8.5%). SDET scores were significantly higher in the 754 MSM with recent-meth use compared to the 5,922 MSM who reported that they have never used methamphetamine (p<0.001). Eighty-two repeat testers initiated methamphetamine between testing encounter, with significantly higher SDET scores after starting methamphetamine.

Given the ethical impossibility of conducting a randomized, controlled trial, the results presented here provide the strongest evidence yet that initiation of methamphetamine use increases sexual risk behavior among HIV-uninfected MSM. Until more effective prevention or treatment interventions are available for methamphetamine users, HIV-uninfected MSM who use methamphetamine may represent ideal candidates for alternative effective prevention interventions (i.e., pre-exposure prophylaxis).

Purchase full article at: http://goo.gl/RTgt91

By: Hoenigl M1, Chaillon A, Moore DJ, Morris SR, Smith DM, Little SJ.

• 1Division of Infectious Diseases, Department of Medicine, University of California San Diego (UCSD), La Jolla, California, United States 2 Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria 3 Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria 4 Department of Psychiatry, University of California San Diego (UCSD), La Jolla, California, United States 5 Veterans Affairs Healthcare System, San Diego, California, United States.

 

More at:  https://twitter.com/hiv_insight

And: http://twitter.com/Prison_Health